Coding and Billing

Use Your Practice Management System for Electronic Claim Filing

By Lori Palmer, OD


Utilize your practice management system to facilitate coding and billing. Then, to maximize this function, file your claims electronically.

Practice management systems typically are thought to better organize daily administrative processes; however these systems can also be helpful in the coding and billing process–if you file your claims electronically. As you consider how to update your PMS, or before you invest in your next PMS, also consider the electronic claim filing service you will invest in. It is important that your PMS is able to integrate with the electronic claim filing service you choose.

My office was forced into using a clearinghouse when one of the primary insurance carriers our patients use stopped accepting paper claims. Now, no looking back!
VisionWeb costs us less than $100/month, but pricing is tiered based on the volume of claims submitted. We are paid twice as fast now on our Medicare claims! Staff time has been reduced on data entry (especially for established patients) and claim processing. The staff learning curve for use of VisionWeb was less than a week. The data entry format was self explanatory, and the clearinghouse was very helpful with training assistance. They even helped track our earliest claims, giving us phone confirmation when they were clearing properly.
Here are three key billing and coding uses of your PMS when coupled with electronic claim filing:

Why Invest in a Claims Processing Service?

Even a small practice might want to consider a claims processing, or clearinghouse, to aid the billing process. Here are some of the key benefits:
Thousands of payers in one location

Patient eligibility verification

Claim submission and tracking

Secondary claim processing

Detailed reporting and analytics

Claim uploading from practice management systems

Electronic remittance advice (ERA) for free

ERA Auto-Posting in compatible practice management systems

Training and customer support for the life of your account

Batch Claims
Practice management software is a significant investment and that’s why your eyecare practice should be putting it to work, especially for claim filing. Creating batch claim files is one of the many features of utilizing a practice management compatibility with an online claim filing service. You can create, upload and submit batch claims directly to all of your connected payers, which will reduce redundancies associated with re-keying claims. For example, watch this video to see just how easy it is to upload claims to VisionWeb from a compatible practice management system.

Patient Eligibility Verification
To make eligibility verification more efficient, having patient eligibility verification functionality built into your PMS is key.  Having this resource is bound to make your entire revenue cycle smoother and you a lot happier. Higher collections and efficient scheduling and check-in are typically two of the main day-to-day goals in an eyecare practice. So, at the front desk it’s easy to see efficiency as saving time. Skipping the eligibility verification process because it’s too slow, however, may not save as much time as one thinks. It actually ends up adding time and labor later when billing needs to resubmit claims for reimbursement. Having this functionality built into your PMS, and then having the ability to file the completed claims–once verified–to your electronic claim filing service creates efficiencies leading to faster payment to the practice.

Electronic, Paperless Patient Statements By Integrating PMS with Electronic Claim Filing
Electronic claim filing offers your practice the ability to store these statements right inside your practice management system. Having a consistent flow of new patients coming into your eyecare practice is something every practice aims for. And if you’re not using electronic claim filing, sooner or later that cost that seemed to be a fixed cost of filing cabinets will soon turn into a variable cost, and then you will eventually run out of space for all of these papers. Piles of paper, in general, stress people out, but by filing online, via a well integrated PMS and electronic claim filing service, you can avoid this and save space, time and stress.

Lori Palmer, O.D., is the practice owner of All About Eyes in Georgetown, Texas. To contact her, visit drloripalmer@allabouteyes-gtown.com.

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