With WWS your facility will be able to:

Keep patients in a compliant and billable status.

Keeping patients in a compliant and billable status is important for all healthcare providers, but it’s especially so for those who rely on payors to pay their claims. If you’re not following your payor requirements, you risk losing money on every claim that goes unpaid. These costs can quickly add up and cause serious financial strain on your practice or health system.

By using the right tools, you can keep your patients in a compliant and billable status by:

• Keeping up with insurance company requirements for renewal & expired Prior Authorization.

WWS’s unique approach to managing Prior Authorization is beneficial to DME providers. With WWS, you can save time by not uploading the same documents over and over again, and you can avoid redundant administrative work by using our secure electronic transfer of documents. giving you the ability and time to focus on patient care or other important tasks.

• Increased workload for administrative staff
• Reduced ability to attract and retain business opportunities 
• Reductions in reimbursement from government and private payers

• WWS saves you time by not having you upload the same documents over and over again. We gather all of your documentation in one place, so it’s ready when your payor requests it. This means less work for you!
• Serve ensures that you get paid for the services you provide by working with many different payers and helping them understand how much they should be paying for your services or products in order to create accurate claims, which leads to quicker payment cycles—meaning more money in the bank!

Conclusion

We think the best part of the WWS approach is that it saves you time and effort with its automatic uploads and real-time updates. It’s a simple, elegant solution for a problem that many healthcare providers don’t even know they have. We believe that when it comes to revenue cycle management, this kind of innovation can make all the difference—not just in your bottom line, but also in your ability to provide quality care to patients who need it most. If you want more information about how WWS can help you increase your collections while reducing administrative costs, we encourage you to reach out today.

1. Create Patient-Friendly Medical Billing Statements

Although medical practices and hospitals are aware of the complexities of the medical billing process, patients are likely to be perplexed. Industry expectations have shifted in such a way that providers must now take a patient-centered approach to this process, so it’s more important than ever to educate yourself on how to remain accessible.

2. Maintain a clean claim rate of at least 95%.

The clean claim ratio of your medical practice is the average number of claims paid on the first submission. In an ideal world, every provider would like to achieve a percentage greater than 95 percent, but the meaning behind the number is what truly matters. The higher your clean claim rate, the less time your staff will spend attempting to identify denial reasons, coordinate payments, and re-submit claims.

3. Don’t Ignore Payer Reimbursements Analysis

Many medical practices place too much trust in payers to reimburse them in full for every claim they submit. Regrettably, this is not always the case. Underpayments are more common than you may believe. Devoting resources to analyzing payment accuracy will reduce revenue loss while providing valuable insight into your practice’s revenue management cycle data.

4. Take Control of Your Accounts Receivable

How frequently do you keep track of your receivables? Do you find yourself pressed for time to respond to a denied claim? Perhaps you should reconsider how you handle contracts and receivables. Coding changes occur quickly in the healthcare industry, and there is no better time to prepare for potential issues.

5. Return to the Fundamentals of Revenue Cycle Management

Are you brand new to revenue cycle management? The first step is to have a consistent cash flow. Even if you’re well-versed in the complexities of medical billing and coding, it’s always a good idea to review your basic best practices to ensure you haven’t deviated from the path.

6. Submit Complete and Accurate Claims

Making sure your medical billing is correct the first time you submit it can save you the time and effort of editing and resubmitting incorrect claims. It is estimated that up to 80% of medical bills contain errors, resulting in weeks of editing, resubmission, and provider’s not receiving payment. Filling out claims correctly and avoiding common errors, such as incorrect patient or insurance information and duplicate claims, can help your medical practice have an efficient medical billing process.

7. Maintain Knowledge of Medical Billing Rules and Regulations

It is critical to be aware of the current medical billing rules in order to ensure best practices in medical billing and coding. Because regulations are constantly changing, staying informed can result in a more efficient process that avoids rejections and medical billing edits. Failure to stay current on medical billing rules can have a direct impact on the cash flow of your medical practice.

8. Always look for opportunities to improve.

Finding ways to improve will continue to help your healthcare practice grow. Because the healthcare industry is constantly changing, looking for ways to optimize the medical billing process on a consistent basis will help to maximize revenue. Aside from staying up to date on current medical billing regulations, tracking performance is critical for identifying inefficiencies and optimizing efficiency. Key performance indicators (KPIs) can help measure the accuracy and efficiency of previous performances and identify areas for improvement.

5 Medical Billing Tips for Your Healthcare Practice

• File claims on a daily basis
• Collect copayments at the point of service.
• Verify and update the patient’s insurance
• Keep track of unpaid claims and follow up on them.
• Make EOBs your friends

The revenue cycle management method relies heavily on payment posting. Payment posting, when done correctly, can improve your practice’s cash flow and income.

In medical billing, what is Payment Posting?

The process of applying remittances to patient medical accounts and reconciling those payments with outstanding bills is known as payment posting. When a patient pays a bill, the payment must be applied to the appropriate bill and patient. Because it takes time for a practice to collect payments, it’s critical to handle adjustments and denials rapidly to avoid cash flow lags. Medical billing might take weeks or months to complete. Billing issues lengthen the duration and make accounting and recordkeeping more difficult. Payment posting problems can also lead to denials, uncertainty, miscommunication, and dissatisfied patients.

What Is the Importance of Payment Posting?

Patients and your practice benefit from accurate payment posting. Practice managers find solutions that don’t irritate patients or result in revenue loss.

Payment posting that is accurate and timely has various advantages for your practice, including:

Accurate payment posting provides insight into the practice’s revenue and day-to-day financial activity. Your office gets a complete picture of your financial situation. These reports help people make better financial decisions.

Prevent Discrepancies – Efficient payment processing in medical billing allows your practice to discover discrepancies before they become problems that affect your revenue cycle.

Detect Errors – With proper payment posting, your practice will be able to detect payment errors before they become major issues. Check the status of payments on a weekly basis to verify there are no errors. 

Increase Cash Flow – Make sure your system is error-free to boost your practice’s cash flow and income.

Identify Recurring Issues – By tracking payment posting, you can identify recurring issues in your revenue cycle. Then, address the faults to develop efficiency inside your accounting operations.

Make Your Payment Posting Process More Efficient

Monitoring your payment posting procedure boosts revenue and efficiency in your practice.

The following aresome of the most prevalent techniques to improve your posting process: 

Empower Your Staff

Is your front-desk staff correctly collecting copays? Is it true that denials are being resent to the payer? Make sure your payment posters are familiar with medical billing software and your payment processing protocol.

User error in payment processing is avoided by paying special attention to training. Additionally, ensure that your staff is aware of any recent changes to billing or coding standards, as this will help you avoid problems with medical insurance companies over patient payments.

Recognize Errors and Trends

Payment posters in your practice should be trained to correctly highlight concerns like previous authorizations or non-covered treatments for the practice manager’s prompt notice. Problems or discrepancies are resolved more quickly when they are addressed quickly.

Make use of ERAs and EFTs.

ERA and EFT payments are preferred by 85 percent of clinics, according to Med Data. Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) are two electronic payment mechanisms used by businesses and institutions.

HIPAA-compliant electronic platforms that can replace paper versions of EOBs are known as ERAs (Explanation of Benefits). ERAs minimize the number of payments that must bemanually input, which is time-consuming and error-prone. ERAs can also be  applied to other benefit packages. EFTs are the tools used to send those payments.

Do you have any queries about how to post payments in your practice?

The wws can help you examine  your revenue cycle management, including any payment posting problems.

A streamlined and efficient financial process is crucial for any successful practice, and is a key to a healthy revenue cycle.

Take a look at these seven monthly revenue tips that will improve your financial process and ultimately free up more time to focus on what matters your patients.

1. Evaluate Accounts Receivable.

Did you know that approximately 15 percent of claims are never paid due to billing errors, and up to 50 percent of re-submitted claims are never paid?

You should be averaging less than 45 days in accounts receivable and striving for an ideal average of under 30.

2. Reduce Excessive Accounts Receivable

There are a number of things you can do trim accounts receivable excess.

Here are a few:

• Separate accounts receivables by insurance and patient balances.
• Separate the different insurance payer types, and understand how their payor specific guidelines affect your accounts receivable management.
• Identify key offending payers prioritized by amounts outstanding.
• View monthly reimbursement trends for each payer.

3. Improve Code Accuracy.

Code inaccuracy is a big time and energy waster.

You can improve accuracy by routinely scrubbing codes before submission.

4. Analyze Denied Claims.

One of the biggest issues that negatively affect revenue is denied claims.

In fact, according to the Government Accountability Office, up to one in four claims are denied. By analyzing your rejects and denials, you can identify patterns that can be corrected. Consider the following:

• Are insurers determining the care a patient received as medically unnecessary?
• Is beneficiaries receiving care outside their networks without realizing it?
• Are names spelled correctly?
• Are numbers consistently entered between two or more parties? If not, this can create a “data freeze.

5. Improve Your Verification Stage.

The claims reimbursement process begins as soon as a patient first makes an appointment with a physician’s office or healthcare provider.

6. Send Clean Claims.

It is crucial to send a clean claim the first time around.

Sure, it might take an extra 30 to 60 seconds per claim to thoroughly scrub it for initial submission. But if the claim is denied, it’ll end up taking an average of 15 minutes per claim.

7. Get Help. Hire a Chiropractic Billing Service.

Keeping up with all the normal, day-to-day tasks that go into running a successful chiropractic office isn’t easy.

Your staff must work diligently and methodically to review suspended claims and analyze where holes or gaps exist with things like compliance, errors and timeliness.

What Are Your Biggest Monthly Revenue Challenges?

Are you finding it difficult to streamline your financial process in order to increase revenue?

What are the most difficult challenges you face? Do you have any additional tips or strategies to share that have made a difference in your chiropractic office?

Many Chiropractors Are Not Aware of the Benefits of Outsourced Billing

When you look out into your office, the situation likely appears under control. We understand that you are good at what you do. Hiring an outsourced billing service can increase revenue, bandwidth, and quality of life for your entire team.

Have you considered the financial and bandwidth benefits of outsourcing your billing services?

Using resources available to you, like medical software and outsourced billing services, will increase your monthly revenue, streamline your financial process, and get you back to what matters helping your patients.

We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.

Contact us for more information.

Now, take it a step further.

• Do you know how to effectively and efficiently secure those payment methods for future use?
• How do your patients respond when asked to keep a card on file?
• Are you even doing these things today?

Many providers struggle to find a happy medium when it comes to speaking to their patients about financial responsibility and actually collecting. we will explore the top ways to optimize your patient collections strategy without costing valuable time and labor resources.

It’s crucial that you obtain every dollar for every visit in a timely fashion. Collecting payments is easier when you have some expert assistance backing you up.

Here are six tips your practice can implement to avoid revenue loss due to the rise in high-deductible health plans and patient’s resulting financial responsibility.

1. Gather patients’ insurance and contact information before their appointments.
2. Verify insurance eligibility and identify any amounts due from prior patient visits.
3. Collect copays and other balances at the front desk when patients check in.
4. Offer multiple payment methods.
5. Offer payment plans and track them.
6. Make follow-up part of the collections routine.

To Conclude:

Collecting more patient payments with less delay should be your new goal, keeping in mind that your practice is a business and that your patient is the consumer. While you are in the healthcare field to help others, you also have a duty to your staff to collect what is owed, making payroll and keeping the doors open.

In the past, most reimbursements were carried out through a business-to-business relationship between providers and insurers, leaving patients largely out of the loop. But now and in the future, reimbursements are a business-to-consumer relationship that is forged between providers and the patients themselves.

There are a lot of moving parts to consider when it comes to getting timelier payments from more of your patients. You may have additional questions or concerns about payment collection that you’d like to address immediately.

The least expensive time to collect is right now…it gets real expensive to collect money tomorrow!”

Click here http://localhost/main-site-update/live-demo/ to schedule a conversation with a WWS experts.

Revenue cycle management is the process that manages claims processing, payment and revenue generation, and often entails the use of technology to keep track of the claims process at every check point. 

Effective revenue cycle management will maximize the return on investment of a hospital. If you don’t have a good system in place, it can be challenging to juggle the various overhead expenses while still needing to pay the physicians and other members of staff. In addition to that, hospitals who want to stay modern and competitive, need to be willing to invest in newer technologies. Since effective RCM should leave to higher ROI at an organization.

Here are some areas were hospitals should always be looking to improve.

The Significance Of RCM

• Effective RCM speeds up the collections process and ensures that claims are being collected. Not only does it promote faster inflows, but it also handles denied claims.
• Many hospitals are still missing out on revenue opportunities because they fail to follow up with denied claims. In addition to all that, RCM deals with coding claims, collecting copays, and patient insurance eligibility.
• Not only does this drive up costs for an organization (needed to pay for postage and printing), but it also is time-consuming and not necessary.
• However, by utilizing new information technologies, you can speed up the processing of claims by not having to worry about manual processes.
• Hospitals nowadays should be looking to cut down on facets such as unnecessary paperwork and verifying contracts with every payer.

Simplify Your Processes

RCM has a lot of moving components.

For your billing and collections processes to be successful, there needs to be synergy within your hospital. Everyone needs to have defined roles within the organization; however, that does not mean there should not be cross-training to some degree.

A hospital is composed of physicians, nurses, administrative people, billing staff, and many others. It is essential that your hospital staff shares common goals and recognizes that they are a team and are in it together. In many cases, when the RCM of a hospital is lagging, it can be attributed back to misunderstandings of responsibilities, inadequate amounts of training, and when people not being on the same page.

Schedule a free live demo to learn more about RCM. Our team will assists you to give your operation the revenue cycle solutions it need!!

How Hospitals Can Improve Their Billing and Collections Processes

It’s not uncommon for hospitals to grapple with account resolution problems, and revenue cycle management is an ongoing challenge for even the best-run hospitals. 

In 2018, many hospitals are struggling to collect payments from not only patients, but insurance companies too.  It can be argued that this is getting increasingly more difficult because patients now have more flexibility regarding how they pay their medical bills.

Insurance companies are requiring more documents than ever before, which is contributing to more medical billing errors. Since medical billing is an extensive process, mistakes are extremely common these days.

Good revenue cycle management depends upon strong communication.

Here are the five ways to make the most of your hospital’s collections/billing processes to reduce your total number of denied claims.

1. Change The Way You Follow Up With Patients  

How are you currently reaching out to patients to collects debts?  Are you doing it on a monthly basis? If you want to improve your cash flow, you may need to switch and do your follow-ups on a weekly basis instead.  You don’t want to harass your patients; however, the frequent and constant communications affords them to at least to consider to negotiate a payment plan or at the very least, pay their bill. You should only make these calls weekdays during normal business hours.

2. Establish Your Collections Process

A great way for hospitals to improve their collection’s process is to request/require payment from patients at the time of their service.  By collecting as much debt as possible upfront, you helping to speed up the entire process.  Other steps that can be taken include checking to see which services patients are eligible for before their appointment and notifying patients in advance when any co-payments are due.

3. Have Multiple Payment Plan Options

There are many instances where a patient is unable to pay a medical bill upfront completely. For this reason, payment plans are a great way to help patients who need help to pay off larger bills. This will take a lot of the burden and stress off of patients and will still allow you to collect payments over time. Consider having a few payment plans for your patients to choose from.

4. Create an Insurance Authorization Checklist

The more that can be done to ensure patient eligibility and proper pre-authorization up front, the more likely the billing and collections cycle is to stay on track until the patient is discharged and his or her account is paid. Provide your admissions personnel with a patient insurance authorization checklist to use when registering patients. Understanding eligibility up front benefits the hospital and the patient, who can be apprised of what his or her out-of-pocket responsibilities are estimated to be.

 5. Don’t Underestimate the Importance of Patient Education

Patients understand that they may receive large bills, and when your hospital helps them know what to expect at every stage of the process, patients can become allies in making sure all bills are settled properly. Patient education should help them understand their financial responsibilities concerning their account balance, and their options for resolving it. Counseling low income patients on possible coverage by third parties like Medicaid should take place before admission, if possible, as should installment payment options.

Conclusion
Streamlining medical billing and collections for hospitals ultimately rests upon strong communication: with personnel so they understand their responsibilities, with patients so they understand what billing statements mean and what payment options are, and with insurers to keep rejected and denied claims to a minimum.

At WWS, we work with hospitals on every aspect of revenue cycle management, to streamline billing and maximize revenues. 

If you would like to know more, please call us at +1(302) 613-1356. We would be more than happy to answer your questions about hospital revenue cycle management and let our team assist you in choosing the right solution.

This concept of meaningful use was enacted with the American Reinvestment & Recovery Act in February of 2009; an effort led by the Centers for Medicare & Medicaid Services.

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.

While this announcement is exciting for patients, allowing for more price and information transparency, the new rules beg the question:

How the New Meaningful Use Program Impact

Hospitals and Healthcare Providers?

1. Reduces Unnecessary Redundancies
2. Challenging ‘One Size Fits All’ Pricing Approach
3. Emphasizes Need for Accurate RCM, Medical Coding and Billing

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 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.

2. 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.

3. 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.

Footnotes:

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 WWS today to learn more about our services, and how we can help hospitals and Healthcare providers to save time and money with our accuracy.

The recent changes and every additions and modification to it demand a considerable amount of training for the in-house staff. The training costs skyrocket and to make it worse, handling prior authorization for DME along with other routine billing responsibilities welcome more errors. That, in turn, forces rejections and denials.

At this juncture, providers could do well with helping a guiding star. One that could bail them out of the deep waters they are sinking into. They have found out that helping hand in the professional DME prior authorization services.

Some of the prior authorization services also go beyond the usual and offers extras like standalone services, free Telemedicine platform, and other solutions like Revenue Cycle Management and Practice Management. All these services come in affordable prices that help the providers to repair the damages done without having to spend much ultimately adding to the revenue recovery process.

Challenges of Prior Authorization

⇒DME prior authorization will be never like before. What was thought to be a great reform to check the rising prices of Durable Medical Equipment and bring an overall clarity in the DME prior authorization process turned out to create complexity and uncertainty instead.

⇒Health insurance companies normally require prior authorization for medications, durable medical equipment (DME) and medical services, and insurance authorization services are available to help handle the administrative burden associated with the process.

⇒However, the American Medical Association (AMA) notes that prior authorization policies are fraught with problems like inefficiency and lack of transparency, which undermines patient care and costs physician practices time and money.

⇒Medicare through its mandate (Final Rule) issued that it is not going to pay for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) without prior authorization. It was aimed to bring transparency in the whole DME prior authorization process and it has managed to achieve its objective to a certain extent.

Here are some steps that can physicians can take to obtain preauthorization and prevent denials:

Be familiar with the coverage and preauthorization guidelines of each payer:

Surgeons must be aware of the coverage and preauthorization guidelines for payers and provide a specific diagnosis on their reports.

Follow the recommended treatment guidelines: 

Physicians should make sure they are following the recommended treatment guidelines before ordering a high-cost procedure for a patient.

Ensure preauthorization even for mundane procedures: 

Two most common procedures that insurers require preauthorization for are imaging procedures such as computerized tomography (CT) scans and magnetic resonance imaging (MRI), and brand-name pharmaceuticals.

Take steps to protect against denials: 

Providers need to have relevant information about the procedures that they routinely perform and enter into the contracting process with this information. They should have evidence to prove the medical necessity of particular procedure as well as reliable resources on coverage for certain diagnoses. Such information would also help during reimbursement negotiations.

Meet the all-payer criteria: 

Providers should make sure that they meet all of the payer’s criteria before submitting a prior authorization request.

Update contracts with insurance companies: 

Insurance companies may update their coverage policy from time to time. Providers need to track these changes and update their contracts to maintain coverage

Conduct regular audits: 

Regular preventative audits can detect issues and help identify typical denial trends for certain procedures. This will allow providers to correct minor problems that may be responsible for a large proportion of the denials. Audits should focus on diagnosis codes and final payment.

Connect at +1(302) 613-1356 or E-Mail at support@wonderws.com to discover how we can help your complex prior authorization process making it simpler and cost-effective service.

When you own medical practice, you have to wear several different hats (as the saying goes). Sure, you obviously wear a doctor “hat,” but other ones tend to be more business-centric.

Keeping a close eye on your incoming revenue streams and outgoing budget will allow you to understand where your practice’s money is moving, but viewing this data more analytically can do even more for you.

Ideally, you should regularly be taking time to observe your practice from a high-level viewpoint with the intention of identifying new sources of profit.

As we look at ways to identify new revenue streams for your medical practice, the best starting point is to establish or reevaluate your vision.

Before you jump into new potential revenue streams, see if you can identify any bottlenecks or inefficiencies in your office’s processes. In doing so, you may be able to find opportunities to strengthen existing revenue sources.

Of course, it also makes sense to research and implement new revenue streams like

1.Have a vision

While this might seem like an obvious point, all businesses – medical or otherwise – should have an established vision for the future.

If you don’t have a vision in place, take some time to think about exactly what you want to achieve with your practice. Naturally, you likely started practicing medicine to help people, but this is your business and you have the opportunity to make it as successful as you want. That only happens, however, when you have clearly established goals.

2. Consider your services

Regardless of what line of medicine you practice in, it can always be helpful to consider the various services that you offer. While it will be harder for specialty-driven practices to add additional services than it might be for a general practitioner’s office, it’s still something worth considering.

For example, if you specialize in ophthalmology, you might simply add more diagnostic services in order to increase revenue.

Individuals will be able to gain insight and advice from you, creating a new revenue stream for your business, and then move on to an appropriate specialist to have their procedure completed if necessary.

3. Target new demographics

One of the best ways to find new revenue streams is by targeting potential patients. While you won’t necessarily be able to broaden the scope of services offered by your practice too greatly, you can considerably expand the number of people aware of your office.

For example, Medical Economics has indicated that posting writing on your work through social networks can help foster a larger awareness of your practice. To ensure that you aren’t leaving any stone unturned, make sure that your practice has a well developed and actively maintained a social presence on popular media sites like Twitter and Facebook.

Reach me @ support@wonderws.comso we can discuss your medical practice’s business needs together, and then determine the next steps so your practice can be everything you want it to be.