eSolutions Acquires Practice Insight
On June 19, eSolutions acquired Practice Insight, a Houston, Texas-based healthcare IT company delivering RCM and automated workflow solutions to providers. Practice Insight has spent the past 16 years successfully developing provider solutions and building strong relationships with providers, payers and resellers.
Adding Practice Insight into the eSolutions’ product family is an extension of our best-in-class clearinghouse products that will strengthen our position in the marketplace and create synergies with our current solutions and clients.
Practice Insight’s powerful platform uniquely aligns with eSolutions’ comprehensive revenue cycle management products. Together, Practice Insight and eSolutions can better serve the evolving healthcare market by delivering innovative workflow solutions, revenue cycle business intelligence, reimbursement tools and advanced performance insights.
For more information on this exciting news, visit https://www.esolutionsinc.com/practice-insight-acquired-by-esolutions or contact your eSolutions account representative.
eSolutions Achieves HITRUST CSF Certification
eSolutions is proud to announce that its eligibility solutions, including its eligibility verification and coverage checker (MVP), claims editor (MedicareACE), analytics and reporting solution (MedicareSAM), DDE connection (Navigator), and denials management tool (Maven), have earned Certified status for information security from HITRUST.
HITRUST CSF Certified status demonstrates that the organization’s solutions have met key regulatory requirements and industry-defined requirements and is appropriately managing risk. This achievement places eSolutions among an elite group of organizations worldwide that have earned this certification.
“eSolutions has always been ahead of the curve on data security and earning the HITRUST CSF Certification validates our efforts,” said Gerry McCarthy, eSolutions CEO. “The HITRUST CSF is the gold-standard that needs to be met, and eSolutions is pleased to be able to demonstrate its commitment by achieving HITRUST CSF Certification.”
Counting Down to PDPM & PDGM
Two new payment models are coming soon – will your organization be ready?
On October 1, 2019, the new Patient-Driven Payment Model (PDPM) will replace the Resource Utilization Group Version IV for calculating reimbursement for Skilled Nursing Facilities (SNFs). PDPM will provide a completely new way of calculating reimbursement: Payments based on patient needs rather than on therapy minutes.
CMS and eSolutions have resources available to help you learn more and prepare:
- CMS PDPM webpage, including fact sheets, FAQs, presentation, and coding crosswalks/classification logic
- Materials from the Medicare Learning Network call in December
- New Medicare Webpage on PDPM MLN Matters Article
- Implementation of the SNF PDPM MLN Matters Article
- Here Comes PDPM: Will Your SNF Be Prepared for the New Payment Model?
- PDPM Is Poised to Transform the Way SNFs Do Business – Are You Ready?
For home health agencies, PDGM is the new Patient-Driven Groupings Model, set to become effective January 1, 2020. CMS said PDGM is its attempt to better align HHAs’ operating model with a U.S. healthcare industry that is quickly evolving toward more value-based rather than volume-based initiatives. The new rules are expected to drastically change home health reimbursement when they take effect next year.
Here’s a list of resources to get more information on PDGM from CMS and eSolutions:
For more information on CMS rules and changes, visit https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/2019-MLN-Matters-Articles.html#
Watch for more PDPM and PDGM resources coming soon from eSolutions! We can help you automate and manage your Medicare revenue cycle, visit https://www.esolutionsinc.com/solutions/medicare
Sign Up to Receive ADRs Electronically
If you’re a provider who bills Medicare Administrative Contractors (MACs) for services you provide Medicare beneficiaries, you can sign up next month to get your ADR request letters electronically.
CMS will begin sending ADR letters electronically beginning in January 2020. Register with CMS in July to begin receiving an electronic version of ADR letters, known as an Electronic Medical Documentation request (eMDR), via the Electronic Submission of Medical Documentation (esMD) system.
Because eMDRs may contain Protected Health Information (PHI), CMS will require a valid consent from the provider or the authorized individual representing the provider, along with destination details, including any delegation to their associated or representing organizations such as Health Information Handlers (HIHs).
In July, providers can register to give their consent for any HIH of their choice to receive transactions on their behalf. Then their ADR letters will be sent electronically as eMDRs. Beginning in January, providers can receive eMDRs (pre- or post-pay) through their HIH and process the data systematically. In April 2020, providers can receive the list of “Requested Documents for an ADR” along with eMDRs through their HIH.
eSolutions is a certified HIH. Designate us as your HIH and register to receive eMDRs through NexusMD or Maven.
Does Your Hospital’s Back-End Process Need a Boost?
Are your hospital back-office processes all that they should be? Does your back-end RCM team have the tools it needs to do its job properly, or is it just an afterthought to your organization’s front-end staff and processes?
Even if you think your intake staff does a thorough job of collecting patient info and verifying eligibility during the initial phone call or visit, your back-end staff still should play a big role in making sure your hospital has all the information it needs to process patient claims.
If your back-end staff has limited access to eligibility information and tools, it will be difficult for it to collect on claims with eligibility errors. And that isn’t good for your hospital’s bottom line.
Find out why your back-end staff is critical to your hospital’s revenue cycle health and how you can reduce eligibility errors by boosting your back-end processes in our blog.
Meet Morgan Brown, Corporate Trainer
If you ask Morgan Brown, she’ll tell you her boss “rescued” her from a job in food services and brought her to eSolutions. Morgan has been an integral part of eSolutions’ Client Services team for almost five years. Currently, she works with the Memphis, Tennessee, team as a Corporate Trainer, tasked with training and supporting TITAN customers, as well as acting as a partner liaison.
Her favorite quote comes from the author of Life’s Little Instruction Book, H. Jackson Brown Jr.: “Remember that the happiest people are not those getting more, but those giving more.” Giving of her time and talents to ensure eSolutions’ clients are well cared for is both a challenge and a goal for Morgan – and she’s passionate about it.
“Being a part of the Client Services team, I am constantly reminded that other people’s problems are my problems,” she said. “I am always striving to make sure that I treat clients the way I would want to be treated in a similar situation.”
Find out more about how Morgan found her way to eSolutions and why she’s an important part of our Client Services team.
Review Choice Demonstration Launched in Illinois
June 1 marked the launch of Review Choice Demonstration (RCD) in Illinois.
RCD is an evolution of 2016’s Pre-Claim Review Demonstration that incorporates more flexibility for home health agencies (HHAs). Instead of submitting pre-claim documentation on all claims, providers can also choose to submit their claims for review after receiving payment, or opt-out and take a 25% payment reduction on all Medicare claim payments.
RCD is coming soon to Ohio, Texas, North Carolina and Florida. No dates have been announced yet, so watch the CMS website for more information.
We want you to be prepared for RCD, and we have some resources that can help:
For the full RCD update from CMS, click here.
Come Visit us at Upcoming Trade Shows
Heading to any trade shows in Q3? We’d love to see you! Be sure to visit the eSolutions’ booth and let us know what’s new with you and your organization.
- July 8-11
Visualutions User Group Conference, Chicago, IL
- July 14-16
NAHC Financial Management Conference, Chicago, IL
- July 21-24
FACHC Annual Conference, Ft. Lauderdale, FL
- July 31
eCW Day Show, Houston, TX
- August 5-6
FHCA Annual Conference, Orlando, FL
- August 5-7
HFMA Region 8 MidAmerica Summer Institute – Kansas City, MO
- August 18-20
NACHC CHI, Chicago, IL
- August 27-29
TAHCH Annual Meeting, Grapevine, TX
- September 24-26
PACHC, Lancaster, PA