Electronic Medical Claims Filing
The Problem: Insurance Companies Hate To Pay What They Owe
As you probably know, the whole process of filing insurance claims is cumbersome, time consuming and energy-draining. The insurance companies have made it as difficult as possible to get paid; they obviously have a vested interest in paying out as little money as they possibly can. One of the best ways they've found to hang on to their money a little longer is that they've created this extremely difficult set of hoops that doctors have to jump through to file and collect their insurance claims.
The energy-draining process is probably all too familiar to you already. First, you’ve got to spend an average of 10 to 15 minutes filling out the CMS 1500’s. That could take hours a day if you have very many patients. Then, if there's any minute detail on that paperwork that's not filled out exactly correct, the insurance company rejects the entire claim and sends it back to you—unpaid. So then you have to figure out what the problem is, attempt to fix it, and then re-submit it and hope you’ve gotten it right the second time around.
The results of this frustrating process are startling: A whopping 32% of claims are rejected, 5 to 15% are lost in the shuffle and NEVER collected, and the average time it takes the doctors to collect their money is 60 to 90 days… and it can be even longer for Medicaid claims.
Then, besides stretching the time it takes to receive payment, this process also presents you with another major problem: It takes a tremendous amount of employee and overhead cost for you to mess with this whole claims filing process. In fact, the New England Journal of Medicine says that a doctor's overhead and billing expenses account for 43.7% of his gross income. That translates into an average of about one and a half clerical workers per doctor at an average cost of $51,564...not including hidden costs like vacation time, insurance, and the like.
The Solution: Electronic Medical Claims Filing
That’s where electronic medical claims filing comes into play. Instead of you relying on your staff to laboriously file claims and then try to baby-sit them through the approval and collection process—and then wait 90 days before seeing a penny of the money—now you can outsource the entire process to a medical billing professional. We are trained professionals who are equipped with proprietary, state-of-the-art software that allows us to electronically file the claims for you. The benefits to your practice are enormous.
Eliminate Software Hassles
You've heard that the Internet would change your world. Now it has. With the our Practice Management System there are no upgrades, no installation, and no hassles. You have access to your client's data 24 hours a day, 7 days a week via the Internet.
Benefit #1:
FASTER…Much Faster: Electronic filing drastically reduces the amount of time it takes to collect from the insurance companies from 60 to 90 days to just 7 to 21 days. This is possible because electronically filed claims are handled by computers and therefore bypass all of the low-wage, untrained human "gate keepers" that work the low-level clerical jobs for insurance companies. These "gate keepers" are the ones who ultimately determine whether or not and how fast you should be paid. But when it’s all handled by computers, there’s no people to bog down the process.
Benefit #2:
LOWER Rejection Rate (By Far): The rejection rate for claims plummets from over 30% to under 2%. Obviously, claims that aren't rejected move through the system a lot faster. Plus, claims that are mysteriously "LOST" by the insurance companies and never paid are eliminated altogether. They can’t be lost when using electronic medical claims filing because they produce an acceptance report from the carrier that ensures receipt.
Benefit #3:
FREES Your Time: This benefit is not always quite so obvious to doctors, but is very significant nevertheless: Many doctors spend as many as one and a half to two hours a day supervising and working on insurance claims. Or at the very least, they have a high-paid staff person working on them. With electronic medical claims filing, you free up your time to either see more patients…and therefore make more money... or else spend more time to playing golf or spending time with your family. If out-sourced electronic medical claims filing frees up the time of one or two of your staff members, now that person can be making patient calls and running the office more effectively instead of worrying about medical claims all the time.
Benefit #4:
IMMEDIATE Cost Savings: You will realize a real and immediate cost savings when you outsource the billing to us. A recent survey in the Medical Group Management Journal showed that the average cost of internal billing departments was 11% of the practices' income. Our outsourced billing services, on the other hand, only charge anywhere from $2.00 to $6.00 per claim to perform the same service, depending on the volume and complexity of the situation. That’s usually 5% or less of the practice's income. And that's just the front-end direct costs of collections. That doesn't even take into the increased effectiveness and efficiencies of actually collecting the money that we've already listed.
