Here are a few tips that may help your healthcare business:
How to increase your revenue and reimbursement rates
Today, the demands of financial responsibility placed on patients for the care you deliver has never been greater. New high deductible and consumer-directed health plans have shifted the payment burden to patients who often only know that they are sick, not how much their treatment will cost. This new dynamic threatens to spark an explosion in self-pay and bad-debt classes that many providers are currently not equipped to face or prevent. The resulting financial troubles could then threaten to impact the delivery of care for everyone.
This scenario is not unstoppable, however, there are important steps providers can take to maximize reimbursements and minimize bad-debt losses. With the right processes in place, providers can proactively work with patients to agree upon payment structure that works for all sides and prevents the negative impact lost revenue has on daily operations.
• Make your patient registration as accurate as possible because it's your best chance to maintain contact with the patient throughout the process. Many write-offs occur because of inaccurate information during this stage which can make it difficult or impossible to contact a patient after the delivery of care.
• Utilize electronic eligibility and benefits verification to create an accurate accounting of what the patient will be responsible for after third party or payer contributions. Many payers and vendors offer this service and the savings can vastly outweigh the costs.
• Be timely and accurate with your billing and make sure your patient statements are as clear as possible to the patient. A patient being consistently confused about what they are actually paying for can create mistrust. Make sure your billing documents are detailed, but still as readable as possible to people with no medical training.
• Have a clear, consistent payment policy that you give to the patient before the delivery of care. This payment policy should define the terms and payment schedule to expect from the patient. Defining this for patients prior to providing service helps reduce confusion for any financial responsibility they may carry after any procedure.
• Reduce staff turnover so that you are not constantly training new registration personnel. Mistakes made in the initial registration process are a primary cause for future billing and payment problems.
• Get the right automated solutions for your situation. Automated solutions can help identify hard-to-find payment opportunities that manual processes miss often even correcting mistakes in patient information. These solutions can offer tremendous return-on-investment because of the revenue they capture which may have otherwise been lost forever.
These tips are just the beginning of what you can do to prevent painful lost revenue and make sure you get paid the largest portion of the total amount possible. Plain and direct communication with your patients can be the key to keeping your healthcare business secure and profitable no matter how the healthcare industry changes in the coming years and decades.
The Emdeon Reimbursement & Revenue Analytics suite of solutions captures payment information and automatically scans to find even the most remote payment opportunities. To learn more about how we can help you capture more revenue and prevent write-offs call us today at 877.EMDEON.6 (877.363.3666) or visit us online.
Stop the Money Drain
Get the Most Mileage out of your Revenue Cycle
Vespa XL150 Winner $300 Fuel Card Winners
Emdeon recently attended and exhibited at the 2008 MGMA Annual Conference in San Diego. Attendees not only learned about Emdeon’s full suite of Revenue Cycle Management Solutions, but a lucky few also walked away with some great prizes! Congratulations to our winners!
• Christine Pope, Will County Medical
• Neta JoKreiger, Great Plains Womens Health
• Ingrid Gordon, Epic
• James Viscardi, University of Rochester Medical Center
• Tim Prudon, Texas Pulmonary
The Real Price of the Rising Cost of Healthcare
As the costs of healthcare continue to rise and the Baby Boomer generation begins to reach the age of Medicare eligibility, there will surely be reforms in the program; past history says that these reforms won't necessarily make it easier on providers to capture the most revenue possible. As the ins and outs of these rules become more difficult to track, providers will have to rely on automated systems which could quick cycle through the dense requirements to make sure providers receive the maximum allowable reimbursement for the delivery of care. Missed payment opportunities would turn into bad debt and write-offs that could cause further problems in the industry.
Examining the value of getting Healthcare IT right, the first time
The amount of money Americans spend on healthcare has increased dramatically in the past 50 years. Without significant changes in behaviors across multiple areas, that trend isn't likely to slow down anytime soon. One area where change is coming and viable solutions exist is in Healthcare IT. The right Healthcare IT solutions could save upwards of $77 billion according to a recent RAND Corporation study but those savings can only be realized if the solutions that are implemented actually work as promised.
Changes in Government Payer Structures
Healthcare spending counts for a higher percentage of the Gross Domestic Product (GDP) of America than ever before. Here's how the Congressional Budget Office (CBO) describes the situation:Over the past 30 years, total national spending on healthcare has more than doubled as a share of gross domestic product (GDP). According to CBO’s latest projections in its Long-Term Outlook for Healthcare Spending, that share will double again by 2035, claiming more than 30 percent of GDP. Thereafter, healthcare costs continue to account for a steadily growing share of GDP, reaching more than 40 percent by 2060 and almost 50 percent by 2082. Federal spending on Medicare and Medicaid, which accounts for 4 percent of GDP today, is projected to rise to 9 percent by 2035 and 19 percent by 2082 under current law.
Changes in Commercial Payer Structures
Already we're seeing fundamental shifts in the commercial payer market based upon the changes that are coming in the near future. Increased focus on the patient’s responsibility to pay is creating a more consumer-based mindset wherein patients do something they've never done before: shop for the best combination of price and service in healthcare. Care related decisions are no longer based on purely the quality of the physician or facility, but on cost-related concerns as well.
As patients start to act more like consumers, providers should evaluate retail and service industries models. Increased focus on fraud prevention, loss reduction, increasing administrative efficiency and price control are all primary concerns for small group physician practices and large healthcare institutions alike. Healthcare IT is a critical component in the solutions to these concerns today and in the future. Once again providers must perform their due diligence to investigate multiple solutions before deciding which one is right for their needs.
Solutions that Work
Even the perfect Healthcare IT solution for a given provider will take considerable investment, but those who diligently research the results of systems before investing in them will be able to maximize their return-on- investment and actually achieve the efficiency and savings goals they set. Investing in the wrong system or the wrong partner could be a setback that is just as hard on staff morale as it is the institution's financial health.
As Healthcare IT becomes a more standardized industry, the documentation and results are becoming easier to obtain and providers would be wise to seek out any resources available to them. It may mean the difference between a solution that works and working to make up for a system that doesn't.
Emdeon Office and Emdeon Denial Manager Enhancements
As part of our effort to continually provide you with the most innovative and effective solutions to Simplify the Business of Healthcare, we’ve recently added new enhancements to two of our solutions, Emdeon Office and Emdeon Denial Manager.
Emdeon Office Enhancement
Credit card processing is now available in Emdeon Office. This new capability is available for all Emdeon Office customers through the payment link at the top of the Emdeon Office home page. Credit card processing capability will also be added to Emdeon Assistant soon!
Emdeon Denial Manager Enhancements
Emdeon Denial Manager now pulls data in a work queue that indicates information for the most current two weeks. Because of the large volume of information that is available for some providers, this modification is designed to avoid delays in checking the initial setup information for the user. A status bar has also been added that enables the user to check progress of denial submissions.
For questions or to learn more about these enhancements, call us today at 877.EMDEON.6(877.363.3666).
Bringing Simplicity to the Era of Change
Streamlining the claims lifecycle
As you know, healthcare billing and payment is changing. It seems to be all anyone can talk about these days, but change isn't exactly what everyone wants from the business of healthcare moving forward. What providers really need is improvement to manage the changes in healthcare billing and payment and more specifically to simplify the business of healthcare. The healthcare industry needs a way to make the claims lifecycle more automated and less prone to errors and delays.
Emdeon knows the importance of Simplifying the Business of Healthcare and has solutions that work together to make the claiming process, denial management, payment reconciliation and payment posting an integrated process that focuses on getting you paid faster and more accurately to increase profitability. In using Emdeon Claim Master, Emdeon Payment Manager and Emdeon Denial Manager together: delays go down and profitability goes up.
Emdeon Claim Master provides a single interface to manage claims to nearly all commercial and government payers. It’s unique tools aid decision support, manage workflow and prioritize resources that result in improved efficiency and increased revenue. Primary and secondary claims can be submitted, corrected and tracked through the power of the web. Automated features reduce errors and oversights to increase first-pass acceptance rates and reduce outstanding Accounts Receivable days. Once claims are adjudicated and approved, all relevant information will be passed on to Emdeon Payment Manager to continue the payment process.
After the claiming cycle is complete, Emdeon Payment manager can facilitate electronic funds transfers (EFTs) from the largest network of payers in the industry and increase the visibility of remittance data. By coupling electronic remittance information with electronic claims payments, Emdeon Payment Manager shortens the reimbursement cycle, dramatically reduces expenses and streamlines workflow. You can also save time because paper checks can be eliminated when EFTs are deposited directly into your account. Convenient and easy-to-read reports accurately account for all payments, including amounts and payers for each transaction, to ensure accuracy and speed.
Unfortunately, sometimes claims do require further adjustments before any payment can be made. In this case, Emdeon Denial Manager is a must-have solution. Emdeon Denial Manager organizes and manages your entire remittance inventory to help staff arrange, prioritize and monitor denials and underpayments while helping them accurately report and view the denied and adjusted amounts. Once the claim is corrected, Emdeon Claim Master resubmits and Emdeon Payment manager takes over for the payment process. Remittance information from the claim is also added to your library and over time this information can be analyzed by Denial Manager to expose root causes, reoccurring patterns and other breakdowns that lead to denials. With a little proactive adjustment, you can see a dramatic reduction in denied claims and accelerated cash flow.
At Emdeon, we understand that the synergy and combined value between such versatile solutions helps simplify your claim and payment processes. By reducing the errors, delays, confusion and lost revenue a disjointed claiming and payment process creates, you can focus on improving new areas of staff efficiency and the patient experience. Together these solutions combine to form some of the many ways we're streamlining the claims process and Simplifying the Business of Healthcare.
To learn more about how our solutions can simplify your claim and payment processes, call us today at 877.EMDEON.6(877.363.3666), or visit us online.
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New Payers On-Board
New payers added this quarter
Emdeon is pleased to announce the following
payers as part of our constantly expanding network:
• Aetna Better Health Connecticut Medicaid- Claims
• AmeriChoice of New Jersey, Inc (Medicaid NJ)- Claims
• Ancillary Care Management/ACM- Claims
• ARAZ- Claims
• Arkansas Managed Care Organization, Inc- Claims
• Berkshire Lehigh Partners- Claims
• Blue Choice Medicaid Managed Care- Claims
• Blue Cross of Idaho Health Services, Inc- Eligibility
• California Medicare- Eligibility
• Central Benefits National- Eligibility
• Citrus Health- Claims
• CM Administrators, Inc- Claims
• Florida Health Care Plan- Claims
• Generations- Claims
• Golden State Medical Group- Claims
• Health Choice Generations- Claims
• Health Plus PHSP- Eligibility
• Highline Medical Service Organization Molina- Claims
• Highline Medical Service Organization- Claims
• InterCare Health Plans, Inc- Claims
• Iowa Mcare A WPS- Eligibility
• Kaiser PPO- Claims
• Lawndale Christian Health Center- Claims
• Med3000- Claims
• Medical Network of Colorado Springs- Claims
• Medicare California Part A- Claims
• MedPartners- Claims
• Metropolitan Health Plan- Eligibility
• Morris Associates- Eligibility
• Preferred Health Systems Insurance Company- Eligibility
• Rhode Island Medicaid- Claims
• RightChoice Benefit Administrators- Claims
• SC Medicare Part A & SW/SE RHHI- Eligibility
• Virginia Premier Health Plan- Eligibility
• WellPath- Claims
• Wyoming Medicare Part A- Eligibility
For a complete list of the payers in our network, visit our website.
Stay Connected with Patients through Informative Statement Inserts
Take full advantage of your patient communications
Looking for an economical and easy way to improve the connection with your patients? Our patient statement inserts are a personal, effective and economical method to keep in touch. In most cases, no additional postage is required because the inserts are included with documents that are already going to the patients. Simply contact Emdeon with the details you want to communicate, and we can create a custom insert just for you. Or, you may choose from any of our existing stock inserts, and we’ll customize it with your logo.
What are some of the ways inserts can help you connect?
• Announcement of New Physician
• Announcement of New Office or Location
• Change of Address Notice
• Changes in the Billing Cycle
• Promotion of Online Patient Billing and Payment Feature
• Promotion of a New Product or Service
• Instructions on Reading a Redesigned Patient Statement
• Promotion of National Health Awareness Observances
• Education on Important Health Topics
Any message you need to communicate to your patients can be executed effectively and economically with a timely statement insert. To learn more about Emdeon Patient Communications or to add an insert to your next round of statements, call 800.537.7563 ext. 73151 or visit us online.
Frequently Asked Questions
Q:I have a different idea for an insert. Can Emdeon help me design an insert to my specification?
A: Yes, we can. We will work with you to customize an insert to meet your needs.
Q: I need an insert designed and sent in a short timeframe. How much time do you normally require for the completion of the insert process?
A: We usually require 5 to 7 business days for a standard insert to be designed, approved and printed.
Q: Can we add our company logo to the insert?
A: Absolutely. Inserts can be customized to meet your needs.
Q: How are inserts priced?
A: Pricing for inserts is based on volume and customization.
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New POS Device Available
Emdeon is now offering a new POS device. The new Vx570 POS machine not only offers all standard POS functionality such as verifying eligibility for Medicaid and Medicare and credit card processing, but it also provides connectivity to all payers in the Emdeon network. The Vx570 also has the option of connecting via the Internet for faster transactions without tying up a phone line.
Call us today at 877.EMDEON.6 (877.363.3666) for more information on the new Vx570 POS device.
