Providing financial, reimbursement, billing and clinical consulting services to nearly 100 home health and hospice agencies, Healthcare Provider Solutions (HPS) needed a solution that added speed and efficiency to the Medicare claims submission and tracking process. After choosing eSolutions’ Medicare Enterprise Pro as its total solution, HPS now drives faster cash flow, accurate reimbursement and delivers the provider-specific intelligence to improve the financial health of their clients.
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Healthcare Provider Solutions Inc. (HPS) helps home health and hospice agencies gain control over their businesses. For more than 15 years, the experienced HPS team has provided financial, reimbursement, billing and clinical consulting to the home care and hospice industries. Headquartered in Nashville, Tennessee, the organization serves clients nationwide with core offerings including billing and collections, receivable collection projects, clinical compliance chart reviews, operational reviews and industry-leading education.
In striving to provide superior service to its customers, HPS began seeking a technology solution that added speed and efficiency to the Medicare claims submission and tracking process. Although they used a clearinghouse and received remittance advice details electronically, the process wasn’t optimal. For 90+ provider organizations, the HPS reimbursement team submitted claims through their clearinghouse, but had to wait two or three days to get submission validation, which added days to A/R. Also, without a robust claims reporting tool, HPS was missing the opportunity make impactful business improvements.
The Solution – Medicare Enterprise Package
After considering other software options, HPS chose eSolutions’ Medicare Enterprise package as its complete revenue cycle and business intelligence solution. The powerful eligibility, claims submission, editing and reporting features included in the package added instant efficiencies to HPS’ daily processes.
One key reason HPS chose Enterprise was for its one-of-a-kind Medicare connectivity capability. Mark Cannon, HPS Chief Financial Officer, said eSolutions was the only considered vendor that provided a direct connection to the Medicare system. Other vendors rebill claims that need fixed, while eSolutions is the only vendor that allows providers to submit, fix and track claims 24/7 through a direct FISS connection, which was a huge selling point for HPS.
HPS saw instant improvement throughout its revenue cycle and workflow and, within a year, Medicare Enterprise had paid for itself by eliminating the need for part of an FTE. “It’s hard to nail down a particular area of impact, but everything about the process was positively affected, from claims processing to follow up,” Mark said.
Medicare Enterprise, which includes specific features for home health and hospice billing, helps the HPS team with its clients’ unique reimbursement requirements. eSolutions offers tools that help hospices bill NOEs within the five-day timely filing window. The products also include tools and reports that help home health agencies submit and manage RAP workflow and payment.
“For our home care clients, the direct data entry process has shortened the payment cycle by a day compared to what we used to deal with,” Aaron Carey, Chief Operating Officer, said.
Aaron added that HPS finds the RAPs at Risk Report a useful tool. “We love that it’s in Excel format and that it
reports daily RAP cancels and pending RAP cancellations for all of our clients in one easy-to-read report,” he said. “We can copy and paste this information and send it to our customers to keep them apprised of pending RAP takebacks.”
Mark enjoys using eSolutions products because they’re intuitive and effective. “For a large agency with multiple provider numbers, eSolutions creates a lot of efficiencies,” he said. “For example, you don’t have to log in and out of multiple DDE sessions, which alone provides great time savings.” He added that eSolutions makes training new staff quick and easy. “If I can train them, anybody can!”
HPS has also injected more customer service value through delivering meaningful, actionable reporting to clients. Mark and Aaron agreed they can generate almost any claim data they want from Medicare Enterprise.
HPS shares eSolutions’ Medicare Eligibility tool with their clients so they can check patient eligibility upfront,
helping to reduce rejected claims. “That’s a nice function we can provide, as it’s a lot easier for them to check their own eligibility data,” Mark said.
The most important thing to HPS customers is when they get paid and how much reimbursement they receive. Medicare Enterprise drives faster cash flow and gives home health and hospice providers the accurate reimbursement they want and need for a successful business.
“It’s hard to nail down a particular area of impact, but everything about the process was positively affected, from claims processing to follow up.”