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Case Study
Efficiency and Accuracy Drive Improved Performance and Satisfaction - Patient Access
“We are now able to process claims daily and obtain faster reimbursement, and claim denials are less than two percent. We can also provide our clients web-based access to all their data while still complying with HIPAA.”
- Donna Gailey
Chief Executive Officer Emergency Billing, LLC
Maysville, Ga
Customer
Emergency Billing, LLC
Maysville, GA
Challenge
Obtain timely eligibility verification and accurate claims processing, and give customers direct access to their data.
Products
Revenue Performance Advisor
Results
- Real-time eligibility verification
- Claims processed daily with less than a 2% denial rate
- 24/7 web-based access for customers
The Customer:
Located in Maysville, Georgia, Emergency Billing is aptly named: it provides comprehensive billing management to organizations providing emergency response services, such as ambulance companies and fire departments, as well as to hospitals. Established in 2006, the company also provides business administration services and has more than 31 clients located around the country.
Employees at Emergency Billing take great pride in their collective depth and breadth of expertise; they have decades of experience with billing procedures, accounting, insurance, compliance and coding. The team is even prouder, however, of its customer service and its track record for helping every client obtain both faster payments and more revenue.
The Challenge: An Inability To Give Clients Direct Access To Their Data, and Dissatisfaction with a Processor’s Service and Support, Results in Inefficiency and Frustration
Donna Gailey, chief executive officer for Emergency Billing, was ready for a change. The claims processer her company was using in 2011 was not meeting her expectations for service and support, which resulted in numerous issues.
“Eligibility verification was consistently unavailable,” remembers Gailey. “And when an error occurred with a claim, we were given the runaround. The clearinghouse would not speak to clients directly, they would only talk to our software provider, who then told us it was a clearinghouse issue. They were always blaming each other and it was an endless cycle; we spent hours on the phone checking eligibility and getting claims processed correctly.”
Another point of dissatisfaction: Emergency Billing’s clients did not have direct access to their own data to be able to check claims status and forecast revenue, so Gailey’s staff had to pull and send reports from their software any time clients needed information.
It was a cumbersome, time-consuming operation, and staff knew they could do better with the right solution.
The Solution: Access To Real-Time Information, Streamlined Workflows, and a Web-Based Interface for Clients
Armed with specific criteria, Gailey’s team searched online for a solution, and also sought recommendations from their software vendor.
“We needed a solution that was compatible with our software, that provided eligibility verification for multiple payers in one location, and that processed clean claims in a timely manner,” she says. An additional requirement was the ability to offer clients web-based, HIPAA-compliant access so they could independently view their own data.
“And we also wanted a partner willing to solve any issues that might develop,” she adds.
Holly Gibson, an account representative for Emergency Billing, says the team chose Revenue Performance Advisor from Change Healthcare because “it offered all the tools we desired in a userfriendly format.”
Revenue Performance Advisor offers billing companies connectivity to more than 2,100 commercial and government payers nationwide via the Change Healthcare Intelligent Healthcare Network™.
Emergency Billing’s motto is ‘Increasing Revenue, One Client at a Time.’ Revenue Performance Advisor has supported our business strategy by processing claims efficiently and by allowing our clients to actually see their revenue increase in real time.”
- Donna Gailey
Chief Executive Officer
Emergency Billing, LLC
Maysville, Ga
This enables real-time eligibility verification and streamlines claims processing. Other solution benefits include the ability to track and manage any rejections or denials expeditiously, and to offer clients visibility into the process.
“The most significant feature for us is the ability for our clients to view claims and remittances,” explains Gibson. “This allows them to view the processing of a claim from the time it is received at the clearinghouse, to when it is sent and accepted by the payer, to when payment is made. It helps answer their questions as to when they will receive payment.”
Web-based access also means Emergency Billing staff and clients can view the same data simultaneously and work as a team to proactively address issues at any point in the workflow. When evaluating solution options, Gibson says it was reassuring to learn Change Healthcare was already familiar with their billing software, and the Revenue Performance Advisor solution came highly recommended from two of Emergency Billing’s own clients.
The Result: Efficient Claims Management, Happier Clients and Better Relationships with Payers
Gailey says partnering with Change Healthcare has been the antidote to operational inefficiency:
“We are now able to have claims processed daily and obtain faster reimbursement for our clients,” she says. “Claim denials are less than two percent and we have a better relationship with payers.
“In addition, our clients can access their electronic claims and remittance data 24 hours a day, seven days a week, versus having to contact our office during business hours. This provides a competitive advantage because informed clients are happier clients.”
Gailey says Change Healthcare staff has also met her company’s expectations.
Their customer service is second to none,” she says. “We have a personal relationship with them. When I have a client I’m bringing over from another billing company and they aren’t collecting any money and don’t have 30 days [to transition], I pick up the phone and call Change Healthcare and say, ‘Can you help me?’— and they are on it.
“My staff tells me, ‘You can change anything in here, but do not change our claims processer.”
Revenue Performance Advisor: Capabilities Important To Billing Companies
- Onboarding is quick and easy: the same enrollment tools are used for all clients so the process is repeatable, scalable and efficient
- Flexible work queues allow you to tailor the product and reporting to workflow and site preferences
- Real-time dashboards can be customized to report on an entire customer list, or by customer group, practice or individual provider
- Clients have access and transparency to all of their data
- Reports can be scheduled for auto-delivery to clients
- Reports can be scheduled for auto-delivery to clients
