In the ever-evolving world of healthcare, the importance of staying connected and having efficient, automated systems cannot be overstressed. In the first of a three-part webinar series, ImagineSoftware's Gray Mason and Martin Grist offer an insightful discussion on some of the most important elements in the medical billing workflow, including the intricacies of patient authorization, payer connections, payment plans, and the utilization of innovative tools such as ImaginePay™, ImagineSoftware’s patient payment portal. This blog highlights and further explores pre-billing operations, providing you with a comprehensive understanding of the seamless solutions available at ImagineSoftware today.
Watch Now - BILL MASTERS Fireside RCM Chats with ImagineSoftware, Ep. 1
ImagineSoftware’s dedication to creating patient-centric revenue cycle management (RCM) solutions starts before your patient even walks through the door. ImagineSimplicity™ is revolutionizing the healthcare experience for both patients and providers, bundling eligibility, estimation, authorization, and payment services before a patient's appointment. This intuitive experience effectively facilitates data sharing with various partners and vendors, ensuring easy, accurate, and efficient information gathering.
According to J.P. Morgan’s Trends in Healthcare Payments Annual Report, two pre-service tools have emerged as critical for streamlining and maximizing revenue; estimation and authorization. Estimation, which can account for 30-35% of overall revenue, is key to understanding the financial liability of patients before service and prioritizing payments. On the other hand, authorization, which may represent 65-75% of a claim, can be a daunting task involving multiple activities.
For prior authorization, it's crucial to understand its significance as it represents almost 70% of revenue coming into today’s practices. Utilizing automation tools can help simplify the prior authorization process, reduce the number of account balances, and decrease the volume of statements sent to patients. Leveraging technology to fuel pre-service workflows helps empower medical professionals to efficiently gather necessary information, such as patient name, provider information, facility, diagnosis, and CPT codes, while reducing manual labor. Ultimately, these strategies contribute to a smoother, more effective patient experience and payment process.
"In an automated world, an order comes into the Imagine authorization solution and within 15 seconds, we're getting a response back. You find yourself in the auto authorization world doing a whole lot less data clicking and data submission where you're just handling the exceptions,” states ImagineSoftware’s Sr. Director of EDI Sales, Gray Mason.
ImagineSoftware's commitment to deliver a flexible and robust financial transaction system, for both providers and patients, led to the creation of ImaginePay™. This comprehensive solution streamlines the patient payment process, catering to varying balances and payment capabilities. For those facing larger bills, patients can personalize payment plans, fitting their individual financial circumstances.
"Everything's accounted for on the front end to help make the patient information gathering piece simple, easy. And it leaves the staff and users prepared,” states ImagineSoftware’s Product Manager, Martin Grist, emphasizing the simplicity and ease of ImaginePay™.
Upon confirmation of an appointment, the process of establishing prior authorization can commence. This, along with various pre-service procedures, including text notifications, URL payments, and appointment reminders are all aimed at preparing for the patient's office visit. Following the visit, the checkout process involves facilitating patient payments with ImaginePay™, equipped with multiple seamless integrations for various payment methods, such as card reader devices, cash, card, ACH, and even payment plans, aiming to simplify this process. Further conveniences such as Apple Pay, Google Pay, and several other advanced features ensure patient-centric, simple, convenient, and fast patient payments. Also available with ImaginePay™ is a user-friendly portal where all transactions take place. With the appropriate permissions, users can manage voids and refunds, run various reports, and administer payment plans. This robust feature set not only simplifies payments for patients but also assists in maximizing collection - both pre and post-service.
Continuing seamless and efficient workflows, ImagineSoftware offers various integrations with partnering Radiology Information Systems (RIS), including API and HL7. Automation technology pulls data from these systems, fueling eligibility, estimation, payment, and prior authorization information to be assimilated into the native workflow through an API, presenting a user-friendly interface or can be accessed via unique revenue cycle workflows.
When collecting patient data, especially payments, cybersecurity is a top priority. With multiple data security certifications, ImagineSoftware offers digital hosting and payment technology that safely and securely collects the data your practice needs.
HIPAA
Third-party auditor report in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH). An audit that reviews for appropriateness, tests, and reports upon our control environment that may be relevant for Confidentiality, Integrity, Availability and Security for Protected Health Information (PHI and ePHI).
SOC 1 Type II
Third-party auditor report on System and Organization Controls (SOC) in accordance with attestation standards established by the American Institute of Certified Public Accountants (AICPA). Recognized standard that reviews for appropriateness, tests, and reports upon our control environment that may be relevant to our internal controls over financial reporting.
SOC 2 Type II
Third-party auditor report in accordance with attestation standards established by the American Institute of Certified Public Accountants (AICPA), Trust Services Criteria. Recognized standard that reviews for appropriateness, tests, and reports upon our control environment specific to the 2017 Trust Services Criteria for Security, Availability, Processing Integrity, Confidentiality, and Privacy.
PCI DSS v3.2 Level 1
Report On and Attestation of Compliance completed by an independent Qualified Security Assessor, signifying compliance with the highest, most stringent level of Payment Card Industry Data Security Standard (PCI DSS). Requires continual and ongoing commitment to maintaining the highest level of data security standards for payment card handling.
Artificial Intelligence (AI) helps empower post-service operations through ImagineEngagement™, instrumental in creating a personalized patient experience for collections. This AI-powered patient-driven solution helps eliminate surprise billing, thus improving cash flow for providers and financial experience for patients. Learn more about increasing patient engagement during our on-demand webinar, Elevating Every Experience – How to Increase Patient Engagement in your Medical Practice.
Imagine’s rapidly advancing technological solutions are revolutionizing the entire revenue cycle, from check-in to zero balance. With 77% of providers reporting that it takes over a month to collect patient dues and an average of 3.3 statements issued before payments are settled, efficient RCM strategies are paramount. Leveraging an end-to-end RCM system enables medical billing teams to automate manual tasks, focusing time on more intricate cases. An end-to-end system also increases patient experiences, from start to finish, boosting provider reputation and revenue.
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Want more? Watch continuing revenue cycle best practices here:
- Fireside RCM Chats: Best Practices for Medical Billing Processes
- Fireside RCM Chats: Best Practices for Medical Billing Post-Service and Evaluation