TAFP and RemitData join forces to improve practice efficiency and revenue

TAFP and RemitData, a pioneer in Web-based reimbursement and productivity tools, have launched a pilot project to improve practice revenue and cash flow by providing family physicians an easy-to-use, online practice management tool that seamlessly works alongside any existing practice management system to identify inefficiencies in their billing process that may be costing the practice lost revenue.

Most practices have seen and understand the value of submitting electronic claims (837 transmission) to health insurers—less paperwork and faster payment. However, the benefits of receiving Electronic Remittance Advice, the equivalent of an electronic EOB (835 transmission) from the payer or clearinghouse, are numerous and even more valuable. Many practices already receive 835 files for the primary purpose of auto-posting their payments. This saves operational time and expense compared to posting payments by hand. The ERA is also chock-full of other powerful data that, if organized and mined correctly, can be used in a number of practical and money-saving ways.

For example, using ERA reports from a health insurer or clearinghouse, RemitData can organize, format, and analyze the data contained in the electronic EOB to provide physicians a report by payer on how often a service is denied and the reason for those denials. This allows physicians to examine reimbursement information to determine how much they are collecting and how long it takes to collect.

According to RemitData’s experience, many physicians find their practices receive multiple denials for certain services. Not only does a practice fail to access that cash quickly in these cases, but it pays billing personnel to submit those claims again.

“Every practice should ask the question: What does it cost to re-work a denied claim?” said TAFP CEO/EVP Tom Banning. “Often a practice will unknowingly make the same billing mistake over and over. A quick report generated from the ERA data can reveal those errors. With that information, you can make an adjustment on the front end and save your practice thousands of dollars.”

Similar to receiving blood results from the lab to determine a patient’s diagnosis, these easy-to-access online reports will diagnose billing pitfalls that cost practices money.

Another, perhaps more powerful, benefit for family physicians as well as TAFP, is the ability to aggregate data in the form of benchmark reports to see how physicians compare against their peers on timeliness of claims payment, denial rates and other factors.

“Imagine the benefit of data organized so that a group of practices in a given region can see denial rates by service from a specific payer as a whole, or how quickly the respective payers are paying a claim for a specific service,” Banning said. “These aggregated metrics compared to the practices’ own information accessed online can be powerful information.”

Aggregated data will also help TAFP support its members by identifying problematic payers and troubling reimbursement trends before they turn into cash-flow shortfalls.

“This information will allow TAFP to keep our members, policymakers and regulators informed in real-time about how payers are operating in different markets so we can affect positive change,” Banning said.

If you would like more information about the pilot or are interested in participating, please contact TAFP’s Tom Banning at tbanning@tafp.org or RemitData Business Development Manager Jack Conley at jconley@remitdata.com or (972) 385-7068.