Thousands of home health and hospice agencies throughout the country entrust eSolutions’ web-based products to speed up cash flow, improve reimbursement and maximize productivity to save precious time and cost. Learn where and how six special eSolutions customers have gained significant improvements at key crossroads of the revenue cycle.
Enhanced Eligibility Verification Prevents Rejected Claims
Many home health and hospice agencies spend endless time manually checking patient eligibility. Since failure to check eligibility and verification errors are the number one cause of rejected Medicare claims, lack of an automated, comprehensive eligibility process can be costly.
eSolutions enhanced eligibility verification tool checks Medicare eligibility in real-time, returning instantly the information you need, including:
- Beneficiary and subscriber verification
- Eligibility and benefits
- Coverage type
- Provider/service specific coverage information:
- PPS episode information
- Hospice periods
- Preventative services
- Coverage changes since prior inquiry
eSolutions also offers a batch eligibility option and automated change reporting features to further prevent rejected claims. What’s great about our automated change reporting feature? It returns any patient eligibility and coverage changes since the last time you checked eligibility in one easy-to-read report. No more manually sifting through heaps of patient data to detect changes on one patient at a time.
Hospice of Cincinnati provides personalized end-of-life care spanning four counties in southwest Ohio. Its team turned to eSolutions to cut unnecessary and behind-the-scenes costs. Kim Kuebler, Medicare Supervisor and Manager, said she couldn’t believe what her staff had been missing by not using eSolutions’ eligibility verification.
The ability for multiple staff members to check patient eligibility simultaneously has increased productivity and saved valuable staff time, Kim said. The Medicare eligibility verification tool has been a great resource for us.
Easy Claims Correction Saves Time and Reduces Errors
There’s nothing wrong with doing things the old fashioned way, unless it comes to correcting claims manually. Correcting claims by hand in FISS is a thing of the past for our home health and hospice agency customers. Our automated Medicare Claims Correction tool replaces the labor-intensive process of updating claims in FISS by allowing providers to correct claims directly in FISS in a browser-based, familiar UB-04 environment.
Brookdale Senior Living, one of the nation’s largest owner and operator of senior living communities, skilled nursing facilities and home health and hospice services, counts on eSolutions to streamline its revenue cycle and simplify complex processes, like manual claims correction.
Layne Tomlinson, Supervisor of Healthcare Accounts Receivable at Brookdale Senior Living, said eSolutions was an immense upgrade to their claims submission process with full editing capabilities, 24/7 access and the ability to work in a web-based interface.
The efficiency of editing claims now is greatly improved, Layne said. We spend less time correcting previously missed claim errors, reducing the time it takes for reimbursement.
Harbors Home Health and Hospice in Hoquiam, Washington, experienced a dramatic improvement in productivity thanks to our Claims Correction tool. Medicare Claims Correction is my favorite product to work with because of how easy it makes our billing process, said Nicole Caffall, Lead Biller. Not only does it tell me when there is a mistake on a claim, but it lets me know exactly what the mistake is and won’t allow me to submit it until it’s been corrected. That alone saves me a ton of research time.
Actionable Data for Informed Business Decisions
The Medicare Enterprise Package provides best-in-class analytics and reporting on your Medicare claims.
St. Anthony’s Hospice, serving three Kentucky counties, counts on eSolutions’ analytics to uncover potential issues and implement meaningful changes. The reports are easy to read and understand, and they allow you take make corrections on the spot, said Jodie Conrad, Director of Operations. I love the daily email push reports, because each morning I can see all of our RTPs, paid claims and generally what our claims look like.
Managing your appeals process shouldn’t be time consuming and costly. Home Health and Hospice agencies across the country rely on eSolutions’ Audit and Denial Management to easily and effectively appeal denied claims and gain intuitive insight into data to prevent future denials.
Ray Davis, Director of Reimbursement and Appeals at Liberty Healthcare Companies, which operates more than 35 home care and hospice locations, believes Engage Audits and Denials has eliminated the struggle of managing the appeals process.
Without Engage Audits and Denials, it would be impossible to manage our ADR process as well as we currently do, he said. We can keep the focus on working with our facilities to develop the best ADR submission possible.
Engage Audits and Denials also streamlines HIPAA-compliant, electronic submission of medical records, assigns workloads to your team and offers in-depth productivity reports so you can manage the process every step of the way.
Improved Reimbursement and Compliance with Special Tools for Home Health Agencies and Hospices
We get it! All the rules and regulations surrounding home health and hospice billing are complicated. You can trust our team to understand your unique challenges and the tools within our products we’ve developed after years of working with home health and hospice providers:
Streamline Hospice NOE Billing
Timing is everything in hospice billing. Getting your Notices of Election (NOEs) to Medicare within the five-day deadline is imperative. Submit your NOEs with our simple, accelerated NOE submission tool that sends your NOE straight to Medicare and eliminates manual entry into the DDE. If you have multiple NOEs piling up, eSolutions has a powerful batch submission tool that allows you to submit multiple NOEs to the FISS with one click.
The key to staying ahead of NOEs is access to essential claim tracking data that helps eliminate major reimbursement delays. Our clients accomplish this using the NOE Tracker and NOE Benchmarking features included in Medicare Enterprise.
St. Anthony’s Hospice biller, Rochelle Carter, said eSolutions has dramatically improved the process of submitting NOEs. NOEs are straightforward, and the tool lets you know exactly what’s needed on those claims, she said. She added that rendering NOE reports is extremely user friendly and accurate.
Take RAPs Head On
eSolutions helps home health providers take Request for Anticipated Payments (RAPs) head on, beginning with upfront patient eligibility verification so your episode goes off without a hitch. Our OASIS Analysis tool helps you easily complete and submit the OASIS file by scrubbing it for errors, submitting it electronically, then returning a validation report so you’re ready to produce a RAP-ready, compliant claim.
Once your RAP is submitted cleanly, eSolutions keeps you on top of the process by tracking RAPs and giving you tools to prevent RAP takebacks. Two special reports, RAP at Risk and the Cancelled RAP Monitor, provide daily reporting on affected claims so you can take action when needed.
Healthcare Provider Solutions, a Nashville, Tennessee company that provides billing services for more than 90 home health and hospice agencies, depends on eSolutions for efficiently billing and managing RAPs. Aaron Carey, Chief Operating Officer said he finds the RAPs at Risk Report a useful tool.
I 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, Aaron said. This report also alerts them to any pending RAP takebacks.
Collect on your MSP Claims – Money that’s Rightfully Yours!
Do you have MSP claims that haven’t been paid? Jodie said St. Anthony’s Hospice hadn’t received full payment on an MSP claim in 15 years, and eSolutions changed that. With billing three to five MSP claims a year, eSolutions more than paid for itself, she said. That’s because eSolutions provides tools that help providers manage MSP claims so they don’t disappear into the unpaid claim abyss.
eSolutions gives home health and hospice agencies several weapons in the arsenal to improve compliance through smart submission and reporting tools. Submit HIPAA-compliant OASIS and HIS files using our transfer service.
It’s critical to ensure you’re reviewing those CASPER reports to keep an eye on care quality so you can maximize your five-star ratings. eSolutions takes the pain out of retrieving CASPER reports by automatically downloading your reports and delivering them straight to your inbox.
Check out our home health and hospice clients’ stories by visiting our case studies page. Want to learn exactly how eSolutions will improve your home health or hospice revenue cycle? We’ve got a whole team of home health and hospice experts who are ready to help you!