We are currently using expEDIum Medical Billing software from expEDIum. We are convinced that this software is the best in the market for our requirements. The superb after-sales service rendered by the company staff is second to none....
Ruby, Administrator, Hospital Internists
A clinic with ten providers that used an outsourced billing company to process claims. They provided inpatient consulting for over ten hospitals and submitted professional claims for their services. The billing company was using legacy billing software.
The issues faced included:
- Not having an integrated electronic claims processing and submission,
- A better view of the claim life cycle and a level of automation,
- Consistent stream of cash flow and a process-driven claims processing,
- Secondary claim visibility and follow-up,
- Data analytics/dashboard and
- Constant denial/rejection/error claims follow-up.
expEDIum migrated this client from their legacy system to the expEDIum Medical Billing solution along with the patient and claims data. expEDIum eMB addressed the main issues faced by the clinic. In addition to the above issues, the answer has a built claim validation and a claim scrubber that ensures only error-free claims are sent to the clearinghouse and the payers. The solution streamlined their billing operation by standardizing the processes, making the claim life cycle more transparent. The biller was able to increase productivity and simplify the billing operation. The billing operations were more streamlined with automation and less paper handling concerning bookkeeping, invoices, etc.
The providers could access their data using secure provider logons, and the clinic administrator had various reports available to her at any time. This installation used Availity, OfficeAlly as clearinghouses, and Payspan Health to receive ERAs from specific payers.
Return on Investment (ROI)
- The clinic processes over 1000 HCFA claims monthly with a denial rate of less than 6%.
- The overall productivity improved, resulting in better claim visibility and denial/rejection processing.
- This installation receives Electronic ERAs (that are auto posted) for about 65% of the claims sent and the remaining 35% on paper EOBs (that are manually posted). The 65% auto posting saved almost a person month of data entry time per year.
- The secondary collection went up from 8.8% (of total charges) to 11% due to increased visibility, resulting in an additional $14,600 collection per year since they started using our solution.
