More on Claims Processing

4 technologies that boost reimbursement

State-of-the-art revenue cycle tools aid collections

Lisa Burdue, accounts receivable manager with Internal Medicine Specialists, a gastroenterology and nephrology clinic in Central Florida, has seen firsthand how utilizing state-of-the-art revenue cycle technologies can pay off. Burdue has managed the implementation of various claims processing technologies at her clinic that not only helped speed up the claims and payment process, but also made her job easier.

Here she discusses 4 technologies that help providers get paid what they're owed.

1) iPad: Tablet computers, specifically Apple’s iPad, have become an incredible asset for hospitals and physician practices. Doctors are able to document and file charges in real time, which in return helps administrators get claims to payers and bills to patient in a more timely manner, saving resources and money.

“There used to be lag time,” said Burdue, referring to the pre-tablet computing era. “Now the doctors are able to get the charges to us [quickly].”

The use of tablet computers not only helps providers speed up claims processing, but is beneficial to patients, said Burdue. “It also helps the patients get the bill a lot faster.”

[See also: Reimbursement issue remains contentious in 2013.]

2) Integrating electronic medical records with your clearinghouse: While to some the combination of EMR and clearinghouse doesn’t qualify as a "new" technology, but more of a combination of two existing technologies, providers must make sure there is no lag between the two and that they’re integrated.

“This is where we see technology at its best,” said Burdue. “We are able to verify coverage and verify plans and send it to the clearinghouse.”

Burdue said the integration between EMR and clearinghouse has helped Internal Medicine Specialists bring down the number of open patient accounts that were 90 days and over to less than 15 percent from 20 percent in only a few years.

3) Online patient portal Despite being a requirement of meaningful use, having an online patient portal has helped Internal Medicine Specialists boost patient collections significantly.

“The portal allows a patient to access their account,” Burdue said. “It allows them to pay a bill immediately.”

Allowing patients to pay bills online with a credit card not only cuts down on postage and envelopes, saving both patient and provider money, but preserves massive amounts of labor time.

Despite the ease of using an online patient portal, some patients are hesitant, which has been a challenge, Burdue admitted.

“Some folks are just reluctant,” she said.

[See also: Reimbursements top the list of providers' concerns in 2013.]

4) Real-time claims processing: Nowhere is technology helping providers get paid more than in the eligibility checking process. Real-time claims processing is becoming more of a necessity than a commodity.

“It’s so critical for us,” said Burdue. "Knowing [up-front] is half the battle.” She says determining if a patient’s insurance covers a particular procedure could mean the difference between getting paid or coming up empty.

Internal Medicine Specialists pays a high price for utilizing an advanced clearinghouse which makes real-time processing of claims possible, Burde said, but the clinic's leadership team feels the return on investment makes it well worth it.