Client Background
The client is a renowned healthcare provider based in Virginia, delivering cardiovascular services to patients. The client has gained popularity in nearby regions because of their compassion, medical expertise, and willingness to deliver quality care to patients to obtain expected health outcomes.
Business challenges
While managing the patients using an EHR platform for a period of time, the client faced some challenges that affected the revenue of the practice. Some of the challenges faced by the client are as follows:
1. Difficulties in logging accurate time
Delivering care to patients with chronic diseases, such as cardiovascular diseases, requires a prolonged duration and various clinical activities. For each activity done on the patient profile, the client has to log the time manually, which leads to errors and justification issues. Also, it consumes a lot of time and manual effort.
2. CPT Codes assignment challenges
The client’s EHR software does not accurately assign the CPT codes according to the treatment, time logged, and service the care manager/physician provides. These errors in assigning accurate CPT codes with respect to the time spent and activity done lead to a loss in the reimbursement amount for the client.
3. Inadequate billing report
The billing report should include all the required details, such as conditions, service details, patient demographics, and service provider information, to obtain the maximum reimbursement.
The client’s EHR software lacked these details in the billing report, which caused the issues in the audit time log that resulted in the loss of reimbursement amount.
4. Billing status tracking
The client has managed a large number of patients, making it difficult to track billing and reimbursement statuses. Delays in submitting claims to the clearing house or insurance companies resulted in revenue loss for the client.
Solution
The client has approached Medarch Inc. for the eCareMD software with the intention of earning maximum revenue by overcoming the billing challenges. Our team of business analysts and subject matter experts took multiple interactions and demonstrations with the client to understand the requirements.
Upon receiving final approval from the client, our team implemented the eCareMD software in the client’s practice. After implementation, the client experienced increased revenue and a reduction in billing compliance issues.
Solution Highlights
The eCareMD software has addressed the client's challenges with its advanced technological capabilities. Some of the key features that overcome the client’s business challenges are
1. Automated time log functionality
To avoid missing time and maximize reimbursement, our eCareMD software has an inbuilt capability of automatically tracking the activity time. Once the care provider starts any activity over the patient profile, the automated timer gets started. It shows the time log screen with the duration once the activity is completed.
This accurate time tracking reduced manual errors and compliance issues in billing submissions, which increased the client's revenue.
2. Automated CPT code assignment
Accurate billing code assignment plays a crucial role in earning maximum reimbursement. To ensure this our eCareMD software comprises built-in ICD 10 codes, which automatically assign the correct CPT code according to the program, the time spent by the care provider, and the treatment given.
3. Individual and comprehensive billing report
The billing report should contain accurate information to ensure maximum reimbursement. Our eCareMD software allows care providers to generate monthly billing reports for individual patients and comprehensive i,e. for all patients. This report contains patient demographics, service provider details, eligible CPT codes, and service details with monitored time.
4. Efficient Tracking of billing status
Using the eCareMD software, care providers were able to mark the status of billing claims as submitted or put them on hold if anything was pending, there were issues in billing, etc. This systematic billing status marking helped care providers track the submitted claims and billing claims that had issues and errors.
Value Delivered
1. Accurate time tracking for activities
The automated time-tracking functionality improved the accuracy of logged time and reduced the manual activities for logging time.
2. Increased billing accuracy and reimbursement amount
With automated CPT code assignment, the accuracy of billing has improved, which has resulted in increased reimbursement amounts for the client.
3. Reduction in delays for submitting billing claims
The eCareMD software enabled care providers to mark the status of billing claims as submitted or put them on hold for issues and errors. It helped care providers to resolve the issues of billing errors and submit them.
4. Increased practice revenue by 35%
The automated time tracking,CPT code assignment and comprehensive billing report generation functioalities of software helped the practice to earn 35% increased revenue for services delivered.