Did You Think Web Based Software Was Too Expensive?

There have been a lot of changes in Medical Billing Software, in the last few years, but one of the biggest changes is the popularity of web based software. There are so many advantages over the traditional practice management systems that many offices are changing over. In the past the biggest problem with the web based programs was the expense.

But now instead of spending thousands or tens of thousands of dollars on a web based system, there is a company introducing an advanced system at a very low subscription cost.

The company is called Xena Health and they are currently looking for some input and possibly even people for the beta testing of the software. If you are interested in finding out more, please complete this short survey and Maggs or Rob will explain more about it.

To receive our free monthly newsletter visit Solutions Medical Billing and enter your email address.

To visit our forum to view questions, post questions, or answer questions on medical billing visit Medical Billing Live

What’s Happening at Medicare?

We used to hear others complain about Medicare and how they would not pay the claims right and how slow they could be and all these other problems they had with Medicare and we always disagreed. We always found Medicare to be quite straight forward and predictable.
That was until Sept 1, 2008 when it seems many Medicare offices changed carriers. We offer credentialing services to medical providers, so we are dealing with Medicare offices all over the country and have found a few areas where this transition didn’t go smoothly at all and our local carrier is one of them.
Under our old Medicare carrier you knew exactly what to expect. If you submitted claims electronically, payment would come in 14 days, 28 days on paper. When something was denied you would call customer service and they would explain to you exactly what was wrong and what you had to do to correct it. Now claims get “hung up in the system” for unexplainable reasons and for indefinite periods of time. Now when we get a denial that is completely wrong or unexplainable, we call customer service and they can’t answer any questions. They only refer you to the remit.
Now when claims are not paid on time or are denied incorrectly, there is little recourse for the provider. We expected things to get better over time but it has been five months since the transition and things are still completely tumultuous. We feel that it is time to contact our local congressman.

To receive our free monthly newsletter visit Solutions Medical Billing and enter your email address.

To visit our forum to view questions, post questions, or answer questions on medical billing visit Medical Billing Live

3 Key Things to do When a Dr Changes Practices

Many problems that we see practices or providers run into is when a doctor decides to change practices. They don’t realize what needs to be done to make sure payment for their services is made to the new practice. There are 3 key things that need to be done when doctors switch practices.

First, all insurance carriers need to be contacted to make the necessary changes. If the provider is leaving a practice where all of the benefits for their services were assigned (or paid) to the group they belonged to then they need to notify the insurance carriers that they are leaving that group.

If they are joining a new group, or forming their own practice they need to notify the insurance carrier of that as well. They want to make sure their services are going to be paid to the appropriate practice.

Each carrier has different requirements or forms that they need completed in order to do this. It is important that the correct paperwork is done. You can’t just send out a blanket letter and expect that to work.

For example, a provider called me the other day to say that he had recently started his own practice but he wasn’t getting any payments from Medicare. I asked if they had notified Medicare of his change. He said he had sent a letter. Well that doesn’t work for Medicare. You must complete a CMS 855I form to make changes to an individual provider number. Even if you just move to another suite in the same building.

Bottom line, the first thing you need to do is to make sure your services are going to be paid to the correct place.

Second, you need to make sure that your practice address is updated. This is usually done at the same time you are updating the payment information. The forms required to be submitted also ask for the new practice address and other info (phone, fax, etc.). It is important though that you make sure the address the insurance carrier has on file for you is accurate.

Third, you need to contact NPPES and update your information on the NPI enumerator’s system. If you have your login information you can simply log in and make the changes yourself. If you don’t you will want to call NPPES and get your login info so that you have access to it. You will want to keep your information associated with your NPI number current.

So, if a provider is planning on changing practices and they want to ensure a smooth transition, they will have a better chance if they make sure these 3 things are done prior to the change, or at least as soon as possible

To receive our free monthly newsletter visit Solutions Medical Billing and enter your email address.

To visit our forum to view questions, post questions, or answer questions on medical billing visit Medical Billing Live

Counting Keystrokes

I’ve been noticing something lately that I hadn’t really considered much in the past. I’ve been counting keystrokes. Why would anyone in their right mind count keystrokes? Well, we have really been working diligently lately at getting systems in place that improve our efficiency and counting keystrokes became an issue.

We’ve used Lytec software for 15 years now and found it to be very user friendly and capable. We are billing for 60 providers with it. Last summer we started looking at web based software to see what all the excitement is about. I guess what really got us interested in the web based software was when we had an account that wanted to hire us if we used a web based software. They asked us to call if we ever change over to a web based software.

What’s that got to do with counting keystrokes? Plenty.

When we looked into web based medical billing software, we realized how much more efficient billing can be than the way we have been doing it for 15 years. The advantages of some web based programs are so great that they could cut our data entry time in half.

Here is an example. Years ago we used to print each claim that was going to go out on paper as we entered the claim. Then we would send the electronic claims. One day Michele had a stroke of brilliance and realized how many keystrokes it saved to change the process. If we sent the electronic claims first and then printed the rest of the claims it saved literally hundreds of keystrokes on an average account. Instead of printing each claim individually, she printed the batch with the same number of keystrokes that it took to send a single claim. To print a claim in Lytec (or a batch of claims) we go through as many as five screens and use eight keystrokes. When you multiply that times maybe 25 paper claims you see the wasted effort.

Then in our search for an affordable web based software we found a company that could make processes such as printing much simpler. Many activities that took several steps with other software were combined into one simple click to accomplish. These simple changes made a tremendous difference in our productivity and efficiency. We would advise anyone looking into purchasing a new practice management system to consider looking at a web based system. Many are extremely costly, especially for a medical billing service, but the one we found is not only affordable but has much more advanced capabilities than most of the others. For more information, complete this short survey and Maggs or Rob will give you more information.

To receive our free monthly newsletter visit Solutions Medical Billing and enter your email address.

To visit our forum to view questions, post questions, or answer questions on medical billing visit Medical Billing Live

Medicare problems

I wonder if other billers are running into the same problems we are with Medicare. For the fifteen years we have been doing medical billing we found Medicare to be one of the most straightforward reliable insurance payors. They have their rules to follow, but if you followed them, the rest was easy. On September 1, 2008 many Medicare offices changed carriers and that’s when our problems started.

It wasn’t just our local Medicare either. One of our services is obtaining Medicare credentialing for other providers so we are contacting different Medicare carriers all over the country. In September we found that we couldn’t even get through on the phone to many carriers. We could continually hit redial or wait on hold with music playing all day and never get to a representative. It took us days to get the mailing address for one Medicare carrier just to mail in the application.

Some providers are calling us looking for help as they applied for Medicare credentialing months ago and still haven’t heard anything. We worked with one provider for over two weeks trying to help him find the status of his application and neither one of us was ever able to get through to a representative. We don’t know if he ever did learn if he was credentialed or not.

One of the problems we encountered with our local Medicare was denials on claims for bogus reasons. We would call and ask what this was all about and were told that it is an internal problem they are working on. Well here it is, almost the beginning of February and we still are having trouble getting some of these claims paid. They still haven’t worked out their internal problems. If our internal problems lasted this long, we wouldn’t have any clients left.

Our most recent problem with Medicare claims are for a specialty where the patient is returning regularly for the same service. Now Medicare is paying at a much lower rate. When we called to inquire, no one could give us an answer. They could not answer one question. It was like they took people off the street and told them to answer phones with absolutely no training. We were told to call ‘telephone reopening’. When we asked why we were asking for the claim to be reopened, they couldn’t tell us. They couldn’t even say if telephone reopening would reprocess the claim. So is this provider just supposed to accept this lower rate now?

What happened to our old reliable Medicare?

I hope not Gone Forever! 😦

To receive our free monthly newsletter visit Solutions Medical Billing and enter your email address.

To visit our forum to view questions, post questions, or answer questions on medical billing visit Medical Billing Live