The Door is a unique organization providing a wide variety of services, including healthcare, to more than 10,000 youth each year. It began using eSolutions’ clearinghouse, ClaimRemedi, to help get cleaner claims out the door, faster. Since it began using ClaimRemedi, which is integrated into The Door’s Practice Management System, workflows have improved dramatically and A/R days have decreased by 15%.
98%
Payer acceptance rate
15%
Reduction in A/R days
The Story
The Door – A Center of Alternatives opened its doors in New York City in 1972. What began as a labor of love with a volunteer staff in an East Village storefront has become a full-fledged organization with almost 200 paid staff that serves more than 10,000 youth each year under one roof.
The Door’s mission to help New York City youth in need hasn’t changed in 47 years. It still works to empower young people 12-24 years old to reach their potential by providing free, comprehensive and confidential youth development services in a caring environment. In its five-floor facility, The Door provides critical services, including: mental health counseling and crisis assistance, reproductive health care and education, legal assistance, GED and ESOL classes, tutoring and homework help, college preparation services, career development, job training and placement, supportive housing, sports and recreational activities, arts, and nutritious meals. The Door has helped a diverse and rapidly growing population of disconnected youth gain the skills and tools they need to become successful in school, work and life.
In the 1990s, the World Economic Forum recognized The Door as one of six premier models for successful youth service delivery, and the U.S. Department of Education and the U.S. Department of Health and Human Services chose The Door as a model program dealing with the pressing needs of children and families in impoverished communities.
The Challenge
The Door serves adolescents, so it doesn’t handle a large volume of Medicare claims and only processes about 50-100 commercial claims each month. But the software it used previously limited its staff on how it could manage claims.
“The software that we were using prior to eSolutions was limited on the payers that it worked with,” explained Nikita Lattimore-Martin, revenue cycle manager at The Door. “We were not able to transmit claims for one of our larger payers. We were also having issues submitting dental claims.”
The Solution – ClaimRemedi Clearinghouse
The Door began using eSolutions’ ClaimRemedi clearinghouse in August 2018. Lattimore-Martin said her team loves the ease of getting claims out of their practice management system and over to ClaimRemedi.
“The bidirectional information that goes between ClaimRemedi and eCW, our PM system, has been great with helping us to identify claims that have been rejected by both the clearinghouse and the insurance payer,” she said. “Prior to using ClaimRemedi, we didn’t have this ability and by the time we logged into the clearinghouse portal to identify claims that may have been rejected, we were a few days behind where we are now.”
ClaimRemedi also has improved workflows for The Door’s staff. Lattimore-Martin said that is due to the ease of using the eligibility tool and the ability to send claims in batches and then view them in the ClaimRemedi portal.
ClaimRemedi’s reporting feature has made viewing stats much simpler for The Door’s staff. Lattimore-Martin said her staff finds ClaimRemedi visually stimulating and appealing, modern and easy to use. “ClaimRemedi offers reports that are easy to read and exportable, which helps with identifying any billing issues before they become a problem,” she said. “I also love how ClaimRemedi looks visually. It makes it easy to view reports, claims history and eligibility.”
But what has been most important to Lattimore-Martin is how eSolutions has catered to her small organization’s needs.
“I appreciate the attention that was given to my organization, and the attention I’ve continued to get post-go live,” she said. “eSolutions’ client services has been great. They have worked closely with us to ensure that our transition to the eSolutions ClaimRemedi product was seamless.”
The Result
According to Lattimore-Martin, ClaimRemedi has reduced The Door’s days in A/R by about 15%. The organization also has seen a reduction in the amount of time it takes the revenue cycle team to review rejected claims.
“eSolutions helped my team get claims out the door in a timely fashion, and work the rejections more efficiently, therefore reducing the possibility of claims being submitted late,” she said.
“eSolutions offers superb support as well as an easy-to-use product that encompasses smart tools to make understanding and managing your revenue cycle easier. I would certainly recommend it to other organizations.”
