As many of our clients and EMS industry peers know, Payor Logic traveled the nation in recent months. We sat with you at fall conferences. We joined you at industry meetings. We shared stories in convention exhibit halls. Throughout our whirlwind tour, three common themes emerged: change is ahead, integration is inevitable and cleaner claims trump faster billing.
The new presidential administration will impact EMS
There’s a saying here in Ohio—if you don’t like the weather today,
wait until tomorrow because it’s bound to change. It feels the same way throughout the healthcare industry this fall. Just when we were getting a bit of a grip on the impacts of the ACA and other changes from the Obama administration, it appears national healthcare regulation will morph again.
We expect significant impacts on payor mixes and self-pay populations. Medicaid expansion programs are once again in turmoil and our national healthcare insurance coverage is headed for another overhaul.
From shore to shore, healthcare industry pundits ask the Payor Logic team how a Trump administration will impact business for the EMS companies we serve. While we’re not entirely certain, we have some educated guesses and rely on built-in technological flexibility to assist with any imaginable scenario.
Integration improves efficiency—analytics get baked in
Every ambulance and EMS company we met this fall seeks to streamline billing practices and analytics through integrated services. We were approached by multiple companies to partner in support of our clients. The goal? Deliver integrated technology capabilities across all the various EMS platforms. Advancements in our processor scalability and web service/API make these system-to-system conversations easier. The results have been astounding with multiple stories of 20-30 percent (some even higher) efficiency increases.
Baked-in analytics and benchmarking are also making it easier to track operational progress for EMS providers. Continued advancement in this area is on the horizon and was certainly a hot topic at every national conference in 2016.
Finally, greater access to patient demographic, insurance and financial information is the last EMS hurdle to overcome as Health Data Exchanges (HDEs) become more available nationwide. During our tour, we noticed that more EMS billing software companies are focused on easing the burden for their clients through better information access.
Clean claims are more important than fast billing
It seems only yesterday that EMS best practice was next-day billing. Providers were focused on getting claims out the door as quickly as possible. Recent changes have seen a shift in this mindset for both direct providers and EMS billing companies.
Today’s EMS leaders are taking an extra day or two in the billing cycle to ensure patient demographics are correct, insurance is verified and the claim is clean. This results in higher self-pay to insurance conversion rates and reduced time spent on claims rework. EMS billing workflows are being reengineered to replace outdated, ineffective processes.
Happy New Year!
Payor Logic appreciates every opportunity to learn from our customers, our peers and our industry. We’ll remain diligent in 2017 to attend conferences and host educational events. First up is a two-day symposium in Atlanta, January 19-20, followed by attendance at the spring PWW events in March and April. See you on the road!