RemitDATA | Case Study
Precise Medical Billing, Inc.
RemitDATA.com
Billing Company Improves Efficiency and Service Levels
with RemitDATA Solutions
Challenge
Even for an outsourced billing company with extensive revenue cycle expertise,
there are opportunities to improve the time- and labor-intensive processes
of tracking claims, handling rejections, and following up on pended claims.
When RemitDATA approached Precise Medical Billing, Inc. (PMB) with solutions
to streamline its manual processes, PMB jumped at the opportunity.
PMB is an outsourced medical
billing company providing
services to more than 60 physician
practices across numerous specialties.
In addition to managing the
Solutions
PMB started by using Reimbursement PRO™ to improve the tracking claims
and remittance, and later added the analytics capabilities of TITAN® to
benchmark client performance and track claim and reimbursement trends.
Results
Reimbursement PRO replaced PMB’s manual processes, making it easy to
electronically look up patient accounts, track rejections, set automated
follow-up reminders, and resubmit claims using forms stored within the solution.
TITAN enabled PMB to benchmark client performance against peers and provide
detailed reports about missed revenue opportunities — all of which improved
efficiency and enabled PMB to deliver a higher level of services to its clients.
revenue cycles of its clients,
PMB also provides training for
medical billing professionals.
Benefits with real ROI
Lower A/R and Denials
Better Processing Time
Reduction in Errors
Improved Client Relations
BACKGROUND
Medical billing is time consuming and confusing, which is why many physician
practices hire outsourced billing companies to handle the task for them. The
challenge for a medical billing company is organizing and managing all aspects
of their client’s revenue cycle and at the same time analyzing and measuring
every step so that even the smallest negative trend can be corrected to maximize
revenue and productivity.
These are the challenges that Precise Medical Billing, Inc. (PMB), Warren Mich.,
faced on a daily basis. PMB is an outsourced medical billing company providing
services to more than 60 physician practices across numerous specialties. In
addition to managing the revenue cycles of its clients, PMB also provides
training for medical billing professionals.
Accelerated Staff Education
RemitDATA | Case Study
Precise Medical Billing, Inc.
Billing Company Improves Efficiency and
Service Levels with RemitDATA Solutions
Until 2012, much of the work that PMB performed for its clients required
tedious manual efforts to track claim rejections, reconcile accounts, file
appeals, and search for 835 remittance statements contained in paper-based
and electronic files. In addition, a substantial amount of time was spent either
on the phone with payers to research claims, or accessing individual payer
websites to download forms and other information.
“TITAN allowed us to
Reimbursement PRO Increases Transparency
perspective, since we
RemitDATA contacted PMB in 2012 and told them about Reimbursement
PRO and how it could streamline revenue cycle processes and provides
transparency into denied claims. “We didn’t know that there was a solution
out there that could help us better manage the process until RemitDATA
told us about Reimbursement PRO,” said Sandia Wagner, CEO of PMB.
Reimbursement PRO is a Web-based solution that provides management
reports, work flow tools, on-demand explanation of benefit (EOB) statements
and historical query tools to help billing companies reduce collection costs
and simplify the entire reimbursement and reconciliation process. Since it is
delivered using a software-as-a-service (SaaS) model, there is no software or
hardware to implement or maintain. Organizations simply subscribe to the
service and begin using it.
Automated Reminders
PMB began using Reimbursement PRO in July 2012 to improve the efficiency
of managing its clients. “With Reimbursement PRO, each account is assigned
to a biller and all 835s go into that biller’s queue, so that when they sign into
Reimbursement PRO, all of the rejections pop right up,” Wagner said. “It’s a
great solution to track rejections and to put claims into a pended folder for later
follow up using the system’s automated reminders. Before, if we put a claim
into a pended folder, we had to remember to come back to it at a later date.
With Reimbursement PRO, we get an automated reminder on the date we specify.”
Easily Access EOBs
Reimbursement PRO also simplifies the task of searching for EOBs when researching
denials and reconciling accounts. “We love that we can just enter a patient’s name
into Reimbursement PRO and view all of the EOBs for a certain date or date span.
This is particularly useful if a claim is rejected as a duplicate, since we can simply view
the claim history in Reimbursement PRO and see when or if the claim was paid, which
look at the revenue
cycle from a different
could pull up information
for each of our physician
practice clients, such
as looking at all of
their rejections. ”
“With Reimbursement
PRO, each account is
assigned to a biller and
all 835s go into that
biller’s queue...”
RemitDATA | Case Study
Precise Medical Billing, Inc.
Billing Company Improves Efficiency and
Service Levels with RemitDATA Solutions
helps us reduce our client’s accounts receivable balance,” Wagner said. “The easy
access to EOBs also helps us when we are researching EOBs for tertiary claims. Since
Reimbursement PRO contains all of the EOBs for the particular patient and date, we
no longer have to go to different web sites or look through the scans for what we
need. This has cut down the processing time tremendously.”
“Having TITAN is a
TITAN Finds Missed Revenue Opportunities
great marketing tool
After using Reimbursement PRO for a few months, PMB added RemitDATA’s
TITAN to its product mix. “We started with Reimbursement PRO because it would
help improve our workflow processes, but as we learned about TITAN, we knew
we needed the in-depth real-time analytics and comparative peer data as well,”
Wagner said.
TITAN provides a real-time, transparent view into essential business metrics,
and includes a powerful analysis system with more than a decade of historical
claims data from providers across the country. Like Reimbursement PRO, TITAN
is deployed via a SaaS model, so no hardware or software installation is necessary.
TITAN analyzes ANSI 835 Electronic Remittance Notices for benchmarking
against regional peer practices, based on specialty and geography. The solution
delivers crucial information to help refine day-to-day processes that reduce
denial rates, accelerate cash flow, increase administrative efficiencies, and
anticipate audits. Through integration with the Practice Management system,
TITAN can also examine Accounts Receivable data for an in-depth cash flow analysis.
“TITAN allowed us to look at the revenue cycle from a different perspective,
since we could pull up information for each of our physician practice clients,
such as looking at all of their rejections. It allowed us to easily put a dollar amount
on all rejections, which we could take back to the physicians so they could see
their missed revenue opportunities. When you put a dollar amount on their
rejections, it has more meaning to them,” Wagner said.
For example, Wagner noticed that one of the bigger issues they were facing
was the lack of the practice’s front-office personnel verifying insurance benefits.
“In today’s insurance climate, patients can have regular Medicare or a Medicare
advantage plan. They can switch from one HMO to another in the commercial
and Medicaid market. These claims were being sent back to the offices to update
the insurance information. Many times once the insurance was updated, the
office would find that the patient was not in network with the particular insurance
or that the service required a referral. Prior to using TITAN, the physicians just
viewed this as the cost of doing business. However, once we were able to go
for our company
because it enables us
to offer these types of
benchmarking services
for our clients”
For more information
visit our website at,
RemitDATA.com
RemitDATA | Case Study
Precise Medical Billing, Inc.
Billing Company Improves Efficiency and
Service Levels with RemitDATA Solutions
into TITAN and put a dollar amount on the scenario, we got immediate action
from the offices and we were able to realize a amazing drop in the accounts
receivables,” Wagner said.
“In another situation, we ran an analysis in TITAN and asked for the 10 mostcommon rejections. From that report I was able to drill down and pull out which
offices were producing these rejections and then which patients. Using the
report, I was able to educate both the billers and the physicians. Somehow,
putting a dollar amount on the rejections has a great impact on how people do
their jobs. These are only a few examples of how you can use TITAN. Our accounts
receivables have gone down and revenues have gone up since using RemitDATA
and Titan. I personally would not run my company without them,” Wagner said.
Benchmarking Against Peers
“With RemitDATA’s
solutions our work gets
done so much faster
because we quickly get
all of the information
we need. We’re able
to get more money for
our clients and have
improved our operations.”
PMB recently started using TITAN to benchmark the performance of its clients
against peers, as well as benchmarking payment turnaround times and rejections
by payer. “Having TITAN is a great marketing tool for our company because it
enables us to offer these types of benchmarking services for our clients,” Wagner
said. “I recently met with one of our clients who is a podiatrist and I was able to
compare his performance against other podiatrists in the state.”
Increasing Efficiency and Effectiveness
Besides helping its clients earn additional reimbursement and reduce AR balances,
the use of Reimbursement PRO and TITAN have helped PMB improve its internal
operations. We literally used to spend days looking for EOBs and other information.
Now we can simply type in a patient’s name and quickly find the information we
need — all without printing out vouchers with a bunch of information that we don’t
need,” Wagner said.
The increased operational efficiency has allowed PMB to restructure its staff to
take on other responsibilities. “When our staff comes to the office, they can quickly
pull up an AR report and see where they should focus their efforts,” Wagner said.
“We’re able to get more money for our clients and have improved our operations.”
For more information
visit our website at,
RemitDATA.com