Near Zero Collections – To Healthy Cash Flow – Emery Medical Solutions
It was a healthcare provider’s worst nightmare: six months with collections at near zero the result of switching medical billing services. Nor was it a simple technology or communications problem—the billing vendor promised collections in the 90-percent range to lure the Center in, then completely failed to interface with their imaging records systems.
Emery Medical Solutions, based in Apopka, Fla., is a comprehensive state of the art diagnostic imaging center serving all of Central Florida with 30 full time staff. Christine Donaldson was hired three and half years ago to help with eligibility and authorizations in an effort to better integrate those functions with front office management.
At the time of her hire, there was a long-established billing manager using PracticeSuite for billing, but three months later, a business decision was made to switch to a third-party billing service.
“They made the switch, and it didn’t go well,” says Donaldson, who was not directly involved with the billing at that time. Despite all the promises made by the billing service, including the promise to significantly boost collections, the crucial connection between Emery’s imaging records system and the vendor’s billing software never occurred.
“I’ve looked back at charts from that billing service, and there are no diagnosis codes in them,” Donaldson says, adding that she was suspicious when she learned that the company wouldn’t let anyone in her office run reports.
Fast turnaround
Six months later, the situation was clear, and the billing manager was let go. The owner of the company came to Donaldson with a status report showing near-zero collections for six months and asked her if she could take over the billing.
Emery’s business manager suggested going back to PracticeSuite as it worked before and had a working interface with their Ramsoft imaging records system.
The relief was immediate. “I was introduced to Vinod Nair, PracticeSuite CEO, who introduced me to their Managed Services staff who were just amazing; I still work with them on a daily basis. “They turned on our account, and that day we began submitting clean claims.”
Donaldson, who has a degree in healthcare administration, learned the ins and outs of medical billing—on the job with the PracticeSuite team backing her up. She learned coding from a temp who was brought in to get Emery back on its feet, then pursued and obtained CPC certification.
Because the owner had sufficient cash flow to survive the precipitous drop in collections, the decision was made not to pursue the backlog of un-coded charges. Instead, Donaldson worked with the newly hired PracticeSuite staff in coding new claims, and the process was incredibly smooth. “We were firing on all cylinders in short order,” she says.
Indeed, Donaldson says that with an experienced billing staff and dedicated account manager backing her up, she and the PracticeSuite team have actually achieved what the other billing company promised, with collections ranging in the 92% area depending on the month. Not surprisingly, owner and CEO Donald Emery is quoted as saying “I am very, very happy with PracticeSuite”.
Top Three PracticeSuite Benefits
The number one benefit of PracticeSuite, according to Donaldson, is its intuitive software interface. “Even when I don’t know exactly what I’m looking for, I can find things and figure it out myself,” she says. “I’ve never needed to look at the help section; and I’ve never watched a tutorial.”
More specifically, “coding and updating the occasional incorrect code is dead simple—and fast”. “After I code something, check it, and hit the post button, within seconds, I see it in the billing software. I have two screens and go back and forth between the two programs; I can code an x-ray, push it to the billing system and fire it off to the insurer in just a couple minutes,” Donaldson explains.
The number two benefit is the responsiveness and flexibility of the PracticeSuite RCM team. When you work with insurances, you’re used to waiting on hold for up to an hour, relates Donaldson. “If I have a patient here, and there’s something in the system I don’t understand, I can reach out to my account manager by chat within the system or pick up the phone and always get the answer I need immediately.”
Being on a first-name basis with the PracticeSuite team and knowing that everyone on the team cares deeply about her and the business she supports has been highly gratifying. “It’s like having my own billing department,” she says. “Whenever we talk about something that needs to be fixed, they always say ‘Let’s fix that now.’”
Having PracticeSuite handle rejections, re-filing, posting payments, and appealing any denials is the real boon to Donaldson who is already busy making sure every image, scan, and diagnostic test is coded properly in Ramsoft. A 100% follow-up rate, added to the fact that when she hits send, every claim is instantly pushed to the billing system, then scrubbed, and then immediately sent to the payer, ensures steady cash flow.
Benefit number three, says Donaldson, is PracticeSuite’s robust reporting. “If someone comes to me and says they need to know something that minute, I can pull it right up,” she explains. She’s able to efficiently reconcile days, weeks, and close out her month on time, and pull together monthly financial and productivity summaries for the owner as well.
Whenever a report template doesn’t quite meet her needs, Donaldson requests a change rather than deleting items every time or running several reports instead of one. “I just call someone at PracticeSuite, and within a week, I have a report I can use,” she says.
Likewise, the PracticeSuite team lets Donaldson know the moment they see a coding/payer trend causing denials. For instance, Medicare has stringent guidelines regarding who can refer patients for scans which can lead to denials on Emery claims. “If my billing team sees something that’s causing problems, I will hear about it,” Donaldson says. “I recently gave PracticeSuite supportive information about a particular practitioner being able to refer, and they went to Medicare and appealed the denial using that information. It’s a tight team.”
