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Last time we talked about why you need to think about getting online, and why your site needs to look good when you do. Today, we’re going to break down one very specific aspect: When you have a presence, suddenly, you have presence. Now that sounds ridiculous, we’ve got it, but bear with us for a moment. When you build a site, and you’ve never had one before, you’re now reaching not just the folks who heard about your practice from Mary and Joe across the street, but, instead, the 300,287,577 internet users in North America alone. Sound better? We thought so, too.

So, you’ve got your site, which means took you our advice. Now that you have a site, you’re now google-able, which means that people now know you’re actually a thing, and that means your practice exists to that 8.5 of 10 North Americans who rely on the internet for virtually all of their information. Don’t take it from us, though, here’s what the folks over at Small Business Trends have to say:

“You stop being invisible. I’m not trying to be flippant, but by creating a website you stop being invisible to the people trying to find you online. More and more studies are telling us about the ROBO effect where customers are learning to research online before buying offline. They’re typing their problems or needs into the search engine of their choice and are researching the companies that appear for those queries. If you don’t have a Web presence, there’s no chance of you showing up and you never even enter into their thought process. In 2011, you can’t afford to be invisible.” –from 5 benefits to having a website for your small business by Lisa Barone on smallbiztrends.com

If that doesn’t drive home that you needed your new shiny site, allow the date to inform you of just how outdated not having one truly is. It was unacceptable to not have a website in 2011… In other words, without one until now, you were 3 years+ past being obsolete. Ouch. (Smarts a little, doesn’t it. It’s ok though, we’re here for you.) With all of that in mind, here’s the bright side: 

“The top benefit of a good website is that it provides another avenue for customers and prospects to find your company. Having a good website shows professionalism and provides customers and prospects with an easy way to engage and share your business online. In essence, your website is available and ready to promote you when you are not. It’s self-sustaining and a great way to attract customers.” –smallbusiness.yahoo.com

So, that’s a thing to feel good about, right? You’re online, people have new exciting ways to get to you. That’s phenomenal, right? Absolutely, but you’re skipping ahead of yourself a bit, so let us help you with that. You’ve made it to the 21st century, and now you’re going to get all of the internet business ever, because that’s how the internet works, right? Not quite. The internet is fickle beast, and to tame it, you have to utilize one tiny (read: massive) piece of it: SEO. What’s that? “SEO: Search engine optimization (SEO) is the process of affecting the visibility of a website or a web page in a search engine's "natural" or un-paid ("organic") search results.” –Google

Basically you have to manipulate the internet with your web wizard powers to make search engines recognize that you’re worth paying attention to. Here’s an article to one of the best ways we’ve seen it explained: http://www.hongkiat.com/blog/beginners-guide-to-seo-best-practices-part-13/ SEO is important, because, without it, you won’t show up in the base-line searches performed by the clients you want. You’ll still show up in searches across the board, don’t get us wrong, but you’ll be really far back on the list, unless google is including location data in the user’s search. There are a lot of algorithms and huge amounts of information that could be divulged upon for days, but we’ll leave you with simply this: You want the search engines to know you’re there, so get on the SEO as soon as you can. It’s vital.

Dealing with insurance claims can be a stressful situation for patients, and it is the role of both the provider and payer to streamline the process of health insurance reimbursement. Since healthcare business practices are becoming increasingly digitized, it makes sense to submit patient medical records digitally as well.  Electronically attaching medical health records to claims can both save time and money, as well as potential headaches when it comes to inevitable document requests during claims adjudication.

Considering that many hospitals and doctors offices are utilizing electronic health records, the next logical step is a system that enables sending that information to insurers with the initial electronic medical claim.  Processing a claim manually can cost three times as much as processing a claim electronically, which means that any additional automation can be an improvement.  When faced with a medial records request, having all of the relevant documentation available digitally – as an attachment - can cut out steps in the process.  In fact, systems like MEA|NEA’s FastAttach™ have been shown to result in faster reimbursement, improved client service, and reduced overhead.

The truth is that an insurer requesting medical records is not uncommon, and a provider may have to submit the entirety of a patient medical record as an attachment to a claim – documentation that can be hundreds of pages long.  However, if that provider is already using electronic records, then submitting them as an electronic attachment makes what could have been a headache into a simple task with a click of a mouse.

Electronic attachments also make it easier to comply with industry formatting and security standards, as well as government regulations.  An electronic attachment solution can ensure HIPAA compliance in sending and obtaining medical records, and simplify things moving forward with expected changes to Medicare documentation requirements.  This technology also decreases the likelihood of lost documentation or mistakes, and increases the number of claims that payers can adjudicate on a daily basis.

Business processes in a large variety of industries are becoming increasingly digitized.  In the new era of the paperless office, it is not uncommon for all kinds of data to be transferred electronically rather than on paper.  The healthcare industry is no exception, and electronic attachments for insurance claims are just one type of EDI in healthcare.  But what is EDI?  Electronic data interchange is more than just email; it is a structured way to transmit data between computer systems, governed by standards that are extremely important for medical claims.

Organizing and sending data between parties in the medical and dental industries has always been a complicated process, particularly in the management of both patient medical records and health insurance reimbursement details.  However, thanks to increases in efficiency, EDI implementation has proven to both save time and save money.  An important element in EDI is that of standards. Each EDI document has a standardized format, which ensures that data can be quickly sent and interpreted on both sides.  It is particularly important that providers and payors utilizing healthcare EDI transactions follow HIPAA regulations and ANSI standards.  EDI formatting specifications are like blueprints for data, EDI guides that serve to make transitions between different data trading partners as smooth as possible.

The reason that EDI has become especially important with respect to insurance claim documentation is the proven increase in efficiency seen with the use of electronic attachments.  Not only do electronic attachments streamline the process, but CMS and commercial payors also require medical necessity documentation for certain procedures or events.  When supporting documentation is included along with an initial electronic claims submission, both providers and payors can see the benefits, such as fewer denials and rework requests and an increase in ROI.  In fact, even though attachments only represent a small part of the electronic claims process (perhaps 10% of claims); they have been shown to have a significant impact on the speed of insurance reimbursement.

When it comes to healthcare, increased efficiency is key.  Waiting for health insurance reimbursement can not only be stressful, but the longer it takes for a claim to be processed, the more resources it consumes from both providers and payors.  The process from claim to reimbursement has a number of steps – but the good news is, new technology has provided ways to cut out some of these steps to streamline the process.  Electronic attachments are one such technology, and among their other benefits, their use may also eliminate some of the need for document imaging.

Consider all of the paper that traditionally fills a healthcare billing office: not just records, but also bills, purchase orders, and supporting documentation.  As healthcare providers move toward the digitization of their business practices, many have been hiring document imaging companies to scan documents into digital format.  Even though the individual practice of how to scan a document is not a complicated one, the sheer volume of paper has led to this being a potentially costly venture.

On top of the initial investment of digitizing past paper documents, providers often continue to pay for document imaging of claim documentation for insurance claims.  In fact, without an electronic attachment solution, documents to be attached to claims may have to go back and forth between being scanned and printed, if they must also be sent manually to insurers – and possibly then scanned on the payor side as well.

An electronic attachment clearinghouse can eliminate some of this burden by ensuring that there is a central repository of attachments that both providers and payors can access from a computer.  Any document imaging must only be done once – or not at all in many cases with electronic patient medical records and electronic charting becoming the norm among healthcare providers. 

Eliminating any step in the claim adjudication workflow can be an improvement in a potentially lengthy process, and electronic submission of attachments has proven to have benefits for both providers and payors.  For example, the savings in time, paper, and postage alone can result in increased ROI, and experiences has shown that without as much paper to wade through, an insurance reviewer can process more claims in a single day, leading to quicker time to reimbursement.

Even though attachments are only applicable in about 10% of claims, they are known to have a significant effect on the speed of reimbursement; MEA|NEA’s clients have reported reducing their outstanding receivables by 10 to 14 days after implementing the attachment solution FastAttach™.  Additionally, FastAttach™ works with any document imaging system that might already be in place.  Whether eliminating steps or supplementing the current process to make it more efficient, electronic attachments work to streamline the claims workflow from all sides.

There’s no question that the healthcare industry is on its way to completely digitizing business processes. The EHR Stimulus Alliance produced a dramatic increase for healthcare providers to not only adopt EHR, but also to begin digitizing other business practices, such as e-billing and the automation of health insurance claims submission. According to a recent study from CompTIA, half of healthcare providers are currently using EMR/EHR systems, and one in three healthcare practices expects to increase their IT spending by five percent over the next year.

One area experiencing substantial growth, and where technology can have a significant impact on the billing process, is electronic claims submission. A 2006 Milliman study revealed that it costs $6.63 to process a claim manually, compared to $2.90 electronically. Because of this significant cost savings, a number of health insurers are beginning to require claims be submitted electronically. Therefore, it’s not surprising that America’s Health Insurance Plans (AHIP) found that 75 percent of all health insurance claims are now submitted electronically, up from 24 percent in 1995. There are obvious additional benefits to electronic claims submission, such as:

Reduced administration time

Increased accuracy

reduced reimbursement period

The Cost of Attachments

Although electronic claims submission is becoming standard practice, claims that require additional documentation are still primarily being submitted manually. Only 4-10% of all claims require attachments, but they tend to have the most significant impact on the payment cycle. A 2002 Health Insurance Association of America (HIAA) survey found that lack of information was the primary reason for pending claims.

Attachments average 4 pages in length and are traditionally submitted manually via paper. If a medical billing manager does not utilize electronic attachments, they must submit the entire claim and attachment manually, thus taking time away from value-added business processes. Paper claims and attachments submissions take anywhere from 28-120 to be processed by the insurer, however electronic submission are often processed in 7-14 days, greatly reducing the reimbursement cycle.

A typical medical billing organization submits an average of over 750,000 claims annually. If just 4 percent of those claims require attachments, that’s 30,000 claims, and at an average of $6.63 per manual claim, the cost equals almost $200,000. In comparison, it only costs $87,000 to process 30,000 claims electronically at $2.90 cost per claim, resulting in a savings of over 50 percent.

Furthermore, the requirements for attachments are already beginning to rise with The Center for Medicare and Medicare’s (CMS) nationwide RAC audits. CMS can request additional documentation on 1 percent of all claims submitted for every 45 days of the previous calendar year. So for example, if a provider submitted 426,000 claims the previous year, CMS could send up to 532 additional documentation requests every 45 days.

If the responsibility of the medical billing department is to maximize the revenue per claim and minimize the cost per claim, it only makes sense to employ an electronic attachments clearinghouse to completely automate the claims submission process. Most electronic attachment service providers, like MEA|NEA, Renaissance, or Jopari, are secure and HIPAA compliant, and do not require software upgrades.

Eliminate Paperwork and Phone Tracking

With lack of documentation often causing pending payments and denials, more administration time must be dedicated to rework, follow-up, and resubmit claims. When filing a claim that requires an attachment, the billing manager must fill out the 837 claim form on the computer, but then also print out that form along with the required documents and images for the attachment, which can range from 4 to 20 pages in length. The claim and attachments must then be either faxed or mailed, and receipt and approval of claim must be verified with the insurance company via phone. The average paper claim takes 20 to 30 minutes to track and costs $3.70 to verify via phone, whereas an electronic claim and attachment can be verified and tracked on a web portal without ever having to pick up the phone.

Imagine time and cost savings if paper and phone tracking were completely eliminated from your administration tasks. By employing electronic attachments, PHI and other Healthcare Documentation can be submitted, tracked, and stored through the electronic attachment clearinghouse secure web portal.

Increase Accuracy

According to the National Healthcare Exchange Services, one of the top reasons claims are denied is because additional documentation is required. Adding electronic attachments to the claims process not only further reduces the room for human error, but also allows you to submit attachments with the initial electronic claim submission, thus greatly increasing the first-pass rate on many claims.

Being that most providers are using EHR, claim attachments that are processed by paper increases the likelihood for duplicate claims, which not only doubles the claim compilation costs but also the administration time to identify and delete the duplicate claim. Attachments also create more documentation that must be generated and reviewed by several claims processors, and increase the probability that information could be entered incorrectly.

When submitting attachments electronically, the required documentation is scanned or uploaded into standard formats, so errors and omissions are more easily identified and information loss is minimized. Furthermore, the attachment can be viewed by up to five processors at the same time, and some electronic attachment clearinghouses will also prompt the billing manager to recognize when additional documentation is required for a claim.

Overall Improved Payment Performance

Attachments are a small piece of the claims process, but can have a dramatic impact on the speed of the payment process. The average billing cycle for a clean electronic claim is 7 to 14 days compared to the 28 days for a clean manual claim. Attachments create extra administration steps, additional documents and images to gather, and more room for data entry error, which means a higher probability for claim rework and a longer billing cycle.

With electronic attachment submissions reducing administration tasks and time, as well as improving first-pass rates, it’s no surprise that overall payment performance will improve. For example, Emblem Health dental division processed almost 20,000 electronic attachments last year, and when calculating the average cost per claim, they’ve saved close to $74,000. Because of these dramatic costs benefits, Emblem Health is currently expanding electronic claims and attachment services to their medical division.

The healthcare industry is becoming increasingly efficient by digitizing electronic patient medical records, medical claims, and insurance claim documentation.  An important part of this electronic shift is electronic attachments, such as those that include supporting documentation for electronic claims.  Not only can submitting claim attachments electronically save money and time, but soon there will be specific government regulations requiring their use for specific procedures or events.

The upcoming requirements will require payors to accept six types of medical electronic attachments in a standardized format.  These include lab, ambulance, emergency department, rehabilitation, clinical, and medication reports.  By making this process paperless and standardized, medical documentation can be included with the initial electronic claims submission Thereby eliminating paper out of the claims submission process.

There are a number of recognized benefits gained from the electronic submission of attachments for both providers and payors.  The savings in time, paper, and postage alone can result in increased ROI.  Providers will see fewer denials and rework requests typically seen with failures to provide additional documentation, and Payors will have fewer claims pending while waiting for documentation requests.  Another way to save time is submitting all supporting documentation that is often requested by payors for specific procedures, with the initial claim; referred to as an unsolicited attachment.  Additionally, the number of claims that an insurance reviewer can process in a single day is limited by the amount of paper they have to wade through; experiences has shown that an electronic attachment solution results in the number of processed claims increasing without an increase in staff.

While some claim that the recession has hurt health care market initiatives to improve revenue cycle management (RCM) and has decreased the importance of healthcare back office technology investments, the global recession, the movement towards consumer medicine, and government legislation have actually made RCM and related technology vital to payer and provider operation. In fact, according to an article in Healthcare Financial Management magazine, strong RCM processes make the difference between profit and loss, accounting for up to $9 million in yearly revenue for a typical 300-bed hospital. The same report indicates that costs could be even higher, because RCM technology has an effect on metrics that are difficult to quantify, such as:

  Lost charges,

Incorrect payments,

Repeated and redundant work.

  Furthermore, a recent report from HIMSS indicates that increasing RAC audits, movements towards managed care, and a larger focus on customer experience are the inspiration for adopting electronic claims and attachment processes. These technologies have the highest adoption rates in organizations looking improve their RCM.

The true cost of rework

The article cited above states that 75% of business office staff in any hospital is dedicated to the massive amounts of work necessary for reworking claims, attachments, and bills. Note that this does not include the number of floor staff members, such as and case workers working to investigate, revise, and refine patient account paperwork.

  Although providers operate in much smaller profit margins (often less than 2%, according to a report from Mark Anderson and the AC Group) the true cost of rework must be examined by both payors and providers. Payors must retain adequate staff levels for documenting denials and reviewing resubmitted claims that often have additional supporting documentation. In order to succeed and thrive in a health care environment that increasingly relies on consumers, costs need to be managed or cut on both sides, if health care groups want to stay competitive and profitable.

  While the prospect of controlling this situation is daunting, electronic systems, and electronic attachments in particular, have great potential to improve RCM in a variety of ways, including reducing or eliminating rework, improving collection schedules, and increasing revenues.

  How electronic attachments strengthen RCM and boost revenues

RCM can be the difference between profit and loss, and since rework is perhaps the largest complicating factor for any RCM program, electronic claim and attachment submissions, are a clear contender for “best” way to improve RCM by reducing rework and streamlining process.

  Electronic submissions and attachments improve RCM by:

  Drastically increasing first-pass rates,

Reducing the 30-day average for reimbursements and payments,

Controlling and reducing administrative costs.

Improving Accuracy

According to Aetna, one of the most unfortunate realities in the health care industry is that, on average, only ¼ of all health care claims are approved on the first pass. A major contributing factor to this bleak situation is inaccurate submissions and attachments. Electronic submissions and attachments improve RCM efforts by driving first-pass submission success further than traditional methods. Electronic submissions and attachments can help organizations to reduce or improve staffing control because claims are initially submitted with the necessary supporting documentation.  

  Electronic processes improve this rate by putting information directly into standard formats and transmitting information via electronic means, so errors and omissions are more easily identified and information loss is minimized. No more illegible handwriting and lost mail. In addition, electronic attachment service providers like MEA|NEA have proprietary systems that automatically review images and other information for fidelity.

Increasing speed

The average hospital receives complete payment 75 days after services are provided, and fails to collect up to 4% of revenue. Compare this to an average 28-day cycle for other markets. The truth is that electronic claims and attachments reduce the length of the average payment cycle to only 7 to 14 days. In fact, on rare occasions, clients working with MEA|NEA have received payment for services in as little as 3 business days.

Slashing Overhead

HIMMS recently reported that, of the $1.3 trillion in outlays spent in the health care industry, 31% of that, or about $403 million dollars, goes to administrative costs. That means that about 1/3rd of the cost of running not just hospitals, but payment organizations as well, goes to administrative and paperwork costs. Electronic submissions and attachments slash this cost by 50% or more by automating the submission process. Not only are submissions made without the need for labor-intensive filing or processing, but they are also stored in perfect condition for years, making recall and review quick and easy.

  The most progressive and flexible aspect of electronic attachments is they need not replace existing processes. Organizations that are ready to experience the advantages of automation, but are not ready to retrain employees on an entirely new process, can simply add a layer of electronic management over traditional methods, rather than replacing them completely.

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