Case Study: Billing Service Improves Efficiency by 90% with InstaMed

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With InstaMed, we have streamlined our processes to manage claims and payer payments, which now integrate seamlessly with my practice management system. We have reduced the amount of time spent on claims management, payment posting and reconciliation by 90% – the cost of two full-time employees! Additionally, by receiving immediate claim responses and processing claims more efficiently, we’re collecting payments for clients more quickly and reconciling payments more efficiently, shortening the overall processing time by weeks. As a result, I’ve been able to expand my business without hiring more staff, reducing overhead and expenses. Choosing InstaMed is one of the best business decisions I’ve made.

- Kevin Milam, Owner, The Billing Center

OVERVIEW OF THE BILLING CENTER

The Billing Center is a billing company with multiple durable medical equipment (DME) provider locations in several states.

BUSINESS CHALLENGE

The Billing Center was inefficiently managing claims and posting and reconciling payer payments, resulting in rising overhead expenses and a high number of days in accounts receivable.

BUSINESS RESULTS

  • Reduced time spent on claims, payment posting and reconciliation by 90%
  • Collecting payments for clients more quickly
  • Reduced overall payment processing time by weeks

THE BILLING CENTER’S STORY

Business Problem

Time-Consuming Claims Submission

The Billing Center’s issues with inefficiency started with the claims submissions process, since its clearinghouse was not integrated with its practice management system. As a result, the Billing Center staff had to manually create each claim individually, download and then submit it, creating inefficiencies in work flows and increasing personnel costs.

“It took two hours every day just to get our claims submitted,” said Kevin Milam, owner of The Billing Center. “It was a huge amount of work.”

Delays in Claim Responses

After submitting claims, the company would not receive responses on these claims for at least one day and more typically, up to five days. Then, if there were rejected claims that needed to be fixed and resubmitted, the company would have to wait even longer before the claims went through, further delaying collection of payments.

“We couldn’t wait that long to get a response on claims, especially when billing for a provider with high volume,” said Kevin. “Each day we spent waiting for claim responses was another day that we weren’t getting paid.”

Inconsistency with Remittances

The Billing Center received remittances weeks or even months after receiving the payments. Therefore, in order to reconcile the payments that came in, the staff spent hours on the phone with payers each day to obtain the payment totals for each provider, increasing unnecessary overhead and personnel costs.

“We were afraid we would miss an 835 because we didn’t know when it was coming,” said Kevin. “There was no consistency.”

Inefficient Claim Information

To process the claims on an 835, the staff had to open up each individual claim to figure out whether the claim had been paid or denied, or if another staff member had begun to reprocess it already. Additionally, staff members could not work on an 835 at the same time, so they could not post and reconcile any payments until all rejected claims had been reprocessed and submitted.

“There was no way to easily work through 835s; we were not working efficiently,” said Kevin.

Posting

Once the company received the claim payments, staff would spend three to four hours each day to download and post each payment individually in order to reconcile payments.

“Even after spending hours posting payments, we still had no idea how much money we had until we manually totaled the payments,” said Kevin.

Hours Wasted on Reconciliation

To reconcile the payments or access information on transactions or denials, The Billing Center staff had to run an individual report for every provider, which took three to four hours each day. Additionally, at the close of every month, the company spent a full week to run all numbers from these reports and manually enter them into a spreadsheet to calculate the month’s revenue.

Solution

Success with Integrated Healthcare Payments

The Billing Center streamlined its processes to manage claims and payments with InstaMed, which integrated seamlessly with the company’s practice management system. Today, the staff submits claims through InstaMed in a matter of clicks. The Billing Center staff knows within minutes which claims have gone through and which claims need to be fixed and resubmitted. This means that staff can reprocess and submit and rejected claims immediately, so the company gets paid considerably faster.

Consistency and Accountability with Remittances

With InstaMed, The Billing Center can count on receiving remittances and payments within a day or two of each other, so the staff doesn’t need to waste time tracking down delayed 835s or payments for posting and reconciliation.

Efficient Claim Information

Today, to process claims on an 835, the staff can view a workflow status summary to easily identify which payments to post and which claims to reprocess. This enables the company to post payments and rework rejected claims on an 835 at the same time to improve efficiency.

“We not only have all of the necessary claim information in our system, but we’re also able to use the information efficiently across multiple staff members, at the same time,” said Kevin.

Automated Posting

When The Billing Center receives the claim payments, staff members simply click to post all payments and view totals by specific payers and timeframes, in real-time.

“We’re posting 200,000 payments in 30 seconds, as opposed to three to four hours,” said Kevin.

Reporting on Payments

With InstaMed, The Billing Center staff can run a summary report across multiple providers, so the staff takes 10 minutes each day to review all payments, transactions, denials, etc., in one place. To simplify monthly revenue reporting, InstaMed’s solution allows staff to automatically generate month-end reports, so they don’t waste time manually adding up the numbers creating significant efficiencies and personnel opportunity and cost savings.

Customer Service

Furthermore, if The Billing Center staff has any questions about a claim or a payment, they can rely on InstaMed’s knowledgeable Customer Service team to respond immediately.

“I know I can always pick up the phone and I’ll reach someone,” says Kevin. “Offering that level of service is how I keep clients, so I like people to treat me that way.”

Business Results

With the InstaMed integrated Claims, Claim Status and Remittance solutions, The Billing Center has reduced the amount of time spent on claims management, posting and reconciliation by 90 percent – the cost of two full-time employees! Additionally, by receiving immediate claim responses and processing claims more efficiently, The Billing Center is collecting payments for its clients more quickly and reconciling payments more efficiently, shortening the overall processing time by weeks. With this significant time savings, the company has been able to expand without hiring more staff, reducing overhead and expenses.

“Thanks to InstaMed, I have more time to concentrate on my business, rather than on my 837s and 835s,” said Kevin. “Choosing InstaMed is one of the best business decisions I’ve made.”