December 9th, 2012 by administrator
As many of you may be aware, PDM uses RealMed (www.realmed.com) as its clearinghouse. One common task that must be done daily is the sending of claims files to RealMed. This may sound trivial, but it’s really kind of a pain for someone to spend time out of their day, everyday, to remember to upload files to RealMed – especially when we are talking about almost one hundred files a day. So, we decided to automate this task. Here’s how.
All of our claims files are entered into one folder by the program that generates them. The two things we want to do is upload the files to RealMed and save the file in an archive folder. We have a SQL Server Integration Services (SSIS) package that does just that!
The first thing our SSIS package does is create an archive folder to store a copy of the file for auditing purposes and the like. We create that folder with that day’s date as its name. Check out the screenshot:
As files are copied to RealMed’s secure FTP site, the files are then moved to the archive folder. Notice that in the last step we send an email to management to let them know the process is complete. PDM runs this automated task every business day at 9am, 12pm, 3pm, and 6pm. That’s right, we upload files to our clearinghouse 4 times a day. So please, get your stuff to us early so you can be one of the first to go out!
By automating this task, not only do we free up labor from a mundane task to better serve you, our client, but we can also take full advantage of that automation by scheduling it to run several times a day. Again, this may seem trivial, but believe me it’s better than having to ask everyone “Hey! Did anyone upload claims yet?!?!” every day!
December 4th, 2012 by administrator
There is simply no way any business can survive this day and age without automating mundane tasks. PDM is no different. In order to increase efficiency, lower costs, and provide the best service we do automate common tasks that would otherwise be very difficult to handle manually.
Let us consider the following scenario: Let’s say you are a doctor and you have patients that are close friends or members of your family. As a courtesy, you would like for any remaining balance of their claims, after insurance has resolved, to be written off. After all, who wants their mom to receive a bill? In order to accomplish this task, someone is going to have to monitor those patients to see when they are seen, when their claims are paid, and then write those claims off. Sounds simple enough, right? Not really. In the past, PDM was asked to do this and we weren’t very successful. We caught most of the claims that needed to be written off but occassionally one would slip by. After some brainstorming, we came up with a procedure to automate the task. Using SQL Server Integration Services, a platform designed to Extract, Transform, and Load (ETL) data, we developed a repeatable procedure to find all patients denoted by the provider whose claims have resolved and to write those claims off with a Provider Adjustment.
This first picture shows the overall SQL Server Integration Services package and the steps it entails. Notice how we email the account manager if there are no claims to write off on that day or if there are.
Each step represents functions that are performed. Let’s take a look at the step named “Update Claims and Enter Report Items.”
That’s a lot of steps! Believe it or not, after all that has run the claims for all patients found have been written off. We currently do this for 18 of our clients (as of this writing) and it takes the entire process about 3 minutes to run and we do this every day at 6am. That’s nothing compared to the hours we were spending before in raw labor.
If you are a new provider and you often find yourself seeing family members of friends in your practice, you should ask us about this service. It’s free of charge!
December 3rd, 2012 by administrator
Welcome to the PDM blog! Using this blog, PDM hopes to stay in communication with our many wonderful clients and the web at large. On this blog we’ll talk about the many things we do at PDM to make collecting your money more efficient and cost effective. We’ll also share news about the medical billing community, news about the different carriers, and link to interesting articles that may benefit your practice. You should bookmark this site and visit it often.
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