February 19, 2018
By New England Accounts Receivable Management
Too Good to be True?
We are all familiar with the old adage: If something seems too good to be true, it probably is! Over the past few years, many of our clients have discovered this to be especially true when it comes to the bundled services offered (or sometimes mandated) through the use of EHR (Electronic Heath Records) platforms.
While there is little debate that such products and services can add real value and efficiency to record keeping and sharing, when it comes to medical billing, often times going the automated route means missing out on significant reimbursement revenue that only an experienced and trained medical billing and medical coding professional could provide.
Recently, a long-time New England Accounts Receivable Management client was persuaded to go with an EHR service provider that claimed to provide billing, coding and reimbursement services, all bundled within their platform. Regrettably, we wished this client well and let them know we’d always be ready to help them out should their experience with their EHR solution prove less than rewarding.
Five months later, after having received exactly zero dollars and zero cents in reimbursement revenue through submission of bills via the EHR system, the client returned to the New England Accounts Receivable Management fold, telling us they realized that the lack of human review in bill coding and experience in resubmitting rejected claims was costing their practice approximately a quarter million dollars per month.
The Biggest Misconceptions
In this instance, the claims were never actually released from the EHR program, so we don’t know if they were correct or not. But one of the biggest misconceptions surrounding EHRs is that it will correctly code for you. And while it’s true that EHR platforms do assign a level of service code for Evaluation and Management Codes and codes for procedures, they fail to take into consideration what diagnosis codes are acceptable for those procedures by each insurance company. This can vary considerably.
The moral of this story is that only an experienced and knowledgeable human can intervene before a claim is sent to ensure correct matching of procedure and dx coding and also to correct and resubmit claims rejecting for other reasons that require correction and resubmission. The biller’s experience and expertise are crucial in the process of payment. So make sure that any technology-based solution you embrace is truly a solution and not a costly replacement to good old human thinking and experience.
A Winning Combination
And, remember, coupling the convenience of an EHR system with the experienced and knowledgeable team at New England Accounts Receivable Management is a winning combination that’s tough to beat. We invite you to reach out today to speak with us about getting the most out your medical billing and medical coding process!
How Much are your Denied Claims Costing You Monthly?
In my consulting business of 35+ years, monthly adjustments or write-offs are recognized areas of great loss to individual medical practices, and yours is likely to be suffering the same loss.
I would like to offer to take 10 of your denied claims and correct them at no charge.Why would I do this for free? I want to prove to you the benefits of New England Accounts Receivable Management being a part of your team.
If you are interested in learning more,
please give me a call at (781) 231-7026 today!