Imagine Blog

Jenna Tropea

Jenna Tropea

As a long-time writer and content marketer, Jenna Tropea covers a wide range of topics from patient engagement to healthcare policy and regulations. Jenna received her MBA from Clemson University and currently serves as Online Marketing Strategist to ImagineSoftware. 

You can contact Jenna via email at jtropea@imagineteam.com

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Why Your Practice Should Eliminate Paper from the Revenue Cycle

“According to a Harvard University economist, the total savings of switching to electronic medical billing is estimated at approximately $32 billion annually.”

“86% of consumers receive paper medical bills, 88% of providers report receiving paper checks and Explanation of Payment (EOPs) from one or more of their payers, and 85% of providers prefer ERA/EFT payments.”

“On average, providers lose $40,000 for every 100 claims that are reworked.”

Did reading these statistics make you stop and think, “How much am I really losing to manual and paper-based processes?” The healthcare industry is notorious for inefficient and costly revenue cycle processes, and paper is one of the main culprits. It creates inefficiencies everywhere – from payer reimbursement to patient collections. If your practice still relies on paper for many of your RCM processes, you’re already behind. The time to make the move to automation is now, and here’s why.

Gain efficiency in every step of the revenue cycle with ImagineSoftware's RCM solutions.

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Electronic Claims

Nearly a third of providers in the US are still using manual claims processes.  Considering that providers spend anywhere between 10 to 30 minutes per claim on manual tasks including fax and mail, there’s a lot of time and money lost.  To put it into perspective, medical providers could save at least $1.1 million labor hours per week be transitioning to full electronic claims processes.  There are many benefits to making the move from paper-based to electronic claims management. 

Scrubbing

Medical billing software with a built in claim scrubbing feature can completely transform staff productivity.  Imagine a workflow in which billers aren’t spending hours sifting through claims.  Claim scrubbing improves validity and accuracy, allowing staff to catch mistakes and make quick corrections before submission.  Your practice is reimbursed faster while staff saves hours of time wasted on resubmission and tracking appeals.

Submission

Think about the cost of paper, envelopes, stamps and office supplies needed to manually submit claims.  Not to mention the costs associated with inaccurate denied claims.  Now compare it to the cost of submitting electronic claims.  Physicians Professional Management Corp (PPMC), and ImagineSoftware client, experienced inefficiencies in their outdated, manual claims processes before making the move to automated medical billing.  Mariya Hebert, IT Manager at PPMC, shared, “Some of the challenges we faced with our last software vendor was lack of automation.  Everything was manual – no electronic remits, no electronic claims files.  Everything was paper, paper, paper.  Now, we send out claims electronically and we receive payments electronically for the bulk of our payors.  We also receive a lot of our patient payments electronically versus before when we didn’t have that option.  We’ve gained a lot of efficiencies.”

Tracking

Tracking status of paper claims makes it nearly impossible to predict where it will fall in your revenue cycle. With electronic claim submission, you can check claim status and know exactly where your claims are in the system. Even better, you can create reporting that is valuable to all stakeholders on timing of reimbursement.

Electronic Patient Collections

Statements

This should be an obvious one, but a large portion of practices still use paper statements for patient collections.  Not only is snail mail an inefficient way to collect, it’s also costly.  Are you keeping track of how much you’re spending on envelopes, paper and stamps?  It’s probably more than you think.

The need for electronic patient collections is amplified by the fact that the tech-reliant millennial generation is becoming a major payer.  Take it from Max Tselevich, CEO of The Doctor who told Rev Cycle Intelligence, “Sending a paper statement to a millennial or leaving a voicemail is about as useless as a hamburger driving a vehicle.”  The truth is that many providers would rather not give up a small percentage for merchant processing to offer patient’s an easier way to pay.  What they’re not taking into consideration is the cost savings associated with paper products and efforts to collect from those patients.

At the end of the day, the move to electronic statements is happening, and if your practice wants to be competitive, you will need to consider leaving paper statements behind and upgrading to an electronic form of patient collections. 

Payments

Patients are seeking more convenient, electronic patient collection methods.  Mailing or calling in to pay a medical bill is frustrating and at times confusing for patients, so it’s your job as a provider to step up to meet those needs.  An online payment portal like ImaginePay™ allows patients to set up automatic payments, which reduces their anxiety and the amount of paper mail coming to them.  “Our patients love ImaginePay™,” said Melanie Gross, Revenue Cycle Director at Akumin.  “We don’t receive nearly as many calls on how to pay medical bills and it has definitely increased our cash flow.”

For patients that need assistance paying for their medical bills, payment plans are another way to improve patient satisfaction while eliminated paper-associated collection costs.  A payment plan will not only improve your rate of obtaining patient payments, it will also give your patients more control over handling their medical bills. 

Make the Move

The world of healthcare as it relates to revenue cycle management is a challenging environment. It is constantly changing as new technologies emerge and patients hold higher expectations on what their experience should look like. Recognize the signal for change and make the move to more automation. Your bottom line will thank you for it.

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ImagineSoftware to hold its 2019 Client Conference in Charlotte, NC next week

Charlotte, NC | May 14, 2019 – ImagineSoftware, the leading provider in medical billing and revenue cycle automation solutions, will hold its 13th annual Client Conference on Monday, May 20, 2019 through Wednesday, May 23, 2019 at The Westin Charlotte. 
 
This year’s Conference theme, BE WILD, encourages attendees to break away from the pack to Bill Exceptionally, Work Intelligently, and Lead Deliberately with solutions and services that will transform their revenue cycle experience. 
 
“We want ImagineSoftware clients to be equipped with the right tools to turn any industry challenge into an opportunity to improve their billing processes – both for the organization and the patient,” said ImagineSoftware President & CEO Sam Khashman.  “Patients are demanding transparency and affordability, now more than ever.  There’s a big push to transform outdated and paper-based billing processes into an automated, well-oiled machine.  It’s ImagineSoftware’s responsibility to provide clients with the technology they need to lead that change and gain a competitive advantage.”

The three-day conference will provide clients with opportunities for peer learning, hands-on product and service demonstrations, and an in-depth look into industry hot topics like the Merit-Based Incentive Payment System (MIPS), cybersecurity, healthcare consolidation, and the patient payment experience. 
 
As revenue cycle management makes the shift towards a more patient-centered mindset, it’s crucial to have partners that help create billing solutions that are beneficial for both provider and patient.  Data Media Associates, Inc (DMA), ImagineSoftware’s Visionary Sponsor, provides solutions that enable a seamless collections process.  “DMA is excited to once again, be the Visionary Sponsor for the 2019 Imagine Client Conference,” said DMA President Cleve Shultz.  “We look forward to seeing each of you in Charlotte.  DMA invites you to stop by our booth to give your patient statement a checkup.   Let’s confirm that you are taking advantage of all that DMA has to offer to increase your bottom line.  While there be sure to sign up for DMA’s giveaway - an Osmo Pocket 3-axis stabilized handheld video camera.  We will see you soon for another amazing Imagine Client Conference to BE WILD!” 
 
We are looking forward to hosting our clients, sponsors and friends in Charlotte, NC next week.  Get ready to BE WILD!
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A Beginner's Guide to Robotic Process Automation for Medical Billing

Have you heard?  The newest buzz term that seems to be floating around every healthcare event this year is “Robotic Process Automation” or RPA for short.  It sounds intimidating, but there are many real-life applications of RPA that exist today that automate the manual tasks associated with medical billing.  Let’s take a deeper look into what RPA does, why it’s important to the world of medical billing, and how practices can take advantage of it without breaking the bank.

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What is Robotic Process Automation?
Robotic Process Automation (RPA) is a software robot that automatically conducts routine tasks to standardize repeatable business processes.  These software bots mimic human activities by interacting with applications in the same way that an employee does. You can think of RPA as a virtual assistant, an invisible employee that completes tedious tasks that allows your real employees to concentrate on more important revenue-generating tasks.

What are the benefits of RPA? 
As a software solution that acts as a low-cost virtual employee, RPA provides an array of benefits that ignite interest from many industries including healthcare.

Reliability – Operations can be performed 24/7 as the bots work autonomously, only requiring human intervention when an employee must make a decision to guide the bot’s next move or to correct an error that the bot caught.

Compliance – RPA will follow company compliance rules and will often provide an audit trail history of the work performed.

Consistency and Accuracy – RPA is configured to perform specific tasks the same way every time with no deviation.  This allows for extreme accuracy and uniformity in task completion compared to simple human errors like typos.

Productivity – Process cycle times (in this case, revenue cycle processes) can be performed at a much faster speed compared to manual work, since the bot operates according to an automated schedule.

Why is Medical Billing relevant to RPA?
Believe it or not, Robotic Process Automation can be added to almost any step of the medical billing process to help automate and standardize areas that are mundane and time-consuming.  Here are some of the most common areas:

Payment Posting

Automated payment posting can help improve productivity and streamline the manual processes of posting insurance payments.  Payment posting is an integral part of revenue cycle management, and if done properly and accurately, will improve cash flow and patient satisfaction.

Electronic Remittance Advice (ERA) is an electronic version of a paper explanation of benefits (EOB) and includes details about the amount billed, the amount being paid by the health plan, and an explanation of any discrepancies between the two.  There are many advantages to adopting ERA, one of which is automated payment posting.  ERA is intended to work in unison with the rest of your medical billing technologies without human intervention.  This allows for faster account reconciliation, fewer operating costs, and enhanced staff productivity.

EHR Automation

Electronic Health Records (EHRs) were designed with the best intentions, to provide valuable patient information in digital form and to make the lives of physicians easier.  Unfortunately, 42% of doctors said they have experienced a burnout at some point in their careers and a major contributor is the adoption of EHRs.  Doctors are spending more time than ever before in front of a computer screen instead of spending their time interacting with patients.  RPA bots can fill in EHR fields automatically and duplicate necessary information across different systems.  This reduces human error and allows physicians to spend more time with their patients.

Claims Administration

Inputting, processing and adjusting claims takes up a considerable portion of administrators’ time.  Claims management is extremely prone to human error, which is typically the cause of initial claim denials.  RPA solutions like ImagineAppliance automate many of the tasks associated with claims administration including charge coding, checking against payer rules and submission.  In addition, “The ImagineAppliance gives us the granular ability to figure out what happens to a denial depending on its corresponding insurance plan,” said Robyn Allen, IT Trainer and Software Administrator at Central Kentucky Radiology.  “This is a huge improvement for us overall.”  According to a report by Ernst & Young, automation can reduce turnaround times for insurance claims by as much as 75-85% and eliminate 50-70% of repetitive tasks entirely.

As pressures rise with the decline of reimbursement rates, optimization of medical billing processes is key to improving your bottom line.  Robotic Process Automation is leading the way to automate many of the manual tasks associated with reimbursement interruptions and can typically be applied without the additional expenses of outsourcing or a complete software overhaul.  You may have the ability to utilize RPA with your current software vendor without knowing it!

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5 of the Best Diagnostic Radiology Coding Tips

How effective are your practice's coding procedures and policies?  In financial terms, medical coding is the life blood of the practice.  It's how the services you provide turn into billable revenue.  Failure to code correctly can lead to a myriad of problems including delays or lack of reimbursement and even fraud.  There are active steps you can take to improve medical coding and maintain a healthy bottom line.  Here are a few tips that are not only recommended by our team, but are also very popular among other radiology billing organizations and billing thought leaders! 

Building a better financial experience for your radiology practice, imaging center, or billing company.
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The 3 C's of Documentation for Radiologists

To promote improved coding and billing, it’s good practice for radiologists to remember the three C’s of reporting and documentation: clarity, consistency and care.  This is something that the coding department, billing department and radiologists should ALL focus on, since some of the most common radiology coding errors – those related to eligibility, referrals, and dictation error – involve all groups.

Dictated reports should be concise, clear, and should meet ACR guidelines by containing the following: 

  • Heading
  • Number of views or sequences
  • Clinical indications
  • Findings
  • Impression/Conclusion
  • Physician signature
  • Diagnostic studies

      Clinical indications, the performed exam, impressions and findings should all be clearly identified.  Here are a few more tips for better reporting:
  •  Report succintly with the referring physician in mind - Leonard Berlin, MD, FACR, radiologist at Skokie Hospital wrote for ACR Bulletin, “Our primary audience is referring physicians who have limited time, so our reports must get to the point and be organized to ensure referring physicians can find the information they need quickly and easily and refer to it again, as needed.”
  • Exam titles should include modality, views, anatomical site, and if contrast was used.
  • Make sure that exam titles aren't listed in the findings or impression sections.
  • Form an actionable impression to make the report more conclusive and encourage an accurate and timely diagnosis.

      Only Report Documented Views

      The number of views claimed must meet the basic requirements of the CPT code reported.  The medical report should include the number of views and it’s the coder’s responsibility to count the number of views and select the corresponding CPT code.

      If the physician includes view location instead of view number, that is an acceptable form of documentation.  The AAPC provides a great example of this: For a 73564 Radiologic examination of the knee with 4 or more views, the documentation must substantiate the number of views.  If instead of listing “4 views,” the physician states, “AP, lateral, and both obliques,” that is acceptable.  However, if the physician states, “multiple views of the knee,” the coder must report the lowest-level corresponding CPT code for that service.

      If your department has a list of “standard views,” coders must proceed with caution when using them.  For example, if a referring physician doesn’t include the number of views in the order, the coders can’t impose their standard views.  The radiology department should instead contact the referring physician and request a new order that includes the number of views that the referring physician would like performed.

      Complete Documentation for a Complete Exam

      For all “complete” studies, there must be complete documentation supported for that study.  Otherwise, coders must code down to the limited exam.  For example, if a complete abdominal study is completed, then there should be documentation for all of the following: liver, gallbladder, common bile duct, pancreas, spleen, kidney, upper abdominal aorta, and inferior vena cava.

      Implement New 2019 Codes

      For the year 2019, CMS has expanded the number of codes available in efforts to help radiology practices obtain payment easier for new services.  There are two new contrast-enhanced ultrasound codes, one new MR elastography code, and three new ultrasound elastography codes: 

  • 760X0X - Ultrasound, targeted dynamic microbubble sonographic contrast characterization (noncardiac); initial lesion - A stand-alone procedure for the evaluation of a single target lesion.
  • 76X1X - Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection – An add-on code for the evaluation of each additional lesion.
  • 76X01 - Evaluation of organ parenchymal pathology
  • 767X2 - First target lesion
  • 767X3 - Each additional target lesion 

  • *Some of these codes may be unavailable until Q2, please refer to CMS documentation provided here

    Include Proper Modifiers

    One of the biggest issues in radiology when it comes to coding-specific lost reimbursement is wrong modifiers used or no modifier being used at all when required.  Coders should refer to the National Correct Coding Initiative (NCCI) to determine if modifiers are necessary.  CMS created the NCCI to promote national correct coding methodologies and to control improper coding leading to inappropriate payment in Part B claims.  The CMS developed its coding policies based on coding conventions defined in the American Medical Association's CPT Manual, national and local policies and edits, coding guidelines developed by national societies, analysis of standard medical and surgical practices, and a review of current coding practices.

    Radiology procedures include both professional and technical components, represented by modifier 26 and modifier TC, respectively. The professional component (Modifier 26) of a diagnostic service or procedure should be appended to a procedure code when only the professional service was rendered and is provided by the physician.  This may include supervision, interpretation, and a written report.  The technical component (Modifier TC) of a diagnostic service or procedure should be appended when only the technical service was rendered and represents the equipment, supplies, and clinical staff.  Payment for the technical component also includes the practice expense and the malpractice expense.  

    Both modifiers should be reported in the first modifier position on the claim.  If the same provider is performing both components, the “global” service should be reported, and no modifiers are necessary to receive payment for both components.
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