Does your patient scheduling software display patient balances at the time of appointment booking?

Does your patient scheduling software support automated patient reminders to save staff time and reduce patient no-shows?

Can you run an eligibility check from your patient scheduling software solution?

First, an eligibility check should be run when a patient calls in to schedule an appointment- this helps not only to ensure that insurance data in the system is up to date and valid, but also to advise patients of the need to be prepared to pay where deductibles have not been met, there is a co-pay, or the patient has no active coverage.

A second batch eligibility check should be run to confirm any changes in coverage or unmet deductible before calling patients to confirm appointments (if using placing traditional reminder calls). This can be a great time to offer to update patients’ payment method and prepare patients for the likely extent of their responsibility.

Can you post charges from your patient scheduling software?

Does your patient scheduling software support patient no-show and walk-out management?

The post 5 Ways to Use Patient Scheduling Software to Improve Revenue appeared first on BrickMed.

Billing and scheduling software for healthcare environments often fails to capture the rich relationships and synergies that can exist between scheduling workflow and the medical revenue cycle. There is often a tendency, both with designers of billing and scheduling software and often in the operation of many healthcare businesses, to see scheduling processes as “front office” and revenue cycle processes as “back office”. The impact of ACA and high deductible health plans (HDHPs) serves to highlight the importance of seeing the front desk as more than a place to process credit cards and book a follow-up, however. Here are a few ways that, when designed properly, billing and scheduling software solutions can bridge the gap between your front desk and your billing office:

Eligibility Checking – Measure Twice

While eligibility checking is often seen purely as a part of the patient registration process, with high deductible health plans seeing an average annual growth rate of 15% according to the 2014 AHIP/ABA HSA Census and high rates of enrollment in high-deductible Affordable Care Act (ACA) plans, the patient schedule is the perfect place for a “last minute” check of patient eligibility and unmet deductibles prior to an encounter. In addition to registration-time checks intended to confirm coverage, if your patient scheduling software has integrated batch eligibility checking, you can easily run a batch eligibility check prior to making appointment confirmation calls, reminding patients with a large unmet deductible or co-payment that a balance is likely to be due at the time of service and familiarizing them with payment alternatives. This leads us to…

Running Credit Cards from the Schedule?

That’s right. When evaluating billing and scheduling software, most practices overlook the importance of being able to capture copay and estimated deductible payments at the time of service. Although estimating deductible payments due at the time of service requires a proactive approach to the revenue cycle (more on that in a future post), you should be ready and able to capture payments at the time of service based on the best information available regarding patient responsibility even if the encounter hasn’t been posted by the billing department. Capturing a patient payment (for later posting against services rendered) can be accomplished in seconds from the patient schedule in properly-design scheduling software and can save even small practices many thousands in uncollected patient balances per year.

The Schedule as a Billing Tool

The scheduling component of your billing and scheduling software can be the perfect posting queue for the billing department (if properly designed). Color-coded views created specifically for the billing department (where, for example, charged-out visits are green), when combined with one-click charge creation from the schedule, can allow the billing department and practice manager alike to see at-a-glance whether all patient encounters that have been checked out have also been billed, while also knowing at a glance how many no-shows and walk-outs graced the day’s schedule.

Everyone is a Revenue Cycle Specialist

Synergies between the front-desk and back-office features of your billing and scheduling software, and the blurring of the lines between them, can result in staff working more easily, increased visibility of patient responsibilities at the time of service, and an improved revenue cycle. Whether scheduling appointments or posting charges, all staff members need the tools to become revenue cycle specialists in the modern practice.

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With a negative adjustment for not reporting satisfactorily in 2015 of 2% of 2017 Medicare payments under MPFS affecting solo Eligible Professionals (EP’s in PQRS-speak … more on that in a moment) and small groups, and 4% affecting groups of 10 or more EPs, the financial incentive to successfully report is not insignificant. This is the first is a series of posts intended to provide a bit of guidance to providers and office managers who are working to navigate the labyrinth of 2015 PQRS reporting options. For starters, let me make something absolutely clear:

If the path to avoiding the 2017 PQRS Negative Adjustment isn’t an obvious one, I feel it’s a tractable one and one worth traveling for most providers and groups; I think you’ll agree by the time you’ve read the last post in this series.

For many of you, the next question is likely to be (or at least it should be) “Am I (or is provider X in my group) an eligible professional?”

The short (and slightly less useful) definition from CMS is “Medicare physicians, practitioners, and therapists providing covered professional services paid under or based on the MPFS are eligible professionals under PQRS.” A more precise definition is to be found in the Physician Quality Reporting System (PQRS) List of Eligible Professionals. I suspect that for most of you reading this post, the answer will be “yes”. Sadly, I’ve come across more than one group that is seeing a negative adjustment in 2015 as a result of misinterpreting the definition of “EP” in 2013.

So, now you know you’re an EP for the purpose of 2015 PQRS reporting. Your next question should be “How big is my group?” Why? Because group size will determine your reporting options (and, in some cases, your reporting requirements). Fortunately, figuring out your group size for PQRS reporting purposes is not difficult (it really amounts to just counting the number of EPs, as defined above, billing under a single TIN). The key, however, is that for some PQRS reporting options you will need to determine the group size at a certain point in time. Specifically, if registering for the Group Practice Reporting Option (more GPRO in the next post in this series), a group practice will determine its group size based on the number of EP’s billing under the group’s TIN at the time of registration. If your group is hovering near 10, 25, or 100 EP’s, if you’re a “solo” provider forming a group, or if you’re in a two-provider group with one provider approaching retirement in early 2015, timing may prove to be of particular significance.

In the next post in this series, we’ll look at some of the reporting options available to solo EP’s and group practices, along with some of the not-so-obvious consequences of each option in terms of provider workload and reporting flexibility.

The post Meeting the Challenge of 2015 PQRS Reporting (Part 1) appeared first on BrickMed.

Many smaller organizations have a need to submit institutional-style claims. These can range from the small single-suite ASC (ambulatory surgery center) to rural health clinics. For many, UB-04 paper claims and/or 837I electronic claims must not only be submitted to payors, but (as in the case of Article 28 organizations in New York) to government regulatory bodies.

The Need for Flexible Institutional Claims Pricing

Unfortunately, this need has historically left smaller institutional providers little choice but to pay “hospital prices” for solutions aimed at organizations with much larger budgets. As we continue to invest in expanding our suite of solutions for institutional billing with the introduction of the BrickMed 837I institutional claims module, we’ve made an important decision regarding pricing for our 837I and UB-04 claim modules. As part of our ongoing commitment to providing powerful yet affordable solutions to providers of all sizes, we have elected to introduce tiered pricing based on organization type and size.

In the weeks to come, BrickMed will be announcing availability of our new 837I institutional electronic claims module along with the new tiered institutional pricing (with the add-on to BrickMed Office starting at under $3,000 for the smallest providers). This represents a commitment to addressing the needs and budgets of small providers, institutional and otherwise, even as we introduce offerings that challenge the highest-priced billing and practice management solutions in the healthcare industry. We haven’t forgotten, as we continue to grow, that our company was built on the loyalty of small practices.

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