GeBBS Healthcare RCM Blog

ERAs Are a Win-Win over Paper EOBs

Posted on Thu, Feb 12, 2015 @ 08:52 AM

The introduction several years ago of the ERA (Electronic Remittance Advice) created a quantum leap in the healthcare billing arena by providing an improvement to the traditional, paper-based EOBs. Astonishingly, many providers have not taken advantage of this revolutionary change. It has been estimated that even today only 46 percent of the claims are processed electronically, while the remaining 54% claims are processed in the traditional paper-based method. However, the Affordable Care Act (ACA) mandated that all healthcare plans adopt and support ERA operating rules before January 1, 2014. 

Here are just a few reasons why you should adopt ERAs:

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Significantly Reduce Processing Time: The major benefit of implementing ERAs is that they significantly bring down the medical claims billing processing time. When payment postings are done electronically, cash flow is accelerated. Also, since everything is electronic, the length of time a paper check or EOB spends in the traditional ‘snail mail’ system is avoided.

Reduce Manual Workflows: By adopting ERAs, providers and healthcare billing companies can reduce manual workflows significantly. Also, the number of employees can be reduced who have been assigned to post payments, or these employees can be reassigned to other medical claims billing functions.

Electronic Posting Efficiency: ERAs allow the use of electronic auto posting features, which enable posting of payments on to the system automatically. The error rate of the automated posting method is much less than that of manual postings, and the time spent correcting manual errors is also lessened.

Cost-Effective: Healthcare providers and medical billing companies can save significant dollars by implementing ERAs. The cost involved in recruiting new employees and training current employees is saved. Huge savings in terms of paper costs, printing costs and mailing costs can be realized. Electronic payment posting is not only time efficient, but also cost-effective.

It’s “Green”: The adoption of ERAs has encouraged several healthcare billing companies and providers to “Go Green.” Approximately, 2.5 billion pieces of paper can be saved by using eco-friendly electronic payment processing.

If you want to immediately achieve these benefits, your practice, hospital or billing company can implement a full-service outsourced payment posting solution that will allow you to instantly convert your paper EOBs to ERAs. Your outsourcing partner will use a technology solution that will import 837 claim data and convert your paper EOB's into ANSI 835/ERAs. The data will easily integrate with your document management system. By outsourcing this work, you can immediately treat every remittance as an ERA.

if you would like more information about the blog topic or how GeBBS can help you:

 

Contact GeBBS Now

 

Tags: Data Analytics, Revenue Cycle Management (RCM), Electronic Remittance Advices (ERAs), Explanations Of Benefits (EOBs), Accounts Receivable (A/R), Insurance Billing Solutions

Why Switch to ERAs?

Posted on Tue, Jan 27, 2015 @ 02:38 PM

Why Switch to ERAs?
In addition to inefficient processing and high administrative costs, paper EOBs contribute to a provider’s

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struggle with physical storage and document inaccessibility. Rummaging through paper archives as a means to investigate and manage secondary claims does not promote efficiency.
Even worse, your medical practice or hospital may miss out on the opportunity to harness the power of big data. In the absence of a readily accessible and centralized data warehouse, providers forfeit the opportunity to effectively analyze their payments and denials in hopes of making smarter business decisions.


How ERA Will Benefit Your Practice?
ERAs were created to handle increasing transaction volumes, complex compliance issues and high administrative costs. ERAs alleviate the tedious process of manually entering, checking and posting payments by automating processes and accelerating the revenue cycle.

The American Medical Association (AMA) estimates that the average provider can save almost $9,500 annually by switching to ERAs. Just imagine your office staff not having to collect mail, file paper documents, manually post payments and speak with payers. Transitioning to ERAs means less administrative waste and more effective patient care.

Adopting a system with the capacity to accept ERAs, post denials and run real-time analytics will allow your practice to track, analyze and manage the revenue cycle seamlessly.

If you cannot accept ERAs today, your practice, hospital or provider group can implement a full-service outsourced payment posting solution that will allow you to immediately convert your paper EOBs to ERAs. Your outsourcing partner will use a technology solution that will import 837 claim data and convert your paper EOB's into ANSI 835/ERAs. The data will easily integrate with your lockbox or document management system. By outsourcing this work, you can immediately treat every remittance as an ERA.

if you would like more information about the blog topic or how GeBBS can help you:Contact GeBBS Now

 

Tags: Data Analytics, Revenue Cycle Management (RCM), Electronic Remittance Advices (ERAs), Explanations Of Benefits (EOBs)

Why ERAs Are More Efficient than EOBs

Posted on Wed, Jan 07, 2015 @ 02:08 PM

It is no secret that the healthcare industry is burdened with costly administrative processes. A good example of this are paper explanation of benefits (EOB) forms that have been estimated to cost nearly $18,600 per physician per year in administrative fees.

With the availability of tools like the electronic remittance advice (ERA), medical practices, hospitals, billing companies and other healthcare providers can jump on the paperless bandwagon and reduce these exorbitant administrative costs.

An electronic remittance advice (ERA) -- or what is frequently referred to as the HIPAA 835 file -- is essentially an electronic EOB. ERAs contain information on whether a claim was paid or denied, final status claims and any adjustments the payer made to the billed amount.

The Affordable Care Act (ACA) requires health plans to implement ERAs under Stage 2 of its Administrative Simplification provision. This represents a strong incentive for payers like Medicare, Medicaid, and other large insurers to phase out paper EOBs.

Why Do You Need ERAs?

Manually posting payments and reconciling patient accounts is time consuming and therefore costly. According to one study, the average physician spends approximately five hours per week on administrative and nonclinical tasks. This translates into three weeks per year on billing and insurance-related tasks.

What causes this “hassle?” EOB formats and claim adjudication codes are not standardized across payers, making it challenging to manually post and reconcile payments. Also, manually processing EOBs is highly susceptible to data entry errors. If your staff accidentally inputs $20.00 instead of $200.00, they will have to check the entire batch to locate the error.

It’s easy to switch to ERAs from paper EOBs. 

If your practice, hospital, billing company or provider group implements a full-service outsourced payment posting solution, you can immediately convert your paper EOBs to ERAs. Your outsourcing partner will use a technology solution that will import 837 claim data and convert your paper EOB's into postable ANSI 835/ERAs. The data will easily integrate with your lockbox or document management system. By outsourcing this work, you can immediately treat every remittance as an ERA.

if you would like more information about the blog topic or how GeBBS can help you:Contact GeBBS Now

 

Tags: Revenue Cycle Management (RCM), Electronic Remittance Advices (ERAs), Explanations Of Benefits (EOBs), Affordable Care Act

Understanding Electronic Remittance Advices: Benefits & Obstacles

Posted on Sat, Nov 17, 2012 @ 02:33 PM

EOBs Are Going the Way of the Dinosaurs – Extinction!
Make Sure Your Facility Doesn’t Follow Them.


The “paper blizzard” that the healthcare industry has been caught in for many years is finally starting to subside. The inefficiencies of dealing with too much paper in the healthcare payment process are well documented.

One of the major contributors to this blizzard has been paper-based explanations of benefits (EOBs). Slowly but surely the clouds are clearing with the advent of more and more healthcare plans moving to electronic remittance advices (ERAs). The efficiencies and technological advantages of ERAs will surely doom the old EOBs to eventual extinction.

The federal Centers for Medicare & Medicaid Services (CMS) reports that 28 percent of administrative staff time spent on billing and insurance-related tasks in a doctor's office goes to receiving and posting payments, follow-up, and payment reconciliation.

CMS's interim final rule, which became effective August 10, requires that medical practices adopt electronic funds transfer (EFT) and electronic remittance advice (ERA). The compliance date is January 1, 2014.

CMS reports that when health plans and physician practices implement its regulations, the industry should save between $300 million and $3.3 billion over the next decade.

The Electronic Remittance Advices are a refreshing replacement for paper-based EOB documents.

The ERAs contain the same claims payment information as EOBs, but they are designed to allow for the electronic posting of payments to an accounts receivable system without human intervention. ERAs provide details about claims payments as well as notice of a payment due to the provider via electronic data interchange (EDI). To accomplish this process, the healthcare industry devised a standard for electronically transmitting the explanation of what the insurer is paying to the provider: the HIPAA X12N 835. This is the reason ERAs are commonly referred to as 835s.



ERAs have been around for several years and their benefits are indisputable:

  • full electronic processing
  • no mailing or faxing paper remittances
  • faster and easier payments
  • easier tracking of payments
  • improved compliance and better auditability

Question:
Why then has ERAs adoption not been more wide spread?



The answer:
Technology Challenge. 

technology challenge

A key obstacle to the faster adoption of ERAs is that many healthcare providers are not equipped to handle them. Smaller provider sites – those with less than 10 doctors – still make up a substantial percentage of the U.S. claims volume. Though many of these providers have signed up for ERAs, most do not have the knowledge of how to load the 835s into their systems, so they end up either printing an imaged version of the 835 or reverting to the paper remittance. In either case, the provider must manually key the data, which defeats the ERA purpose.

 Smaller hospitals, in particular, seemed to be challenged by ERAs. Either they can't post the ERAs because their systems are too antiquated, or the format of the ERAs is not compatible and won't post cleanly, creating downstream exceptions that are costly in time and labor.

As a healthcare provider, how can you make sure your facility can take advantage of the benefits of ERAs?

A professional medical billing outsourcing provider can ensure that your facility has the technology and staff training to accept ERAs. They can help you meet the technology challenge that is holding back so many healthcare providers and ensure that you don’t go the way of EOBs and the dinosaurs – extinction. 



Tags: Business Process Outsourcing (BPO), Electronic Remittance Advices (ERAs), Explanations Of Benefits (EOBs)