Hope Family Care chose eSolutions’ clearinghouse which works in tandem with their practice management software. Now Hope Family Care has a streamlined claims process with a 99 percent clean claim rate and less than a 3 percent denial rate.
Clean claim rate
Claim denial rate less than 3%
Claims paid within 90 days
Hope Family Care, established in 2010, is a three-provider family practice serving about 250 patients each week in Globe, Arizona. When the practice opened, it outsourced its billing functions to a third-party vendor.
Hope Family Care began having organizational difficulties working with its billing vendor. Office Manager Leslie Felix said the Hope Family Care team was frustrated, as the outsourced vendor paid little attention to their accounts. The practice experienced lower than expected reimbursement and lacked the ability to dive into the causes.
The Solution – eSolutions’ Clearinghouse
In 2015, the practice decided it was time to gain control over its own billing by bringing it back in house, which meant using a medical billing clearinghouse to submit claims to insurance. Hope Family Care uses eClinicalWorks EHR and practice management system, which offers its customers a choice of four preferred clearinghouse partners, including eSolutions’ clearinghouse service, ClaimRemedi. “We chose ClaimRemedi based on the friendly customer service and sales approach,” Leslie said. “We felt it was important to work with a company that was easily approachable when we had issues and was quick to respond to our concerns and needs.”
The Hope Family Care team has enjoyed the many benefits of ClaimRemedi, including its easy integration with eClinicalWorks, eligibility verification, scrubbing features and patient statements. “The solutions have been easy to work with,” Leslie said. “Now we have a good billing and workflow system in place.” She also likes the dashboard, which allows her to view her top denials and evaluate the denial reasons.
Since implementing ClaimRemedi, they’ve had a significant improvement in reimbursement rates, which are now high. The practice is enjoying a 0-1 percent claim rejection rate and on average, less than a 3 percent denial rate. “I have personally worked with many clearinghouses over the 30 years I’ve been in this industry and have found the reporting services and customer service provided by eSolutions outstanding compared to the others,” Leslie said.