eSolutions Welcomes Chris F. Hart as VP, Product & Strategy
eSolutions, a leading provider of revenue cycle and workflow management technology, announced today that Chris F. Hart has joined the company as Vice President, Product & Strategy. In this role, Hart will be responsible for overseeing strategic project development and managing eSolutions’ expanding product suite.
“I’m honored to join the team at eSolutions and to help build on the company’s 20-year history of delivering market-leading revenue cycle solutions to healthcare providers,” Hart said. “I’m excited about the chance to contribute to the company’s continued success by driving new product development, strategic partnerships and an acquisition strategy.”
Hart brings extensive expertise to eSolutions from Experian, where he recently served as Vice President, Strategy-North America. He holds a Bachelor of Science in Engineering Science and a Master of Business Administration from Vanderbilt University.
“eSolutions is in a period of unprecedented market growth,” said Gerry McCarthy, eSolutions Chief Executive Officer. “As healthcare providers continue to face an increasingly complex and changing ecosystem, they will turn to partners who have a strong vision and core systems to effectively manage their organizations. Chris’ strong drive for innovation and excellence, combined with eSolutions’ successful formula for delivering transformative products clients trust, make him the ideal person to drive our next phase of growth.”
Here Comes PDPM – Are You Ready?
PDPM is only days away! As of October 1, PDPM is here to stay and your skilled nursing facility’s billing processes and revenue cycle will undergo a huge transition.
To help you stay on top of your revenue post-PDPM implementation, eSolutions has made some changes in its Medicare Enterprise products. Most notably, Medicare Analytics SNF users will notice an updated report for changed HIPPS codes. The report includes the original HIPPS code submitted, what it was changed to, and the FISS reason for the change in coding. This allows your billers to review the change and dispute it if they feel it’s in error.
If you need information and tips to help you prepare for PDPM, eSolutions offers these resources and more:
- Webinar: The Ins and Outs of PDPM, Simplified
- The SNF Guide to PDPM: What Every SNF Needs to Know
- PDPM Is Poised to Transform the Way SNFs Do Business – Are You Ready?
- Webinar: PDPM, Triple Check and Medicare Meeting
PDGM Arrives January 1, 2020
By now, you know that the Patient-Driven Groupings Model is coming January 1, 2020. Your home health agency is no doubt making changes throughout your facility in order to play by the new rules. PDGM is expected to present challenges and opportunities for HHAs, as the new rules will drive agencies to better align their operating model with a U.S. healthcare industry that is quickly evolving toward value- rather than volume-based care initiatives.
If you’d like some last-minute tips or need to get your staff up to speed, eSolutions is proud to offer you these resources:
- Counting Down to PDGM resource page, where you can find links to the latest PDGM news, FAQs, Preparation tips, Behavioral Adjustments FAQs, Intake tips and more.
Don’t forget to sign up for eSolutions’ webinar, “PDGM Changes Impacting the Bottom Line,” at 2 pm, Thursday, October 29. Presenter Karri Wright, senior director of product management at Homecare Homebase, will discuss how PDGM will impact your HHA’s bottom line. She’ll cover admission source and period timing (with elimination of therapy) upcoding; variable LUPA threshold per period instead of episode; responsibly managing comorbidities and primary diagnoses; and other considerations for agencies. Click here to register today.
Patient Intake Is Critical. How’s Your Game Plan?
Patient intake is a crucial step in the reimbursement process. Onboarding patients, collecting their information and determining what services are needed requires time, efficiency and consistent communication with referral sources. Intake and front-end eligibility lay the foundation for accurate reimbursement and, if it’s done incorrectly, organizations can face delays in payment and major disruptions in their cash flow.
With PDGM starting January 1, 2020, having an efficient patient intake process is more important than ever for home health agencies. They must adapt to changes like tighter deadlines, more payment groupings and increased claim volume. Having a flawless intake process while taking on these new challenges will make the transition much smoother. Check out our blog post on PDGM’s Impact on Patient Intake.
Find out how to improve your hospital’s intake process with eSolutions’ blog series, Improving Your Hospital Intake Game. In Part 1, learn how to evaluate and improve your eligibility process. Part 2 explains the importance of back-end processes and helps you assess whether your back-end staff has the support it needs to succeed. Part 3 dives into discharge planning and explains why it’s critical.
Review Choice Demonstration Begins Soon in Ohio
Review Choice Demonstration begins for Ohio home health agencies (HHAs) September 30, 2019. By September 15, Ohio HHAs had to choose between pre-claim review, post-payment review, or opt-out and take a 25% payment reduction. Agencies that choose pre-claim review will ultimately have more control over their claims, reimbursement timing and cash flow.
CMS will continue to post updated information on its RCD informational website. It anticipates 60-90 days between beginning the demonstration in the remaining states of Texas, North Carolina, and Florida. CMS and Palmetto GBA will provide at least 60 days’ notice before the start of the demonstration in each additional state. Providers may send any questions to: homehealthRCD@cms.hhs.gov.
For tips on preparing for RCD, check out our helpful eBook, Getting Ready for Review Choice Demonstration.
Moving from HIQA to HETS
This fall, CMS will migrate Part A provider eligibility inquiries from the Common Working File (CWF) to the HIPAA Eligibility Transaction System (HETS). CMS intends to terminate access to the HIQA, ELGA, ELGH and HIQH eligibility systems. Going forward, HETS will be the single source for eligibility transactions.
eSolutions is fully prepared to assist our customers in managing the transition to HETS. You will receive notice about coming product updates and changes as we help you transition. For more information about this important transition, please contact your eSolutions Account Representative or download our HETS Transition FAQs.
How Can eSolutions Help? Check Out These New Case Studies
eSolutions helps different organizations get cleaner claims out the door faster, dramatically improve workflows and strengthen their revenue health. But don’t take our word for it. We’re proud to share the stories of two different customers’ journeys in using eSolutions’ products to succeed.
The Door is a unique organization in New York City providing a wide variety of services, including healthcare, to more than 10,000 youth each year. Since it began using eSolutions’ clearinghouse, ClaimRemedi, which is integrated into The Door’s Practice Management System, workflows have improved dramatically and A/R days have decreased by 15%.
Caring Healthcare owns and operates a group of 15 Texas-based skilled nursing facilities (SNFs). Since Caring Healthcare began using eSolutions’ special CASPER Reports tool in combination with the Medicare Enterprise package, its billers’ manual tasks have been greatly simplified.
Read more eSolutions case studies here.
Client Services Spotlight – Meet Kelly Reilly
The world of claims is not an easy one to navigate, but fortunately for eSolutions’ clients and staff, Kelly Reilly is there to help guide everyone through the choppy waters.
Kelly is an EDI analyst and Trainer Tier 3 at eSolutions. She provides customer support through analyzing raw data files, troubleshooting payer rejections, training peers in various EDI and clearinghouse tools, and creating training documentation.
“Many clients are used to looking a paper claim forms such as UB04 or CMS 1500 claim type forms and really do not know what an electronic claim looks like at all, so it is my job to interpret and quite often translate the information so clients know why their claims are being rejected or denied,” she explained.
Find out more about Kelly and why she’s an important part of our Client Services team.
See You at Upcoming Trade Shows
eSolutions will be busy traveling this fall. If you’ll be attending any of the following shows in Q4, 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.
Alabama Primary Health Care Association Annual Conference – Gulf Shores, AL
Cerner Health Conference – Kansas City, MO
Georgia Primary Care Association Annual Conference – Alpharetta, GA
MACtoberfest – Asheville, NC
South Carolina Primary Health Care Association Annual Conference – Columbia, SC
Becker’s HIT + Revenue Cycle Conference – Chicago, IL
AHCA/NCAL Annual Convention & Expo – Orlando, FL
MGMA Annual Conference – New Orleans, LA
NAHC Home Care & Hospice Conference & Expo – Seattle, WA
Pennsylvania Association of Community Health Centers Annual Conference – Lancaster, PA
Maine Primary Care Association Annual Conference – Bar Harbor, MA
California Primary Care Association Annual Conference – San Diego, CA
eClinicalWorks National User Conference – Orlando, FL
iPatientCare NUCON – Cincinnati, OH
Texas Association of Community Health Centers Annual Conference – The Woodlands, TX
Community Health Center Association of New York Annual Conference & Clinical Forum – Tarrytown, NY
PointClickCare Summit – Dallas, TX
NextGen User Group Meeting – Orlando, FL
HFMA Georgia Fall Institute – Savannah, GA
Modernizing Medicine Momentum 2019 – Orlando, FL
Illinois AAHAM Annual State Institute – East Peoria, IL