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An automated claims service can reduce the time, expense, and risk of processing insurance claims. But the existing products don’t always meet the needs of audiology or speech-language pathology practices. Most products require a practice management system; many are designed for large practices that have full-time administrative support; and none of them are customized for speech-language pathology or audiology procedures.
What’s a speech-language pathology or audiology practice to do?
To address these issues, ASHA rolled out an online claims management service at the 2002 Convention. PracticeSource, which delivers business automation solutions to simplify the business aspects of running a practice, launched a new claims service that is designed to solve these unmet challenges and is customized to meet the needs of ASHA members.
A Web-Based Solution
Recognizing that many ASHA members are in solo or part-time practices, and many large practices have a network of independent providers, PracticeSource was determined to deliver a solution that could be used through the Internet, without installing expensive software. Two types of services are available:
• Direct Entry —This version of the automated claims service is available through the Internet. The secure, password-protected service can be accessed from any Web-enabled computer, anytime, anywhere. Claims data can be entered into a familiar form provided by the Health Care Financing Administration (HCFA), which is completed online, with all recurring fields automatically completed to save time and avoid repetitive typing.
• System Entry —For practices that use practice management software, this version enables claims to be processed and submitted with information from your installed system.
Error-Free Submissions
In addition to easy submissions, the online claims system increases the odds that the insurance company will accept the claim. Each time a claim is submitted, the system takes it through 180+ automated edits before sending it to the payer. This ensures that claims are error-free, decreasing the chance of rejection.
Less Time on Hold
All too often, once claims are submitted, they seem to fall into a black hole. In the past, the only way to track claims was to call the insurance company and stay on hold to get claims status information or wait until either payment or a rejection letter arrived. The PracticeSource service includes an electronic claims tracker, which provides status updates on all submitted claims. Providers have a real-time record of the receipt of the claim and the process status, and can run reports on individual claims, or all claims, and receive information sorted by provider, location, payer, or payer records.
Providers will also spend less time on hold waiting to get patient eligibility verification from insurance companies. PracticeSource’s claims service includes an online eligibility verification tool that enables providers to verify patient eligibility online, in seconds, without the need to make a phone call—providing peace of mind that patients are covered, even before they walk in the door.
HIPAA Compliance
In addition to administrative savings in processing and tracking time, reduced paperwork, and faster reimbursement, an online claims service ensures that practices meet the HIPAA requirements for electronic data transmission and privacy of patient information.
Because it is a Web-based solution, the PracticeSource service can be delivered at a cost that can be easily justified by the time, paperwork, and postage savings. In setting the price, PracticeSource listened to ASHA members and developed a flexible pricing model that varies based upon claims volume, practice size, and type of claims submission structure.
Online Solutions, Offline Help
While the system can easily be installed and used on the Web, and training is available online, PracticeSource also provides live support through a customer support team that can be accessed through a toll-free telephone number. The customer service team can help you with purchase-related inquiries, personalized training and implementation support, and claims processing questions. To learn more, contact PracticeSource by phone at 1-866-722-2843 or visit www.practicesource.net.
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