It's Not About Billing, Anymore

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Taylor Moorehead, Zotec regional partner, was giving RBMA 2013 Summit attendees a test drive on the company’s cloud-based CZAR analytics tool, a work-in-progress. The solution is designed to give practices more data, in real-time, exportable (and importable) in Excel, so that no one has to wait until the end of the month to discover a month’s worth of dropped charges due to an interface that stopped working when the RIS was upgraded (you know it happens).

“It’s really not about billing anymore, it’s about exceptions management,” adds Zotec’s Steve Collins, director of business development. “There’s the tough part to get of AR—the 20%—and these tools are allowing us to let the client have visibility into where the opportunities to optimize revenue are.”

Paul Andres, new business development at The Cvikota Company, says his is as much a data company as anything else. “Getting a clean claim out the door is no longer enough,” he says.

“Take contracting,” Andres adds. “he payors have all of the information, and the docs are at a disadvantage. We try to mine the reimbursement data to be able to provide docs as much information about individual CPTs for individual payors so when they go in to negotiate contracts, they at least have a fighting chance.”

The one thing Andres says he is constrained from doing is sharing a client’s data with another client. “It’s not right,” he says. “While we have the capability, we are limited by good business practices.”

This issue of who owns the data and in what form it can be shared is likely to raise ethical, legal, and regulatory issues as billing companies morph into data companies and providers begin sharing data across institutional lines. One big EHR company is piloting an initiative to aggregate and share data, but it is encountering pushback from some physicians, Andres says: “The problem is the insurers are already doing it.”