News: Health IT Outcomes

Striking a Balance Between Claim Scrubbing and Customer Service

This article outlines the qualities healthcare providers should expect from their insurance billing providers to facilitate error-free claims and positively impact the revenue cycle.

Government legislation and regulatory agencies continue to fuel the movement toward an environment defined by pure electronic data interchange of insurance claims and resultant reports. In addition, insurance payers are becoming more stringent on how claims are paid. These are changes for which not all healthcare organizations are prepared. In order to remain compliant and viable, these organizations need a claims servicing partner that is flexible enough to react to these changes in legislation, while incorporating technology and service that facilitate error free claims to positively impact their bottom line. Although maintaining open lines of communication should be an unwritten standard, many healthcare organizations have become accustomed to and accept mediocre customer service from their insurance billing service providers.

The Challenge

eProvider Solutions is a Sioux Falls, South Dakota-based company that started in 2005, whose cornerstone is providing excellent customer service to our clients. Our company provides a range of services for healthcare provider customers in all 50 states, ranging from single provider clinics to very large health systems. We create a supportive environment for customers who may not have in-house expertise in insurance claim billing and also provide clear, insightful answers to the complex questions of our more knowledgeable provider customers. Because we provide services in a diverse and complex industry, we follow a business strategy that is agile and adaptive in order to help our customers comply with the constantly changing requirements of federal, state, and local regulations.