We get it! Skilled Nursing Facility (SNF) teams need more hours in the day. Hundreds of SNFs throughout the country entrust eSolutions’ web-based products to streamline workflow, speed up cash flow and improve financial outcomes. Learn where and how six special eSolutions skilled nursing customers have leveraged eSolutions to get back their valuable time and increase revenue.
Enhanced Eligibility Verification Prevents Rejected Claims
Many SNFs spend countless hours 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:
- 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.
Systems Services, Inc., is a large organization operating approximately 90 nursing homes throughout Missouri and billing nearly 3,000 Medicare claims a month. Its 10-person billing team relies on the eSolutions Medicare eligibility verification tool to automate processes that formerly took hours.
Medicare Enterprise dramatically impacted eligibility runs, slashing the time to run an eligibility report by 80 to 90 percent,” said Angel Best, Systems Services Medicare Biller.
Direct DDE Connection and Easy Claims Correction Saves Time and Reduces Errors
Chances are, your revenue cycle vendor doesn’t have a direct connection to the DDE. eSolutions has a unique direct DDE connection service that offers faster, more reliable communication with the DDE system across multiple locations. Connecting faster to the DDE means your staff processes more claims in less time.
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 SNF customers. Our automated 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, SNFs and home health and hospice services, counts on eSolutions to streamline its revenue cycle and simplify complex processes, like manual claims corrections.
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.
Reduced Rejections and Denials with Powerful Business Intelligence
The Medicare Enterprise Package provides best-in-class analytics and reporting on Medicare claims.
NHS Management oversees 42 SNFs throughout the southeast U.S. With eSolutions’ reporting and analytics tools, the NHS Management billing team is able to track and trend claims in real-time, enabling them to spot and fix any errors within the system on a daily basis. As a result, NHS Management is receiving their reimbursements much faster and is running more efficiently.
It’s amazing to see how much extra time we have to focus on other tasks, said Erica Ashford, NHS Management Regional Manager. We’re all very satisfied with all of the products we use and only wish we would have found them sooner!
Managing your appeals process shouldn’t be time consuming and costly. SNFs 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 24 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 SNFs
The complex rules and regulations surrounding SNF billing can make your head spin. You can trust our team to understand your unique challenges and the tools within our products we’ve developed after years of working with skilled nursing providers:
Manage Therapy Caps
You could increase your productivity up to 90 percent when billing therapy claims using Medicare Enterprise! It features a Therapy Caps Report that tracks therapy caps so you have a heads up that prior authorization is required. You’ll receive multiple automated alerts as your patient approaches, hits and exceeds the maximum threshold.
For patients who are near or have exceeded the therapy cap, our Claims Correction tool includes a KX Modifier feature that applies modifiers to multiple line items with one click!
Continuum Health Care Services is an Iowa-based organization that owns and manages several SNFs. It’s team made the move to eSolutions products to help simplify billing under the demands of the state’s Managed Care Organizations (MCOs).
“The KX Modifier Tool is huge for our organization. Before we had eSolutions, we had to manually correct claims and add the modifiers in the FISS, which means we were deleting every line item and re-entering it, said Brenda Mortenson of Continuum Health Care Services. I bet there are times when having this tool saves us 30 minutes per claim. It’s one of the greatest things ever!”
Systems Services uses the KX Modifier Tool frequently according to Angel. It’s awesome and it’s one of my favorite features, she said.
Crossover Claims Made Easy
Medicare Enterprise Pro includes special capabilities for SNFs to handle crossover claims with our special tool, Medicare Secondary Crossover. No more searching for crossover claims or missing an opportunity to bill a claim. Days before you get notice of remittance, Medicare Secondary Crossover identifies Medicare Secondary Payer claims that didn’t automatically cross over. It will shorten your payment cycle and supply you with UB and 1500 claim forms automatically. It also provides detail and summary reporting for claims that crossed over.
eSolutions gives SNFs several weapons in the arsenal to improve compliance through smart submission and reporting tools. Submit HIPAA-compliant Minimum Data Set (MDS) 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 SNF clients’ stories by visiting our case studies page. Want to learn exactly how eSolutions will improve your revenue cycle? We’ve got a whole team of SNF experts who are ready to help you!