In-house medical coding and outsourcing with ECLAT

The Difference Between Keeping Your Medical Coding & Billing System In-House and Outsourcing

Maintaining a healthy revenue cycle management process and medical coding and billing management system is no easy task to take on your own. Depending on healthcare providers and organizations budgeting needs, they can choose to train their in-house staff to medically code or outsource instead. Both options have their advantages and disadvantages, but with a little bit of research, you will be able to decide on which one is best for your company.

With a professional medical coding and billing company like ECLAT Health Solutions, you will be able to receive quality medical coding and billing assistance to make your company’s healthcare experience inevitably better for patients. Since your healthcare company relies on efficient and experienced medical coders, we have provided more details below to help you understand whether in-house medical coding or outsourcing is better for your company.

In-House Medical Coders

Using an in-house medical coder also means your company will be responsible for training internal employees to code within your health organization in addition to their initial workload. In-house medical coders can ensure quality control and easy accessibility. Whenever an error needs to be corrected, you will be able to have immediate communication to in-house medical coders to fix any issues. Training your employees for medical coding also means that you will benefit by receiving a return on your investment. While some medical coding companies believe coding domestically is the best route, in-house coders can generally end up being more costly, which includes purchasing of medical coding and billing technology and the time spent on training staff to code as well. If any errors were to occur, in-house medical coders and healthcare providers are held liable for it. In addition to that, having only several in-house coders could lead to further coding support issues when someone goes away for vacation, gets sick, or resigns.

Outsourcing Your Medical Coding

In a case when an in-house medical coder resigns or a company starts a new business, outsourcing can benefit healthcare providers because they are often less expensive and save healthcare professionals more time. Professional medical billing companies also provide transparency in regards to presenting intricate performance reports to healthcare providers to show what can be improved with their medical coding and billing processes. An experienced medical billing company is consistent since their main focus is solely on coding and billing.

When it comes to denials management, a denial does not fall entirely on medical coding and billing. This may include diagnosis and procedure coding, missing details in records, clinical validation, discharge disposition codes and many other factors. Approximately 90% of denials can be prevented by making sure that medical coders are up to date on the current coding updates and that documentation is completed and recorded accurately. With the support of an experienced medical billing and coding company, those denials will be reduced significantly. ECLAT offers exceptional denials management services that go above and beyond to pinpoint the cause of a denial or claim. Our services consist of a thorough evaluation of any denials and partial payments received. ECLAT’s Accounts Receivable (EAR) team is responsible for following-up with the payers, patients, providers, facilities and other parties involved with the improperly processed claims. While they keep track of the payment and denial trends on every account and secondary follow-ups, ECLAT’s Appeals Team (EAT) will appeal the denials as soon as the correspondence has been received from payers. Our team takes pride in serving our customers with the most proactive medical coding and billing support possible.

Choose ECLAT Health Solutions To Provide Accurate, Efficient Medical Coding & Billing Services

Whether you are considering training your staff to be your in-house medical coders or you are looking to outsource instead, ECLAT Health Solutions provides quality hospital billing and coding solutions to healthcare providers in Northern Virginia that can help you choose what would be best for your organization. Our medical coders understand it isn’t an easy decision but you can trust us because we have years of medical coding experience and training to provide you with the services you need to enhance your company. Our services will further help your company run more efficiently and effectively. Contact us and speak with an ECLAT professional medical coder today!  

Here’s Why The Global Medical Coding Market is Growing Exponentially

Medical coding is an essential medical language that is utilized by health organizations and hospitals around the world everyday. The global medical coding market is thriving in developed countries, but with all this growth, constant changes need to be made to improve efficiency and the effectiveness of healthcare experiences and procedures everywhere.

With the global medical coding market on the rise, medical coding and billing companies, such as ECLAT Health Solutions, must be quick to adjust to the constantly changing health industry. As one of the top medical medical coding companies in Northern Virginia, our team of certified specialists ensure every code is chosen with precision, which will overall help healthcare providers avoid hefty fines and insufficient patient care. Below are a few reasons why the global medical coding market is growing.

Decrease in Fraudulent Errors

As the global medical coding market expands, the more likely it is for insurance fraud and issues to occur. If medical documents are being misinterpreted more frequently and electronic health record (EHR) shortcuts are increasing errors, then there is a higher risk of inaccuracy and even malpractice. Maintaining a healthy and accurate coding system with professional medical coding assistance means patients will receive the proper care they need and providers are giving the highest quality of healthcare to patients.

Growing Demand of Coding Services

There is a rising demand for a universal language in medical documents. The need for quality healthcare services reflects how often medical coding procedures are being adopted between various providers. Without medical coding, it would be difficult to provide the current standard of health services to patients today.

Encourages More Coding Opportunities

With medical coding services growing exponentially, this also expands the job market for medical coders. As the need for coding services grows, medical coding employment opportunities will double. A need of more coders proves that health providers are working to find the best ways to improve accuracy and cultivate a healthy revenue by creating more coding careers.  

Constant Coding Updates

Since there’s a need for a universal medical coding system, we are taking advantage of technology to help healthcare entities record accurate medical documents in a world of constant ICD system changes. Medical technology such as computer-assisted coding (CAC), blockchain, and electronic health record (EHR) alignment are used to help reduce complex coding issues, improve accuracy in medical documents, and increase efficiency. These medical systems are furthering the global medical coding market by providing medical coding solutions and classification updates to better the healthcare industry.

ECLAT Health Solutions is Northern Virginia’s Top Medical Coding Company

Make sure your medical documents and codes are recorded and tracked accurately with a professional medical coding company. Trust ECLAT Health Solutions with your company’s medical billing and coding procedures to reduce any complex coding and billing errors and upcoding occurrences. Our team of medical coders are dedicated to helping providers increase their coding accuracy and provide solutions to improving areas of inefficiency. We strive to provide assistance tailored to our clients needs to enhance their overall coding system for a better healthcare experience. Contact us today to speak with one of our medical coding specialists today!

Coding Q & A with ECLAT Expert – Marie Thomas

Question:

J96.00 (Principal DX) – Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
S06.6X6A (Admitting DX) – Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter
00N.00ZZ (Principle Procedure Code- ICD-10-PCS) – Release Brain, Open Approach
What would be the appropriate APR DRG, is it 020-1, 020-2, 020-3 or 020-4 or something else?

Answer:

All Patient Refined Diagnosis Related Groups (APR-DRGs) are similar to Medicare Severity Diagnosis Related Groups (MS-DRGs) in that they are calculated from a preassigned numerical weight listing – multiplied by a fixed dollar amount based on each individual provider.  The base rate of APR-DRG is derived from how sick the patient is via codes assigned, considering the severity of illness and the risk of mortality.  APR-DRGs are unlike MS-DRG’s in that the base rate for MS-DRG is calculated from the codes assigned from a single complication or comorbidity.  Medicare groups claims using MS-DRG for reimbursement.  Some Medicaid, Workers compensation, no fault and commercial payers group to APR-DRG for reimbursement.  3M developed the APR-DRGs version (v#) and provide updates annually.  It is important to work with payers to understand the APR-DRG listing and weights.

Using the 3M APR-DRG grouper Version 18.3.1.0 (131), PDX J96.00 admitting DX S06.6X6A PCS 00N00ZZ, the APR DRG is 950 SOI = 1 ROM = 2 (a relatively low risk patient based on the coding)

If the documentation supports the PDX J96.00 admitting DX S06.6X6A and secondary diagnosis S06.6X6A with the PCS 00N00ZZ the APR DRG is 10 and the SOI = 3 and ROM = 4 (these codes reflect a much sicker patient with risk of dying).

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www.cms.gov

Webinar Roundup: Exploring Respiratory Failure from a Clinical Perspective

As revenue cycle management, medical coding, and clinical documentation improvement professionals, the topic of acute and chronic respiratory failure is something that comes across our clients’ screens regularly. It is a very unique health issue that many don’t fully understand, and that can be difficult to document. Because of its distinctive properties, and popular audience request, we felt it was a topic that needed some discussion. That is why we chose this quarter’s webinar topic from our “Experience the Brilliance” webinar series to explore respiratory failure from a clinical perspective. Joined by ECLAT’s Senior Director of Coding and HIM Operations, Marie Thomas, and clinical care physician, Krishna Thandra, MD, we discussed the basics of respiratory failure, how it is viewed from a clinical perspective, and how to identify and document it from a medical coding perspective.

2018-07-31 13.00 Exploring Respiratory Failure – A Clinical Perspective from Giovanna Govea on Vimeo.

Exploring Respiratory Failure – A Clinical Perspective from Giovanna Govea on Vimeo.

The Clinical Perspective

First, the MC of the webinar, Giovanna Govea of ECLAT Health Solutions, defined respiratory failure before introducing Dr. Krishna Thandra to offer a clinical perspective. According to the late Robert S. Gold, MD, “respiratory failure basically means that the lungs cannot meet the needs of the body to supply oxygen and remove carbon dioxide.” In clinical trials, signs of respiratory failure include increased respiratory rate, increased burden of oxygen, decreased oxygen levels, and increased carbon dioxide levels.

When someone experiences respiratory failure, there are some key physiological changes that occur:

  1. Impacts the heart because of the lower oxygen level
  2. Cor pulmonale may occur with right sided heart enlargement
  3. Liver may become enlarged/engorged, swelling of LE or UE, irregular rhythm
  4. Risk of blood clots

As Dr. Thandra discussed,

The Medical Coding Perspective

Identifying respiratory failure quickly and properly is imperative to a patient’s health. After respiratory failure is identified by a physician, the clinical documentation is the next important step in the process. The clinical perspective helps us to better distinguish clinical criteria for acute vs. chronic respiratory failure, and to identify the correct medical coding assignment for respiratory failure cases. There are 3 important sets of criteria for identifying acute respiratory failure, as outlined in the webinar by Marie Thomas, Senior Director of Coding and HIM Operations, all of which can be found on pages 7-9 of the webinar handout. It is important to look closely at these criteria, as some distinctions are vital to identify in order to document the condition properly.

What happens if a patient is admitted with respiratory failure and another acute condition? The principal diagnosis depends on the individual patient’s situation and what caused the admission of the patient to the hospital. This coding guideline applies regardless of whether the other acute condition is a respiratory or non-respiratory condition. If the documentation is unclear, the physician should clarify which of the two conditions was the reason for admission. In some cases, both conditions may be equally responsible for the admission, just make sure that the severity of illness and intensity of service are equivalent for both.

Case Study and Poll

After reviewing respiratory failure from clinical and coding perspectives, Marie walked the webinar attendees through a case study followed by a question. To view the case study and see if the audience answered correctly, be sure to watch the webinar replay and review the webinar handout. Feel free to let us know what you think the answer is by commenting below.

Join Us for Future Segments of “Experience the Brilliance” Free Webinar Series

Our “Experience the Brilliance” Webinar Series is meant to provide educational insight to medical coders, CDI professionals, and HIM professionals for FREE on a quarterly basis, so be sure to join us next time! Follow ECLAT on LinkedIn for updates on future webinars and industry-related news.

global medical coding company

What Does ICD-11 Mean for Global Medical Coding Companies?

Global medical coding companies must keep up with industry technological and regulatory changes, and the recent announcement of ICD-11 is another change that we must adapt our processes to meet. But before we get into what the ICD-11 changes mean for medical coding companies, let’s remind ourselves of the purpose of ICD, and how essential it is to global medical coding. ICD, or the International Classification of Diseases, is a tool for reporting and grouping conditions and factors that influence health. The purpose of ICD is to allow for a standardized and systematic recording, analysis, interpretation, and comparison of medical data collected. Most useful to medical coders, ICD is used to translate diagnoses into alphanumeric codes which permit storage, retrieval, and analysis. Whenever the ICD is revised and updated, it means that global medical coding companies like ECLAT Health Solutions must take necessary measures to comply with its new structural changes.

Training

According to World Health Organization’s (WHO) recent release, some major structural changes are set to be implemented under ICD-11. One of the key revisions is meant to simplify coding structure and electronic tooling, which is meant to allow health care professionals to more accurately record conditions. This means that for global medical coding companies, this new and simplified coding structure must be comprehensively understood by its professionals. Extensive training, research, and practice are all required for medical coding companies to ensure that coding quality and accuracy will not be lost amidst the ICD-11 transition. Also, the code structure itself is projected to be updated, so what many medical coders knew like the back of their hands will now need to be re-learned.

No need to panic

The preview of the ICD-11 transition, which is set to be released for adoption by member states of the WHO in May 2019, may seem like a daunting announcement to some. Medical coding companies and health care professionals as a whole have become so accustomed to ICD-10, that the thought of drastic system and structural changes involved in ICD-11 may cause stress and insecurity. However, NO NEED TO PANIC! ICD-11 is an exciting announcement, as it marks innovation and forward thinking in the world of disease classification. A lot has changed since ICD-10 was introduced, and the way we view certain diseases and disorders should evolve as well. Like with any new piece of technology or information, there is always a learning curve, however the light at the end of the tunnel is brighter than ever, the health information management world will continue to improve its practices to promote patient transparency and reduce unnecessary hospital costs.

ECLAT Health Solutions is Ready for ICD-11

ICD-11 goes into effect January 1, 2022. The World Health Organization offices are still working on a global implementation plan to do this, and our team will be standing by to respond and take action to update our medical coding processes as necessary when the plan and final release is announced. As a leading global medical coding company, ECLAT Health Solutions is looking forward to ICD-11 and the impressive impact it will have on health care and how we classify diseases, disorders, and other health issues. To learn about the ECLAT Advantage, and what sets our medical coding company apart from others, contact us today!

new meaningful use program

How the New Meaningful Use Program Affects Hospitals and Healthcare Providers

Meaningful Use is defined by the use of certified electronic health record (EHR) technology in a meaningful manner, ensuring that the certified EHR technology is connected in a manner that ultimately improved the quality of care. This concept of meaningful use was enacted with the American Reinvestment & Recovery Act (ARRA) in February of 2009; an effort led by the Centers for Medicare & Medicaid Services (CMS). There have been several updates to the rules surrounding meaningful use since it was made priority by CMS nearly 10 years ago, but the most recent announcement in April has a large effect on how hospitals and other providers process health information.

Starting in 2019, hospitals will be required to have a patient’s electronic health records available on the day they leave the hospital, as well as better access to price information. Further, some regulatory burdens on hospitals will also be lifted. The new rules are meant to promote better interoperability between providers and for patients. At ECLAT, we embrace the EMR technology and include meaningful use concepts in our ongoing Revenue Cycle training program. Ensuring the abstracting and coding information is accurate, timely and complete is essential to meeting meaningful use strategies. While this announcement is exciting for patients, allowing for more price and information transparency, the new rules beg the question: how does this affect hospitals and healthcare providers?

  1. Reduces Unnecessary Redundancies

Hospitals spend billions every year on administrative duties related to regulatory compliance, totally $39 billion according to the American Hospital Association. Fortunately, CMS eliminated 25 total measures that will save hospitals over 2 million hours of work. Additionally, quality measurement will be more streamlined as a significant number of criteria acute care hospitals are currently required to report on will be eliminated.  The lift on these regulations will better assist with the receipt and exchange of documents among systems, which inherently allows medical coding companies like ECLAT to close accounts faster and enhance clinical documentation for more accurate reimbursement. In short, it removes unnecessary and redundant measures from a number of programs, ultimately saving hospitals time and money.

  1. Challenging ‘One Size Fits All’ Pricing Approach

While hospitals are welcoming reduced regulation with open arms, many are concerned by the CMS rule requiring them to post their prices. The goal of this is to promote more effective price transparency for patients, however, what individuals pay varies greatly depending on their insurance coverage. Nevertheless, this price transparency is meant to ultimately offer the best value to patients, where they reap the benefits associated with more choices and thus better health outcomes.

  1. Emphasizes Need for Accurate RCM, Medical Coding and Billing

Hospitals also now must make their patients’ EHR data available upon the day of discharge, which means hospitals must incorporate up-to-date technologies and processes to make this happen. This involved using up-to-date EHR technology beginning in 2019 in order to quality for incentive payments and avoid Medicare payment reductions. On top of this, it’s essential for hospitals and providers to ensure their revenue cycle management, coding and billing processes evolve with these new rules to ensure continued accuracy.

These new rules announced by Centers for Medicare & Medicaid Services mark an interesting transition in healthcare information management, and while some of the rules require challenges for hospitals and other healthcare providers, these changes hope to ultimately improve efficiency, transparency, and accuracy. In these ever-changing times of healthcare regulation, it’s also important to have a revenue cycle management partner to help you keep up. Contact ECLAT Health Solutions today to learn more about our services, and how we can help hospitals save time and money with our 95% accuracy or greater guarantee.

A Medical Coding Company Can Help Providers Prevent Fraudulent Error(s)

The financial health of a practice relies heavily on accurate medical coding. Selecting the wrong code is not only much more likely to result in a claim denial but it can lead to the wrong treatment being given, as well as illegal consequences. This usually happens in three ways: the facility ends up choosing a code for a milder treatment than what is really needed (undercoding), chooses a code for a more expensive treatment (upcoding) or reports separate procedures that can usually be combined, therefore falsely increasing reimbursement (unbundling).

In some cases, upcoding is accidental. A coder may misread clinical documentation or misunderstand a diagnosis due to lack of physician documentation and may inadvertently choose the code for a more expensive treatment. However, some practices have exhibited intentional upcoding and unbundling.

Both intentional and non-intentional upcoding can have damaging effects on providers. To prevent this, providers looking to ensure they have accurate medical coding and true reimbursements should partner with an experienced medical coding company. ECLAT Health Solutions can guarantee a 95% coding accuracy or greater to ensure our clients prevent these inaccuracies. Below, we’ll cover the various consequences providers can avoid by choosing to work with our medical coding experts:

 

Potential Increased Financial Burden on Provider

When upcoding or unbundling is successful, of course, the facility enjoys falsely-acquired, increased revenue. However, the financial consequences of when this fraud is detected far outweigh the benefits. If the incorrect code is discovered by the insurance provider during claims processing, this will result in a claims denial, which can carry a hefty price tag.

This is nothing compared to the cost of being reported and found guilty of healthcare fraud. Last year, Carolinas Healthcare faced a $6.5 million fine for upcoding lab test results. They received $80 more per urine test they conducted than they should have, resulting in false revenue. This revenue did not surpass, however, the huge fine they ended up paying.

Providers should not take this financial burden lightly. Choosing coding specialists like ECLAT Health Solutions is the best way to ensure all codes are chosen accurately and the provider steers clear of fines.

 

Potential Increased Bills for Patients

Upcoding and unbundling is bound to result in a higher cost for a patient. There has been a large increase in financial responsibility falling to the patient in recent years, and upcoding and unbundling can only contribute to this. If a patient’s insurance does not fully cover the more expensive treatment reported with the coding, they will need to pay more out of pocket. This can in turn affect their decision to remain loyal to a provider or seek elsewhere for less expensive treatment, which ultimately affects revenue.

 

Coding Audits & Investigations

Providers who draw attention with their upcoding are likely susceptible to coding audits or criminal investigations. Because upcoding and similar fraud like unbundling costs the healthcare industry billions of dollars annually, the penalties for these offenses are severe. Not only does upcoding cost facilities a lot of money, as in the case of Carolinas Healthcare, but can damage their reputation and credibility with patients, insurance providers, and other practices alike. Even if a provider is not found guilty of upcoding, investigations send a negative impression to the public.

HHS has begun cracking down on healthcare fraud and developed a proactive approach to fraud protection that hopes to detect more fraud issues. Part of these measures include using predictive analytics to prevent false medical bills. It has become increasingly crucial that providers take every possible measure to prevent upcoding, whether intentional or unintentional. There are serious legal implications and consequences of fraud and abuse. Learn more about these implications here.

 

Choose ECLAT, Your Trusted Medical Coding Company

Trusting a medical coding company to handle your daily coding is the best way to ensure accurate codes and no upcoding. ECLAT Health Solutions not only helps providers increase their coding accuracy but identify potential inefficient practices or other areas of concern to prevent accidental, or intentional, upcoding. It is everyone’s responsibility to report accurate information based on patient documentation, reflecting the severity of our patients and the costs associated. We work closely as an extension of our clients to help them become proactive in their coding practices and earn a true ROI.

 

CACs vs Human Auditors & Coders

2018 is the year of the ICD-10 audit! Two years after ICD-10 was implemented, coding and documentation regulations have finally stabilized, after some providers experienced tumultuous transition periods. Now is the perfect time for providers to run ICD-10 audits to identify any current errors and opportunities to improve their coding practices for the future.

Providers looking to improve their coding practices may turn to automation systems after an audit delivers unfavorable insights into their coding practices. While automation systems such as CACs may appear cost-effective and accurate for coding and auditing, it is crucial that providers also realize the value of skilled human coders and auditors as a supplement to these systems. ECLAT Health Solutions offers ICD-10 coding and auditing services, provided by a staff of medical coding and billing experts. Below, we explore why providers who use automation systems must not forget the importance of human coders and auditors:

 

1. Coders & auditors may catch coding mistakes a computer may miss

Although automation software can certainly streamline parts of the revenue cycle, it cannot completely replace the human touch. Coders and auditors may be able to detect nuances and errors that a CAC may not pick up. CACs are designed to analyze the context around the keywords listed on documentation, which can prevent false codes from being assigned for symptoms that do not require codes, saving the provider from a coding mistake and potential claim denial. However, on the other hand, this also means a false code may be assigned when it is not required, which may also lead to a claim denial and lost revenue.

A coder or auditor will better be able to notice clinical indicators that define the severity of the illness and intensity of required service, along with the specificity of the type and acuity of the condition. This closer eye for detail is essential for minimizing coding errors as much as possible.

To ensure the utmost accuracy, providers must not strive to fully automate the coding process, but to instead supplement automation software with the assistance of a medical coding provider. ECLAT Health Solutions has a team of expert coders and auditors who are dedicated to providing our clients with accurate coding to prevent claim denials. We are skilled in CPT and ICD-10-CM coding and have a comprehensive 3-Tier Quality Assurance Process to ensure accuracy. We also offer thorough auditing services to identify our providers’ coding errors and identify opportunities for improvement. We offer support for all chart types, specific chart types, specific coders, high alert cases (RAC, OIG, etc.), or other focused areas (MS-DRG, ROM, SOI, APR DRG, APC, POA, etc.).

 

2. Coders & auditors may identify errors in clinical documentation

Because CACs analyze medical documentation to assign codes, they only review and understand the data provided on each piece of documentation. If a document was filled out incorrectly or inefficiently, the code that CAC assigns may not be the most accurate code for the diagnosis or treatment provided, and CAC may not be able to detect the flaw in the documentation. Similarly, to return to our example, if a document states that a patient exhibited symptoms of heart failure but did not in fact suffer heart failure, a CAC may code it incorrectly.

A coder, however, may better understand the context surrounding the patient experience and the data reported on the documentation, which will affect the code that will need to be assigned.  A coder will understand that the symptoms did not result in heart failure and should not be coded as such. Repeated errors or inefficiencies are best spotted with human eyes of a skilled credentialed coder. A seasoned coder or auditor will be better equipped to identify misinterpreted patterns and propose suggestions for how to improve to the proper staff.  They will also be more aware of any query or clarification opportunities that would lead to optimal quality statistics and accurate reimbursement. A CAC is not as capable of detecting these nuances and patterns.

The best way for providers to identify errors in their coding and documentation processes is to partner with a medical coding company like ECLAT. Our coding and auditing staff thoroughly reviews our clients’ coding processes to not only detect errors but make suggestions for improvement. Our clinical documentation improvement services are also designed to address issues in a provider’s documentation processes to help reduce coding mistakes and claim denials.

 

Facilities who are struggling to earn their full revenue or have coding errors should perform an audit through a medical coding provider. ECLAT Health Solutions’ auditing staff holds a wide variety of specialties, including inpatient medical records, outpatient same-day surgery, emergency department medical records, and clinical documentation improvement opportunities. We can perform audits for providers large and small and detect errors that CACs may not be able to. Our audit platform includes “audit to educate” and we pride ourselves in providing deliverables that include graphics, executive summary, audit details and education. Although complete automation may seem appealing to providers looking for cost-effective, productive solutions, we believe there is no complete replacement for human coding and billing staff. Our auditing and coding staff are here to ensure accuracy, efficiency, and a true ROI.

Why Choosing a Billing Company That Practices Billing Transparency is Crucial

One of the biggest issues plaguing healthcare providers is implementing the best billing practices and receiving full, on-time payment from patients. The need to improve billing practices is more important than ever, with roughly 30% of healthcare revenue being paid by patients.

Because the stakes are high, many healthcare providers turn to billing companies to handle and improve their billing and collections practices. The billing staff at ECLAT Health Solutions are dedicated to helping our clients improve their billing and collections practices to foster a healthier revenue cycle in the utmost professional manner. While many billing companies frequently call and hound customers for payment, ECLAT understands that these conversations require professionalism, discretion, and compassion. We never harass customers and strive to make paying as easy as possible for them. Furthermore, we strive to meet our clients’ financial goals and billing needs and recommend actions that will help them improve areas other than patient payment.

Allow us to provide some insight into why a transparent, cooperative relationship between a billing company and a provider is so crucial:

 

1. More On-Time, Complete Payments

With the increase of financial accountability and burden for patients, having a cooperative, transparent relationship between the billing company and healthcare provider will help boost on-time payments. Of course, patients not paying their bill on time means less revenue for a provider, but an added strain is the time and money it can take for a provider to pursue a collections battle. Therefore, when a patient does not pay on time, it is usually not viable for a facility to take legal action, and they may never see that revenue.

A billing company like ECLAT will assess the current billing and collections practices and determine where the provider can improve to ensure on-time payments to prevent these errors. For example, if a provider does not currently have staff explain a patient’s charges directly with them, this patient may feel overwhelmed by the charge or uncertain of how to pay, and therefore may pay late, if at all. A billing company can provide this crucial conversation (or train the provider’s administrative staff to do so) and help encourage patients to pay on time—and pay in full, too.

ECLAT Health Solutions is your trusted partner for ensuring your billing and collections practices translate to more on time payments. We offer EFT/ERA enrollment to our clients, and our billing staff post and reconcile ERA/EOB/Denials to the PMS every day. For collections, we offer weekly, bi-weekly, or monthly follow up to remind your patients of their outstanding payments, and always practice compassion, discretion, and professionalism in these conversations. We work to earn our clients the revenue they need while keeping their patients satisfied and coming back for any necessary future treatments.

Read our post “3 Medical Billing Best Practices for Receiving More On-Time Payments” for payment collection tips.

 

2. Improved Billing Practices

Transparency between a billing company and provider is necessary for improving the provider’s end-to-end billing practices and revenue cycle, even beyond increasing the rate of on-time payments. Providers must have accessibility and accountability for their practice and partnering with a billing company can establish this. Having a secondary set of experts review their medical coding practices translates not only to increased revenue from patient payments but more efficient, accurate processes that lead to fewer costly mistakes.

ECLAT Health Solutions billing expert Dorothy Lodato, who has years of experience with medical billing, stated, “In many cases, a provider’s in-house staff receives payment regardless of how much money is collected from patients, while a billing company gets paid a percent of the money collected.” Therefore, it is mutually beneficial for billing companies to be transparent with their clients and offer effective suggestions for improvement; the provider receives the revenue they need from patients, and so does the billing staff.

We work on a personal level with our clients to determine what is currently missing from their billing and collections processes. Our clients’ billing goals become our billing goals, and we always hold open communication with our clients to determine opportunities for improvement.

 

When it comes to improving billing practices, it is crucial that providers choose the right billing company for the job. Providers must partner with a billing company that promotes cooperation and transparency to best foster a healthy revenue cycle and see an increase of payments. ECLAT Health Solutions’ medical billing experts specialize in helping our clients remedy their current billing issues and take advantage of opportunities for improvement. Our open collaboration with our partners allows us to get to know their practice and meet their billing goals.

Benefits of Offshore Medical Coding for Your Domestic Staff

More and more healthcare providers are utilizing offshore medical coding and are enjoying a variety of benefits. One of the biggest appeals of offshore medical coding for many providers is the bottom line – hiring overseas coders is more cost-effective than searching for employees at home. This is a huge asset for providers, but it certainly is not the only one. Financial incentives aside, outsourced medical coding also has several benefits for a facility’s domestic staff. Below, we explore some of the ways that offshore coding can benefit your domestic employees.

 

Freedom to Focus on the Administrative Side

Outsourcing your medical coding practices leaves your domestic employees with more time and resources that they can put toward bolstering and reworking other areas of your facility that need help, such as your administrative tasks. Refining the administrative side can help improve your facility’s billing and collections practices, patient experience, and claims submissions process, all of which will help increase efficiency and foster a healthier revenue cycle. Any staff who may have been doubling as coders or assisting with coding processes will now be free to focus on their main roles and responsibilities.

 

No Need to Re-Train Domestic Employees

Healthcare providers that feel their domestic employees’ lack of training has affected their efficiency or revenue may dread the effort, money, and resources that they will need to put into retraining them. Offshore coders are joining the workforce with the same qualifications, skills, and training as new coders in the United States at a reduced cost, making them capable of providing accurate medical coding and maintaining security. When providers look overseas for their coding solutions, they eliminate the need to spend valuable funds on training programs for their domestic staff. Offshore coders will need to receive some training to become familiarized with your facility’s best practices and procedures, but this is minimal and spares your facility the cost of a complete training overhaul that your domestic employees may need. No re-training for domestic employees also saves them time and stress, and allows them to focus on other, more important tasks and processes.

 

Fewer Errors and Less Stress

Using skilled offshore coders for your medical coding needs can help drastically reduce medical coding errors. In some facilities—often small or understaffed ones—busy staff may be prone to making coding errors, especially if these domestic staff are new to the workforce or have been struggling with the switch to ICD-10. Highly trained outsourced coders will likely make fewer errors, which means the rest of your staff will not need to scramble to fix mistakes such as claims denials. Often, the stress involved with fixing errors can actually lead to more mistakes being made, which compromises the health of your revenue cycle.

To earn the benefits of offshore medical coding, both for your finances and your staff, partner with an expert international medical coding company!

 

Offshore Medical Coding – The ECLAT Difference

ECLAT Health Solution’s team of outsourced medical coding experts are highly trained in ICD-10 coding procedures and are trained to maintain HIPAA and HITECH compliance. Not only is our coding secure and accurate, but our 3-Tiered Quality Assurance Process ensures we deliver superior work every step of the way. During this process, we closely analyze and review any cases that our coding team have questions on and prevent or fix errors. We go above and beyond to help your practice enjoy a healthy revenue cycle and increased revenue with our 24-hour turnaround and holiday and weekend coverage at no additional cost.

Contact ECLAT today to learn more about our offshore medical coding services.