The Revised CMS-1500 Claim Form

The Revised CMS-1500 Claim Form

The transition to ICD-10 codes comes with a revised CMS form to facilitate reporting. The National Uniform Claim Committee (NUCC) approved the use of the revised CMS- 1500 Claim Form in February 2012. The new CMS-1500 form will be printed with 02/12 in the lower right hand corner to indicate it’s the replacement for the 08/05 version.

The CMS-1500 must be used when billing Medicare and other federal payers for services. Clinicians must indicate when submitting claims on CMS-1500 if they’re using ICD-9 codes or if they’ve already made the transition to ICD-10. It’s essential that clinicians maintain communication with their payers and clearinghouses and conduct testing to ensure submissions are being transmitted and received correctly.

Medicare began accepting the revised version of claim form CMS-1500 on Jan. 6, 2014 and all submissions after March 31, 2014 must be done with the revised CMS-1500.

For those who have received a waiver for electronic transmission, Medicare will continue to accept paper claims, but only on the revised form. Medicare will deny any claim submitted on the old CMS form on and after April 1, 2014.

The new CMS-1500 was required to correctly report and document the thousands of new ICD-10 codes and the alpha-numeric system that will be used. Use of the new form is mandatory when billing any federal payer. Many of the line-by-line item changes were relatively small, such as changes in wording. For example, TRICARE CHAMPUS has been shortened to TRICARE and the Social Security number is now referred to as an ID number.

 

Other line items with which clinicians were familiar were eliminated entirely, since the information will now be reported elsewhere on the form or not at all. A number of lines now read “Reserved For NUCC Use” and data that includes employer’s name, school and balance due that wasn’t reported on 837P weren’t deemed necessary and aren’t required on CMS-1500.

An enhancement on the form allows clinicians to list up to 12 diagnosis codes per patient. CMS-1500 has a number of open fields, but they can’t be utilized to report additional data. Practitioners now have qualifiers to identify them as a referring, ordering or supervising provider and diagnosis codes that were labeled 1-4 now have an A-L designation.

The ICD-10 codes are more specific and the CMS-1500 reflects that. The new form has a QR Code that can be scanned with a smartphone. The QR Code takes users to the NUCC website. The revised CMS-1500 also underwent changes that would provide practitioners with the ability to add extra qualifiers when needed.

Any reimbursement claims filed prior to implementation of the revised CMS-1500 that must be resubmitted for any reason should be transmitted utilizing the revised form. This is true even if the previous claim was submitted on the earlier form.

A copy of the form can be downloaded for examination purposes, but it can’t be utilized to submit claims. CMS-1500 uses exact red ink match technology and much of the embedded information will remain invisible when it’s scanned with an Optical Character Recognition (OCR) device. Clinicians should be aware that payers can opt not to process claims that are submitted in black ink and doesn’t use the red ink match technology.

It will take some time for clinicians to familiarize themselves with the revised CMS-1500 form and the new ICD-10 codes, but the form is now an accomplished fact. The new codes and forms are a reality of the healthcare environment and clinicians must use them or risk not receiving reimbursements.

How to Solve the Problem of Patient Payments

How to Solve the Problem of Patient Payments

Patients are usually the last to pay their part of the bill for services they received. To encourage patients to pay their bill, practitioners must make it as easy as possible for them to do so. That means implementing a variety of online payment options. Practices that offer that service are more likely to collect from clients without the need for multiple billings and reminders.

Multiple Payment Methods

In Touch EMR™ allows patients to pay with multiple methods that include cash, check, money orders, and credit and debit cards. Older clients are less trusting of technology and are less likely to utilize payment methods that require them to divulge personal information online, or they may not have access to a computer. For those patients, checks and cash are typically the preferred method of payment.

The In Touch EMR™ is the most sophisticated system in the world, providing a convenient way to pay that’s available to clients 24/7. It’s safe, secure and boosts revenues. The company assists therapists in setting up a merchant account that enables payments to be deposited directly into the clinic’s account, usually in as little as seven days.

Recurring Payments

With the In Touch EMR™, patients also have the ability to make recurring payments. When faced with a large bill, many clients panic and don’t pay anything instead of making smaller but steady payments. In Touch EMR™ solves that problem. Client amounts are broken down into convenient and manageable payments that they can make over time. Clinicians can offer discounts for cash payments and balances paid within a specific amount of time to encourage remittance.

Convenience, security And Eco-Friendly

There’s no need to store sensitive data on-site with In Touch EMR™. The software maintains data in the cloud for added security. The software is HIPAA compliant and adheres to the protocols set forth by the Payment Card Industry Data Standard. The cost of collections is significantly reduced and billers can focus more on claim submissions.

The integrated software is an environmentally friendly method that virtually eliminates paper bills and statements. There may be times when a paper document is required and In Touch EMR™ provides the ability to print one when necessary. When an online payment is made, the data goes to the biller for posting.

Convenience for clients is an essential concept for clinicians that want to increase revenue collection. Online options utilize methods with which most patients are familiar. Practices with online payment options are perceived as more progressive and desirable. An added benefit of offering online payment options is that patients are more likely to recommend the practitioner to others, providing valuable word-of-mouth marketing.

Make Life Easy for Your Biller

Make Life Easy for Your Biller

Next to the clinician, the biller is the most important person in the practice. The biller is the individual that ensures claims are correct, submits them, and monitors each reimbursement request to ensure the physical therapist gets paid. The In Touch EMR™ and In Touch Biller PRO make the biller’s job easier, thereby increasing productivity and revenues.

Simple Solutions

Billers need billing software that’s simple, efficient and super powerful. Those three attributes are contained within the In Touch Biller PRO software. The most time consuming task for a biller is manually entering information from paper documentation. That’s a task that should be avoided at all costs. In Touch Biller PRO works with multiple operating systems, allowing billers to work with the system they’re most familiar with, whether it’s a PC, Mac, iPad or Android.

The integrated In Touch Biller PRO can be used in conjunction with In Touch EMR™ and other software to send claims directly to the billing system. The software allows billers to access one-touch functionalities to scrub, edit and submit claims.

In Touch Biller PRO software is compatible with hundreds of payer and clearinghouse systems through the United States. Built in crosswalks assist billers with the ICD-9 to ICD-10 changeover.

Automatic Functions

When ERAs are returned for the biller’s attention, he/she can post patient statements to the client’s file with a touch of a button. Billers can utilize multiple methods to communicate with patients about their portion of the bill, send reminders about outstanding balances, and print paper copies if needed. With In Touch Biller PRO, the patient billing process is accomplished quickly and efficiently with no need for hours spent entering data by hand. Claims can be transmitted individually or as a batch.

Billers are highly skilled professionals, second only to clinicians in their importance to the practice. Billers keep the flow of revenues coming in and anything practitioners can do to make their biller’s job easier will pay dividends well into the future.

In Touch Biller PRO provides one-touch abilities and automatic functions that eliminate manually entering information. Billers are more efficient and practices attain better cash flow.

Outline of a Simple, Efficient Workflow

Outline of a Simple, Efficient Workflow

Efficiency is the key for every facet of a practice’s workflow. EMR and billing software should be integrated, offer one-touch functionalities and complete many tasks automatically. Technology can make a practice infinitely more efficient and thereby more profitable. It makes the biller’s job easier, allowing income to be generated more quickly. From one-touch functionality to voice recognition documentation, In Touch EMR™ and In Touch Biller PRO software is specifically designed for efficiency and better profitability.

Bring In The Patient

In Touch EMR™ has the ability to schedule patients, communicate with them through multiple methods, and create automatic patient files. When the client arrives for their appointment, In Touch EMR™ has the built in ability to quickly validate patient insurance eligibility online with hundreds of payers, and more can be added as needed.

The In Touch EMR™ is the only EMR with an iPad app. Patients can take a photo of themselves for identification purposes, photograph their insurance card and complete patient data with the iPad. The Web-based system maintains information in the cloud for security and HIPAA compliance. When the required information is obtained, the front desk can hit a single button to automatically create a patient file. The client is now in the system and the file is available to the clinician.

Claiming Revenues

The integrated In Touch EMR™ works with In Touch Biller PRO to create a simple, yet efficient workflow. In Touch Biller PRO scrubs claims and allows for changes to be made when needed. It identifies potential problems and prompts billers for modifiers and other data to ensure each claim is clean for submission. The system enables billers to review all claims, no matter what their status

Reporting Statistics

Sophisticated reports can be generated with In Touch EMR™ to keep clinicians advised of the most profitable procedures and payers, where most referrals are originating, and the most productive staff members. Reports can be generated based on a comprehensive array of user defined parameters to monitor every facet of the practice.

Clinicians can utilize features that include the advanced flow sheet, voice recognition for documentation, automatic creation of patient files and automatic claim submission. The In Touch EMR™ is designed to create and enhance an efficient workflow that allows practices to become more profitable, while making it easier for clinicians to do their job.

In an era of dwindling reimbursements and increased regulatory requirements, clinicians must use every resource at their disposal to make their office efficient and profitable. In Touch EMR™ and In Touch Biller PRO work in tandem to accomplish those goals with technology designed for the way clinicians work.

The Three Key Elements of Claim Submission

The Three Key Elements of Claim Submission

The financial success of a practice relies on the biller’s ability to complete claims and submit them as quickly as possible. Automation is the key to accomplishing that goal. In Touch EMR™ provides practices with an extensive array of automatic functions to make clinics more efficient, productive and profitable.

Billers should have access to three key functionalities within their billing software. Those elements make their job easier and allow them to submit clean claims that are far less likely to be denied or encounter problems during the payment process.

Automatic Forwarding

When the clinician has completed the patient encounter documentation, he/she should be able to hit a single button and have the EMR system automatically forward the claim to the billing department. In Touch EMR™ provides that ability. Claims are carried forward form the EMR to the billing system automatically, complete with the CPT and ICD codes, documentation and other pertinent information needed to submit the claim.

Making Changes

In Touch EMR™ allows billers to make changes within the claim when a conflict arises. The software automatically notifies billers of potential problems and incompatibilities within the claim. Billing professionals can then utilize their experience, expertise and insight to edit the claim appropriately. In Touch EMR™ and In Touch Biller PRO work together to seamlessly expedite the claims process.

Next to the clinician, the biller is the most important person in the practice. Providing the biller with software that offers the ability to rectify coding conflicts and works with them to expedite claims makes their job easier and creates a better cash flow for the clinic.

Keeping It Clean

The ability to scrub claims before they’re transmitted is essential. It reduces denials and facilitates every step of the payment process. In Touch EMR™ provides automatic scrubbing to create clean claims that are paid faster. It makes the biller’s job easier, promotes productivity and simplifies the claims process from start to finish.

The built-in abilities of the integrated In Touch EMR™ and In Touch Biller PRO work harmoniously to facilitate the claims process, while automating key abilities it with a variety of one-touch functionalities. The software systems provide the means to edit claims to resolve conflicts that would result in denials, allowing billers to submit clean claims that are paid quickly for improved cash flow.

The Importance of Patient Pay Online Options

The Importance of Patient Pay Online Options

Studies have shown that people are more likely to pay any bill rather than their doctor bill. Collecting patient pays can be difficult, especially larger amounts. Making it as easy as possible for clients to pay their portion of medical bills improves collection rates, while fostering the patient’s perception of the practice as one that’s modern and makes an extra effort on their behalf.

There Are Always Options

Clinicians must offer patients options and the first place to start is through the ability to make payments online. Clients are already used to doing things online and many utilize a mobile device for their transactions. With the In Touch EMR™, online payments can be linked with the clinician’s merchant account and deposited directly into the practice’s account, usually within seven days.

Online payments offer patients the convenience of 24/7 access and the ability to use a variety of payment methods, from credit and debit cards to electronic checks. Older patients may not have access to the Internet, while others may be afraid to disclose the appropriate information. For these patients, traditional checks and cash are still an option.

In Touch EMR™ also offers patients the ability make recurring payments. The software breaks down client amounts into manageable amounts that they can pay over time. Clinicians may want to consider offering discounts for situations that include cash payments or balances that are paid within a specified amount of time.

Convenience And Security

In Touch EMR™ provides the means to accept payments without the need to store sensitive data on-site. Information is maintained in the cloud and strict security protocols are in place that complies with the Payment Card Industry Data Standard.  In Touch EMR™ is HIPAA compliant.

Going Green

Accepting online payments utilizing the In Touch EMR™ is significant progress in the process to go green. It eliminates a majority of paper bills and statements, though there will still be instances necessitating a paper bill be printed and mailed.

“Online payments create better revenue cycles and reduce the expense of collection costs.”

Billers spend less time on sending reminders and statements, and can focus more on the claims process. Necessary payment data is sent to the billing department for posting to patient accounts. The team at In Touch EMR™ will even help clinicians set up the system to begin accepting payments electronically.

The ability for patients to pay their bills online is crucial as more individuals shift away from carrying cash or writing checks. For many, paying for products and services is simply a matter of entering a credit or debit card number. Any clinician that doesn’t have the ability to collect payments online is cheating their medical practice of a quick and convenient way to improve revenues, and incurring significant costs in time, effort and printed reminders.

Studies have shown that people are more likely to pay any bill rather than their doctor bill. Collecting patient pays can be difficult, especially larger amounts. Making it as easy as possible for clients to pay their portion of medical bills improves collection rates, while fostering the patient’s perception of the practice as one that’s modern and makes an extra effort on their behalf.

There Are Always Options

Clinicians must offer patients options and the first place to start is through the ability to make payments online. Clients are already used to doing things online and many utilize a mobile device for their transactions. With the In Touch EMR™, online payments can be linked with the clinician’s merchant account and deposited directly into the practice’s account, usually within seven days.

Online payments offer patients the convenience of 24/7 access and the ability to use a variety of payment methods, from credit and debit cards to electronic checks. Older patients may not have access to the Internet, while others may be afraid to disclose the appropriate information. For these patients, traditional checks and cash are still an option.

In Touch EMR™ also offers patients the ability make recurring payments. The software breaks down client amounts into manageable amounts that they can pay over time. Clinicians may want to consider offering discounts for situations that include cash payments or balances that are paid within a specified amount of time.

Convenience And Security

In Touch EMR™ provides the means to accept payments without the need to store sensitive data on-site. Information is maintained in the cloud and strict security protocols are in place that complies with the Payment Card Industry Data Standard.  In Touch EMR™ is HIPAA compliant.

Going Green

Accepting online payments utilizing the In Touch EMR™ is significant progress in the process to go green. It eliminates a majority of paper bills and statements, though there will still be instances necessitating a paper bill be printed and mailed.

“Online payments create better revenue cycles and reduce the expense of collection costs.”

Billers spend less time on sending reminders and statements, and can focus more on the claims process. Necessary payment data is sent to the billing department for posting to patient accounts. The team at In Touch EMR™ will even help clinicians set up the system to begin accepting payments electronically.

The ability for patients to pay their bills online is crucial as more individuals shift away from carrying cash or writing checks. For many, paying for products and services is simply a matter of entering a credit or debit card number. Any clinician that doesn’t have the ability to collect payments online is cheating their medical practice of a quick and convenient way to improve revenues, and incurring significant costs in time, effort and printed reminders.