As a manager of people and process combined with strict compliance, I spend most of my free time thinking of how to combine these three things and still manage to have the most efficiency. I don’t think I’m alone in this line of thinking. RescueNet Billing Pro is the closest system that I have seen that combines the three: people, process and compliance. The Regional Emergency Medical Services Authority (REMSA) has a staff of seven billers and is the exclusive ground ambulance provider for Washoe County (Nevada), including the cities of Sparks and Reno.
In the first three months of using RescueNet Billing Pro, we are seeing the staff embrace the ease of the system. The most common response that I hear is that “it makes my job easier.” They aren’t working as hard to find the dollars, and the ePCR information is sliced and diced in such a way as to lay out the facts for the employee to assimilate it more quickly. Here’s how RescueNet Billing Pro’s key features are working for us.
Prior to RescueNet Billing Pro, our process was to have the biller look at the standard five – Medicare, Medicaid and three of the most common local insurances that we had – to determine if a patient is categorized as self-pay. Now, we just use the Insurance Discovery feature; and while that is running, read the record and begin the coding process. We have gained tremendous efficiencies on this one process alone. For example, all relevant insurance criteria, such as hospice info, is available upfront, which greatly improves the efficiency of our front-end processes. There is a minute or so to wait for the results, but the manual process took considerably more.
The Demographic Verifier feature has had both immediate and long-term pay-offs. For example, incorrect patient names or common names make the insurance search process manual and very time-consuming. We’re already finding that having a unique identifier, such as the social security number (SSN), makes finding patient insurance in our in-house database much more efficient. A long-term payoff we hope to see is a reduction in mail returns. When an address isn’t acceptable to the U.S. Postal Service database, the system highlights the address in red as a visual prompt to help the staff make the right decision. Of course, we know mistakes won’t disappear entirely, but to eliminate obvious mistakes and have the postal address ready has been a significant improvement.
The Mileage Calculator allows our billers to catch errors before submitting the claim. We have made some serious mileage mistakes in the past, but with this feature, we have a quick visual check to verify that there is no discrepancy between the trip distance using the odometer and the trip distance using Google Maps. Accurate pickup and destination addresses help prevent time-consuming and costly denials. Our goal is to always have the cleanest bills possible.
The ability to see the entire PCR at a glance saves time and, I believe, increases our ability to stay in compliance. The feature enables you to quickly identify that an ALS intervention happened and what it was exactly by highlighting the box or field to grab the biller’s attention. Critical compliance information, such as signatures for both crew and patient, are available at a quick glance instead of having to scroll to the bottom of the multi-page PCR. This feature, combined with the Emergency Medical Dispatch (EMD) code that is easily seen in the MISC box, allows for improved compliance because the biller can see what is needed for every bill.
In the last three months, we have seen many improvements; but I believe there are more to come. We managed to close the last month on time with one person retiring, one new person and our fastest person taking a couple of days off. Need I say more?