For any hospital, healthcare network, or physician’s office faced with the challenge of managing complex payment processing operations, lockbox service providers make for essential partners. Medical lockbox services can help to automate and accelerate slow, manual in-house processing; maintain compliance; avoid errors, bad debt, and write-offs; and shorten the revenue cycle.
A capable lockbox partner with EOB to ERA conversion tools eliminates the manual cash posting, facilitates auto posting directly in the provider’s patient accounting system, and reduces the hassles of cash reconciliation. On top of that, the 2019 CAQH index showed the provider cost of manual remittance to be $5.35, while an electronic transaction only cost $1.78, for an average savings of $3.57 per transaction. There’s no question that this kind of service provides significant value to healthcare providers. The only question is: how do you choose the right one?
Here are 4 key things to consider while selecting a medical lockbox partner:
What kind of payments can it accept?
The act of requesting and accepting payment sounds simple enough, but as ERAs, paper EOBs, ACH, checks, credit card payments and associated correspondence add up, managing the totality of the accounts receivable work stream can get pretty complicated. In fact, in absence of a standardized form, the number of templates a provider may need to deal with could be as high as the number of payers - sometimes reaching upwards of 20,000 EOB templates. A good medical lockbox solution is designed to simplify and streamline processing of healthcare receivables, regardless of payment type. And the best options should be capable of handling your payments, regardless of the format in which they arrive.
Is it PCI and HIPAA compliant?
Lockbox solutions are great for healthcare providers, but they aren’t unique to the healthcare industry. When assessing a lockbox solution, be sure to assess its level of compliance and whether it was built specifically for healthcare companies or if it is intended as a more general solution. Issues arising from gaps in compliance cost the average hospital about $47,000 per bed, or $1,200 per patient annually. Healthcare and finance are among the most regulated industries in most countries, so finding a solution that emphasizes compliance is particularly important.
Does it help reduce claims denials?
Denied claims make up 15-20% or more of the average provider's total claims volume. Consider as well that variances in EOB documentation templates can add confusion and slow down payment processing even when things go well. Additional processing work, correspondence, and back and forth between provider and payer result in increased costs and decreased efficiency. Improving your recovery rate through automated data management and reconciliation, and a more streamlined denials management process can significantly improve your bottom line.
Does it improve process transparency?
A lockbox solution that compiles and organizes transaction and payment data and provides in-depth reporting can help you gather the bigger picture and find ways to improve. This goes for just about any new solution you may be considering, especially when it comes to managing and optimizing complex processes. Look for a lockbox solution that increases your visibility into the metrics that matter and provides flexible reporting capabilities so that you can gather the insights you need to help optimize your system. For example, Exela’s ability to convert proprietary denial codes to industry standard Claim Adjustment and Remarks Codes (CARC) helps ensure proper accounting of denials and application of cash to appropriate patient and adjustment accounts.
How does Exela do it?
Exela has been providing lockbox services for over 30 years, and our Medical Lockbox solution has built upon our success to provide payment processing solutions that address the specific needs of healthcare providers. Our lockbox services can be integrated with add-ons such as Revenue Integrity Services, Medical Coding, Audit & Consultation Services, Denial Management & Analytics, Appeals & Grievances Services, Medical Record Management Services, and Collections to name a few. Taken together, these offer a cost-effective, efficient, and comprehensive medical lockbox system for healthcare providers.
- Exela offers omni-channel intake of both digital and paper formats to create a comprehensive, centralized processing system.
- Paper digitization is achieved through our in-house scanning platform and intelligent character recognition (ICR) technology, which enriches data to provide benefits beyond typical OCR engines. Our automation solution is capable of supporting non-standard claims and variations within claims.
- Payments from all sources are quickly and accurately converted into 835 electronic remittance files, which can be posted directly to medical billing systems, resulting in improved accuracy and quicker turnaround time, benefitting the end customer.
- The web-based denials management tool provides a simpler and more direct workflow through which denials can be addressed. The original claim and related remittance information is given in a single view so that users can easily determine if they should adjust the claim, bill the patient, or appeal the denial, further reducing expensive processing time and cost.
- Automated processing of EOB templates results in fewer denied claims and greater clarity in tracking and resolutions of denials, improving the payment recovery process.
- Detailed reporting supports reimbursement and performance analytics that improve process auditing and contract negotiations with payers.