era live webinar - presentation slides

ERA (Electronic Remittance Advice) –“Everything You Wanted To Know But

Were Afraid To Ask”

September 21, 2010

Live Webinar Presentation - ERA

Meet our Expert Panel Specialists

Cindy Dunn, RN, FACMPEConsultant - MGMA

Paula Kozlowski National Sales Associate

Orlando Negron Customer Service Rep.

http://www.mgma.com/index.aspx�

ERA (Electronic Remittance Advice) –“Everything You Wanted To Know But

Were Afraid To Ask”

September 21, 2010

Live Webinar Presentation - ERA

Objectives

• Review history of electronic transactions.

• Understand the purpose of the RA and ERA production.

• Examine different components of the ERA.

• Realize the positive financial impact of electronic transactions on the medical practice.

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Medical Practice Dilemma

Question:

– How do you increase practice profitability in an environment of declining reimbursement, increasing expenses and increased competition?

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One strategy: Utilize electronic transactions.

Inquiring Minds Want To Know

• 10% of payments to health providers in the U.S. are made electronically.

• 9 in 10 providers still receive paper checks.• All electronic payments: save $11 billion annually.

• Pew Internet & American Life Project findings:• 74% of Americans use the Internet.

• 71% shop online.• 55% bank online.1

• Americans online• Three-fourths pay bills online rather than write paper

checks.2

1Pew Internet & American Life Project, Generations Online, January 2009.2CheckFree/Fiserv 2008 Consumer Banking and Bill Payment Survey.

Presenter

Presentation Notes

Paper costs, and as Newt Gingrich has written, “Paper kills.” We’re talking about $30 billion wasted on paper in American health care. Two thirds of this is bound up in paper-based health claims, billing, and payments by check to doctors and hospitals. $30 billion of waste on inefficiency is a statistic that can concentrate the minds of Democrats, Independents and Republicans alike—all health citizens.

Electronic Transactions

Presenter

Presentation Notes

Industry usage of electronic Billing and Payment transactions by type; also illustrates total electronic and paper transaction percentages across all types. The percentage of total electronic utilization is the "Index" shown on the top right-hand corner of the page. Note: These figures are for medical claims-related transactions only. In later phases of the Index, we plan to expand the Index to include dental, vision, Worker's Compensation and clinical transactions like e-prescribing.

Healthcare Efficiency Index• Claims:

• Presently 75% electronic utilization.

• Provider cost savings electronic vs. paper: $3.73

• Payer cost savings electronic vs. paper: $0.73

• Eligibility:




• Claim Status:




Presenter

Presentation Notes

The U.S. Healthcare Efficiency Index© (USHEI) is a forum for raising awareness and monitoring business efficiency in healthcare. The USHEI seeks to provide a national reference to track and measure the transition from a paper-based healthcare system to an electronic one. ��We all agree that paper is costly, inefficient and prone to errors. Let's work together to address the billions of dollars that can be saved today through simple steps like electronic payments and remittances. The National Progress Report on Healthcare Efficiency is the first annual report on the findings from the primary research phase of the U.S. Healthcare Efficiency Index©. The Advisory Council for the Index oversaw the development of a detailed methodology, a secure data collection infrastructure and a formal data collection process that is now yielding an initial set of data. This report places the findings in the context of the recently enacted healthcare reform legislation, as well as the HITECH Act, passed as part of the American Reinvestment and Recovery Act (ARRA). It assesses the landscape and suggests a set of trends likely to impact the healthcare industry in the months and years to come.

Healthcare Efficiency IndexClaim Payment:


• Cumulative Provider and Payer cost savings electronic vs. paper: $4.80

Claim Remittance:



TOTAL:

• Total unrealized industry savings: $29,718,502,500

• Present transaction types by percentage: 57% paper / 43% electronic

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Presenter

Presentation Notes

The National Progress Report on Healthcare Efficiency is the first annual report on the findings from the primary research phase of the U.S. Healthcare Efficiency Index® (USHEI). The USHEI was launched in 2008 to raise awareness of the potential cost savings associated with adoption of basic electronic transactions in healthcare.

HIPAA (Health Insurance Portability and Accountability Act of 1996)

• HIPAA covers a number of important health care issues.

• Webinar focus on Administrative Simplification portion of HIPAA (Electronic Transactions and Code Sets requirements).

• Four parts to HIPAA’s Administrative Simplification: – Electronic transactions and code sets standards

requirements.

– Privacy requirements.

– Security requirements.

– National identifier requirements.

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Presenter

Presentation Notes

HIPAA calls for changes designed to streamline the administration of health care. It promotes uniformity by adopting transaction standards for several types of electronic health information transactions. No longer can every insurer have unique requirements for the processing of claims. Everyone covered by HIPAA will be required to provide the same information -- standard formats for processing claims and payments; as well as for the maintenance and transmission of electronic health care information and data. In the short term, HIPAA will require effort, resources and commitment on the part of certain providers’ offices and other covered entities’ offices. In the long run, however, this law has major benefits. Right now, there are over 400 different ways to submit a claim. With HIPAA there will be one way to conduct electronic claims. With these standards in place, your office staff may spend less time on the phone getting information they need. As a result, the standardization of submitting claims and simplification of processes should make getting paid quicker and easier – and less costly. The requirements mandated by HIPAA should also help providers take advantage of new technologies and ultimately improve their overall business practices.

Transactions• Transactions are activities involving the transfer of health care

information for specific purposes.

• HIPAA requires every provider who does business electronically to use the same health care transactions, code sets, and identifiers.

• HIPAA has identified standard transactions for Electronic Data Interchange (EDI) for the transmission of health care data.

– Claims or equivalent encounter information.

– Payment and remittance advice.

– Claim status inquiry and response.

– Eligibility inquiry and response.

– Enrollment and disenrollment in a health plan.11

Acronyms

• RA- Remittance Advice

• SPR- Standard Paper Remittance

• ERA- Electronic Remittance Advice

• MREP- Medicare Remit Easy Print

• CARC- Claim Adjustment Reason Codes

• RARC- Remittance Advice Remark Codes

• EFT- Electronic Funds Transfer

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Presenter

Presentation Notes

We will be using during this webinar

What is a Remittance Advice (RA)?

• Notice of payments and adjustments sent to providers, physicians, billers, and suppliers.

• Explains why any original charges were not paid in full.

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Presenter

Presentation Notes

When you submit a claim for payment to Medicare, the amount Medicare pays may not match the amount you initially billed. Along with your payment, your Medicare contractor sends you a notice called a Remittance Advice (RA).

Purpose of Remittance Advice (RA)

• Provide a “justification” for payment.• Explain reimbursement decisions.• Reduce resubmission of claim.• Provide information to allow rapid follow-up

action, resulting in quicker payment.• Post to accounts receivable.• Use it to correct any errors that may have been

encountered during claims processing.• Bill secondary health care plans that cover the

beneficiary.

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Types of RA’s• Electronic Remittance Advice (ERA)

• Standard Paper Remittance Advice (SPR), also known as an Explanation of Benefits (EOB).

• Produced as a hardcopy (paper) form of the RA, while the ERA is produced and sent electronically.

• Both feature similar information.

• ERA offers several advantages over the SPR:

• Faster communication and payment notification.

• Faster account reconciliation through electronic posting.

• Less paper generated.

• More detailed information.

• Access to data in a variety of formats through supported software.

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How is RA Used?

• Post payments.• Review claim adjustments.• Bill secondary health care plans that cover the beneficiary.• Correct any errors that have been identified during claims

processing.• Post decision and payment information automatically to

the appropriate beneficiary accounts when a compatible accounts receivable software application is being used (or post manually to accounts receivable, if receiving the SPR);

• Print specific payment information as needed by using translator software; and

• Identify potential problems with the way the original claim was submitted to avoid the same errors with future claims.

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RA and the Claims Processing Cycle

• Once the claim has been received and accepted by Medicare contractor, it is processed and payment is determined. • Payment floor

• 13 days - electronic claims• 28 days - paper claims

• Once processed, the practice will receive any payment through Electronic Funds Transfer (EFT) or a check in the mail.

• RA accompanies this claim payment or claim adjustment (including a denial).

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Standard Paper Remittance Advice (SPR)

• Practices can elect to receive a paper Remittance Advice (RA), this is a Standard Paper Remittance Advice (SPR).

• SPRs are also known as Explanation of Benefits (EOBs).

• SPRs are organized differently than Electronic Remittance Advices (ERAs) and cannot display as much information.

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Code Sets Appearing on the Remittance Advice

• RAs display information in various fields, some of which contain codes.

• RAs contain many codes.

• Two types of codes:– Medical codes

– Non-medical codes

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Types of Codes - Medical Codes

• Medical code sets are clinical codes used to:• Identify procedures, services, supplies, drugs, and diagnoses that apply

to a beneficiary.• Characterize a medical condition or treatment.

Medical code sets that have been approved by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) include: • International Classification of Diseases, 9th Revision, Clinical

Modification (ICD-9-CM) - Volumes 1, 2, and 3 Codes - ICD-9-CM is the official system of assigning codes to medical diagnoses and procedures.

• National Drug Codes (NDCs) - The NDC is a number which uniquely identifies a manufacturer's product or drug.

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Presenter

Presentation Notes

Take a minute and mention ICD-10

Types of Codes - Medical Codes

• Medical code sets that have been approved by HIPAA also include: • Healthcare Common Procedure Coding System

(HCPCS) Level I - HCPCS Level I, also referred to as Current Procedural Terminology, 4th Edition (CPT-4) Codes.

• HCPCS Level II Codes - HCPCS Level II codes are used for procedures, supplies, and drugs not included in the AMA's CPT-4 codes.

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Types of CodesNon-Medical Codes

• Non-medical or non-clinical codes• Characterize a general administrative situation, rather than a

medical condition or service.• State abbreviations, ZIP codes, telephone area codes, and race

and ethnicity codes are examples of general administrative non-medical code sets.

• Non-medical codes are also used to identify payment adjustments.• Non-medical codes are used frequently on the RA to explain

adjustments. • Group Codes• Claim Adjustment Reason Codes (CARCs)• Remittance Advice Remark Codes (RARCs)• Provider-Level Adjustment Reason Codes

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Non-Medical CodesGroup Codes

• Group Codes identify:

• Financially responsible party or

• General category of payment adjustment

• Group Code is always paired with a CARC.

• Code Payment Adjustment Category Description

• CO Contractual Obligation - used when a contractual agreement between Medicare and the provider, or a regulatory requirement, resulted in an adjustment.

• When CO is used to describe an adjustment, a provider is not permitted to bill the beneficiary for the amount of that adjustment.

• CR Correction and Reversal - used for correcting a prior claim. It applies when there is a change to a previously adjudicated claim.

• OA Other Adjustment - used when no other Group Code applies to the adjustment.

• PR Patient Responsibility - represents an adjustment amount that is billed to the beneficiary or insured. Typically used for deductible and coinsurance adjustments.

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Claim Adjustment Reason Codes

• CARCs • Provide financial information about claim decisions.• Communicate an adjustment, or why a claim (or service line) was paid

differently than it was billed.• Always paired with a Group Code. If there is no adjustment to a claim or service

line, then there is no associated CARC.• Code Financial Information

• 1 Deductible amount • 2 Coinsurance amount • 3 Co-payment amount • 4 The procedure code is inconsistent with the modifier used or a required

modifier is missing.• 96 Non-covered charge(s).

• CARCs are maintained and updated three times per year by a national health care code committee.

• Listing of all CARCs and their descriptions www.wpc-edi.com/codes.

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Presenter

Presentation Notes

Prior to HIPAA, proprietary coding systems were used by non-Medicare health payers in the U.S. To relieve the burden on health care providers to interpret different coding systems, CARCs and RARCs were adopted under HIPAA to be used by all U.S. health payers. The table below shows examples of several CARCs.

http://www.wpc-edi.com/codes�

Remittance Advice Remark Codes• RARCs

• Used with CARCs to further explain an adjustment or to provide information, such as if and what appeal rights apply.

• Used to relay informational messages, even when there is no adjustment (for example, "N363 -Alert: in the near future we are implementing new policies/procedures that would affect this determination").

• RARC examples• M1 X-ray not taken within the past 12 months or near enough to the start of treatment.• M2 Not paid separately when the patient is an inpatient.• M3 Equipment is the same or similar to equipment already being used.• M4 This is the last monthly installment payment for this durable medical equipment.• M125 Missing/incomplete/invalid information on the period of time for which the

service/supply/equipment will be needed.• N1 You may appeal this decision in writing within the required time limits following receipt of this

notice by following the instructions included in your contract or plan benefit documents.• N24 Missing/incomplete/invalid Electronic Funds Transfer (EFT) banking information.

• RARCs are maintained by the Centers for Medicare & Medicaid Services (CMS) but may be used by any health care payer when appropriate.

• RARC may be reported at the service-line level or the claim level, as applicable, on any ERA or SPR.• Listing of all RARCs and their descriptions www.wpc-edi.com/codes

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Provider-Level Adjustment Reason Codes

• Provider-Level Adjustment Reason Codes • Explain adjustments that appear on an RA but are not related to a specific claim

or service.• Examples: Late charges, forwarded balances, early payment allowances, interest,

and penalties.• Provider-Level Adjustment Reason Codes.

• 50 Late Charge Used to identify Late Claim Filing Penalty.• B2 Rebate Used for the refund adjustment.• IR Internal Revenue Service Withholding Used for Internal Revenue Service

withholdings.• L6 Interest Owed Used for the interest paid on claims on an RA.

• Provider-Level Adjustment Reason Codes are maintained by the Accredited Standards Committee (ASC) X12N Insurance Subcommittee, and are a part of the ASC X12N 835 version 004010A1 standard.

• List of Provider-Level Adjustment Reason Codes may be found in the X12N Health Care Claim Payment/Advice Implementation Guide, which is available on the WPC-EDI website.

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http://www.wpc-edi.com/codes/view/533/377/�

http://cms.meridianksi.com/kc/content/ilc/courses/7E05868E9AB74104A3F29A8468FD16A1/m1_lesson_2/HIPAA_Standards.pdf�

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What is the 835?

• HIPAA-compliant format that allows for receiving third party reimbursement payments and adjustment information in an electronic format.

• Full name: Health Care Payment & Remittance Advice

• Also know as Electronic Remittance Advice or ERA.• Current HIPAA-compliant version

– ANSII Standard X12 835 Version 4010 Addenda A

Presenter

Presentation Notes

The 835 transaction is the HIPAA-compliant format that allows for receiving third party reimbursement payments and adjustment information in an electronic format. The full name is the Health Care Payment & Remittance Advice. It is also known as the Electronic Remittance Advice or E-R-A. The current HIPAA compliant version of this transaction is ANSII Standard X12 835 Version 4010 Addenda A.

How Is an ERA Generated?

• A variable-length record designed for wire (electronic) transmission.

• Produced in the Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant Accredited Standards Committee (ASC) X12N 835 Version 004010A1 format - referred to as Transaction 835 (or “the 835”).• Information provided in this file is standardized

and is governed by HIPAA guidelines.

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Electronic Remittance Advice (ERA)

• Does not eliminate biller’s ability to review EOB’s.

• Automatically populates required information for Secondary Filing.

• Reduces manual labor hours posting payments by 75%-90%.

• Eliminates data entry errors.

• Provides for check reconciliation.

• EOB information is typically populated inside your billing system.

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Benefits of 835 Transaction

• Retrieved and posted electronically into Practice Management System (PMS) by batch mode.– Allows for faster and more accurate posting of payments

• Contains codes that can be posted directly into Practice Management System:– Standard Adjustment Reason Codes (also called Claims

Adjustment Reason Codes)– Remittance Advice Remark codes– NCPDP Reject/Payment codes

• Denied claims can be manually posted.

Presenter

Presentation Notes

There are three main benefits from the 835 or ERA. The ERA is retrieved and posted electronically into PMS system by batch mode which allows for faster and more accurate posting of payments. The ERA contains the standard adjustment reason and remark codes as well as the National Council for Prescription Drug Programs (NCPDP) Reject/Payment codes which can be posted directly into PMS.

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Overview of 835 ERA Process

1. ERA files retrieved from insurer.2. ERA files loaded into PMS (CollaborateMD).3. Files batched based on local procedures.4. ERA files posted to Accounts Receivable.5. Payments/adjustments rolled back to PMS Third

Party Billing.6. ERA reconciled with payment received.

Presenter

Presentation Notes

The 835 ERA process must be completed in a specific sequence. Retrieve the ERA files Load the files into RPMS Batch the files according to local procedures Post the ERA files to Accounts Receivable Rollback payments and adjustments to RPMS Third Party Billing, then Reconcile the ERA with the payment received. [Trainer’s Notes] ERAs are retrieved from insurers either via a web download process or by FTP/modem into the RPMS Accounts Receivable Application.

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Testing the 835

• Must test 835 process before beginning production.

• Contact insurer’s EDI department.– Request guidance on procedures and

documentation requirements before receiving files.

– Determine test and production requirements.– Complete required applications.

Presenter

Presentation Notes

Must test the 835 process before you can begin production. To begin the 835 testing process, contact the Electronic Data Interchange or EDI department of the insurer. Request their guidance on the procedures and the documentation requirements that must be completed prior to receiving files. Working with your EDI contact, determine the test and production requirements for that insurer. Obtain copies and complete any applications the insurer requires.

Viewing the ERA

• The 835 file is not suitable for viewing.

• To view and print the information in the 835, you must view the 835 using translator software.• Other translator software purchased by providers

may present information in a different manner.

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Version 5010 and ICD-10• January 1, 2012

– Standards for electronic health care transactions change from Version 4010/4010A1 to Version 5010.

– These electronic health care transactions include functions such as claims, eligibility inquiries, and remittance advices.

– Unlike the current Version 4010/4010A1, Version 5010 accommodates the ICD-10 codes, and must be in place first before the changeover to ICD-10.

• October 1, 2013

– ICD-10 will affect coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just those who submit Medicare claims.

– Compliance dates are firm and not subject to change. If your practice is not ready, your claims will not be paid. Preparing now can help you avoid potential reimbursement issues.

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Presenter

Presentation Notes

If you electronically submit administrative transactions, such as checking a patient’s eligibility, filing a claim, or receiving a remittance advice, either directly to a health insurance payer or through a clearinghouse, the version of the transactions currently in use will be updated. On January 16, 2009, the Department of Health and Human Services (HHS) announced that updated versions of the HIPAA transactions will be required for use by physicians and others on January 1, 2012. The Centers for Medicare and Medicaid Services (CMS), is the agency within HHS charged with overseeing compliance with the standards. The Version 5010 change occurs well before the ICD-10 implementation date to allow adequate Version 5010 testing and implementation time. If providers do not conduct electronic health transactions using Version 5010 as of January 1, 2012, delays in claim reimbursement may result. If health plans cannot accept Version 5010 transactions from providers, they may experience a large increase in provider customer service inquiries affecting their operations. Preparing for ICD-10 and Version 5010 – including potential updated software installation, staff training, changes to business operations and workflows, internal and external testing, reprinting of manuals and other materials, and more – will take time.

Changes - 5010

• Infrastructure changes from the previous Version 4010 in preparation for the ICD-10 codes:– Increase in field size for ICD codes from five digit

to seven digit alphanumeric code.

– Addition of a one-digit version indicator to the ICD code to indicate Version 9 versus Version 10.

– Increase in the number of diagnosis codes allowed on a claim (eight to 24 codes).

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ICD-10 and Version 5010 Timelines

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Effects of Automation

• Operator/Registration: "I didn’t realize how important it was to put in all the correct information – like all the parts of the address and every type of insurance the patient has and the relationship between the patient and insured person."

-Registration/Operator

• "If you don’t enter the codes right, the claim keeps coming back."

-Coder

Presenter

Presentation Notes

The lag time has been cut from several weeks to a matter of days. So if you submit a batch of files, and a batch of files could be hundreds of files, they’re submitted, they go in, they’re run through a checker, the next day you get a answer back whether the claim checker worked and the claims were accepted, and three days later you're paid. With a paper process somebody on the other end had to go through all these claims, check them and check them and check them, find errors, see if they were legitimate, and it would be weeks, sometimes months, before you got paid for that claim.


• Billing Office: "You have to edit every claim thoroughly. If you don’t, the claim will be rejected. Figuring out the error reports is not fun."

-Billing Clerk

• "We put off doing this for a long time because the old way seemed to work fine. But we are so much more efficient with the new process. We can actually keep up with the work."

-Front Desk Manager

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• Accounts Receivable: “The thing that I really like about the 835 is that posting is so much easier. Now we have more time for reconciliation.”

- Business Office Manager

• Administration: "We were really worried about what this would mean to our revenue stream. We knew in the long run we would get paid much faster. But what would happen when we were going through testing? Well, it really wasn’t so bad. We planned for the extra labor time that would be required and it is really paying off."

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Costs

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Electronic Transaction Saving & Opportunities For Physician Practices Milliman Technology and Operations Solutions: January 2006

Presenter

Presentation Notes

A physician who currently relies on paper and telephone calls for insurance administration may be able to save more than $42,000 a year through simple steps to increase electronic transactions for operations like claims submission, referral and preauthorization requests, and eligibility verification. These are savings that go right to the bottom line. The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) require health plans to accept standard electronic transactions for basic insurance administration functions and to provide electronic responses at no extra charge or delay. The focus on HIPAA has provided a special impetus for physicians to assess potential savings from greater use of electronic transactions. To help better understand the benefits of electronic transactions, Milliman, Inc. compared differences in the cost of manual and electronic transactions for a typical physician practice environment. The study considered six key transactions: • Claims Submission; • Eligibility Verification; • Referral Certification; • Preauthorization for Care; • Claim Status; and • Payment Posting. This analysis found that implementation of electronic transactions can reduce the annual insurance administration costs by more than $42,000 per physician. Although these savings may vary widely depending on practice specialty, employee productivity, existing use of technology, and other variables, these savings are significant enough to justify greater use of electronic transactions for many practices. II. Methods Milliman developed a methodology for estimating the costs of manual and electronic transactions. For each of the six transactions considered, Milliman identified the tasks required to perform the transaction both manually and electronically. The study found that for manual transactions, most practices follow similar processes. There is much greater variance among practices, however, in the use of technology, and the associated costs, for electronic transactions. In the most technologically advanced environment, many transactions are completely automated, effectively eliminating the need for staff involvement in processing. More commonly, however, technology improves efficiency by reducing some manual processes, but human intervention is still required. For this study, Milliman assumed that office staff perform some administrative functions but, whenever possible, rely on electronic transactions for sending and receiving transaction communications instead of the telephone or mail. Fully automated practices may be able to achieve significantly greater savings. In developing its estimates, Milliman: • Identified the labor time and costs required to perform the tasks for both manual and electronic transactions • Calculated the fully loaded time cost of labor including employee salary, benefits and payroll taxes, and general and administrative overhead • Calculated the fully loaded cost per transaction, based on the estimated labor requirements. Electronic transaction costs included the cost of transaction fees and a 12-month amortization of set-up costs. • Adjusted cost based on inflation factors to account for any differences in time between source data and the present To validate its estimates, Milliman tested the results by observing administrative procedures in actual physician practices and medical groups. For the study, Milliman made assumptions on the operating environment of the typical solo physician practice. Milliman’s model practice may not represent other physician practices, specialties or operating models. Since the study results are dependent upon these assumptions, the actual savings of any given physician practice may differ from those presented in this report. III. Results Implementation of electronic transactions significantly reduces costs per insurance administration transaction. Milliman estimates per-transaction savings range from 50% to 90% depending on the complexity of the transaction.

Each Practice Can Save• Annual cost for manual transactions was over

$70,000.– Annual cost for electronic transactions was less

than $28,000.

– Subtracting the annual electronic cost from the annual manual cost resulted in:

Savings of over $42,000 per year from

implementation electronic transactions.

41Electronic Transaction Saving & Opportunities For Physician Practices Milliman Technology and Operations Solutions: January 2006

Automation vs. Manual

42

Electronic Transaction Saving & Opportunities For Physician Practices Milliman Technology and Operations Solutions: January 2006

Other Findings• Electronic claim submission reduced claim rejections and the

need to resubmit claims multiple times.

• Electronic claim submission improved cash flow and reduced accounts receivable days because claims are paid more quickly.

• Electronic eligibility verification allowed Practices to validate every patient’s insurance eligibility on every visit reducing the collection and billing costs for patients without coverage, and reducing bad debt.

• Electronic transactions reduced the office staff telephone time.

• Electronic payment posting significantly reduced accounts receivable errors, and improved customer satisfaction.

Electronic Transaction Saving & Opportunities For Physician Practices

Milliman Technology and Operations Solutions: January 2006

44

Cindy Dunn, RN, FACMPE

Senior Consultant, MGMA

E-mail: [email protected]

Cell: 859-421-2219

Thank You

mailto:[email protected]�

http://www.mgma.com/index.aspx�

CollaborateMD.com The overall mission of

a medical practice is to improve the

overall quality of patient care.

CollaborateMD is a trusted

health information technology

expert that can get you there.

888.348.8457

CollaborateMD.com

Thank you for attending

Presenter

Presentation Notes

As an industry expert in Health Information Technology, we are committed to helping doctors improve the overall quality of healthcare nationwide. With the utilization of automated features, you have the capability of increasing revenue and efficiency while improving patient satisfaction. Optimizing your front office is the key to improving the revenue cycle of your practice.

References• Understanding the Remittance Advice

www.cms.gov/MLNProducts/downloads/RA_Guide_Full_03-22-06.pdf

• Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) www.wpc-edi.com/codes

• Milliman Electronic Transaction Savings & Opportunities For Physician Practices http://transact.emdeon.com/documents/milliman_study.pdf

• National Progress Report on Healthcare Efficiency

• http://www.ushealthcareindex.com/resources/USHEINationalProgressReport.pdf

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http://www.cms.gov/MLNProducts/downloads/RA_Guide_Full_03-22-06.pdf�


http://transact.emdeon.com/documents/milliman_study.pdf�

http://www.ushealthcareindex.com/resources/USHEINationalProgressReport.pdf�

http://www.ushealthcareindex.com/resources/USHEINationalProgressReport.pdf�

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