July 2008
AdvancedMD Shines During NPI Transition
On May 23rd, CMS required payers nationwide to accept only a provider's National Provider Identifier (NPI) as the ID in a claim, instead of any legacy IDs associated with that payer. Competitors to AdvancedMD had a tremendous spike in customer service calls after the May 23rd date. AdvancedMD had a DECREASE in calls after the deadline.
Here's what's happened nationwide in the first 2 weeks with that potential disaster for claim payment:
- Emdeon (formerly WebMD) clearinghouse reported 4x or more increase in Medicare/Medicaid rejections
- Vendors are reporting major spikes in call volume. Misys is telling their customers that they have a 50% spike, and asking for everyone to be patient.
- RelayHealth (our clearinghouse) tells us that although AdvancedMD claims are fine, problems with claims coming from other systems have resulted in an 80% increase in their call volume.
- Some quotes from a May 30th story in Modern Healthcare IT (www.modernhealthcare.com):
Cyndee Weston, executive director of the American Medical Billing Association, Sulphur, Okla., said she has received grim reports from some of the trade group’s 1,400 members who run independent billing companies. Only 12 physicians in a 42-physician California group served by an AMBA member could submit claims without them being rejected, Weston said.
Martin Jensen, chief analyst and chief operating officer at the Tulsa, Okla.,-based Healthcare IT Transition Group, a healthcare consulting firm that has tracked the NPI issue and has been a frequent critic of HHS’ plan to go ahead with the NPI, said he’s heard from a state Medicaid official who said claims flow had fallen from a normal 100,000 a day to less than 20,000. The report, Jensen said, was “frightening.”
Meanwhile, back at AdvancedMD:
- AdvancedMD experienced a daily call average DECREASE of 4.4% the week after the deadline (even accounting for Memorial Day), and our claim rejections remained flat to our 12-month average from RelayHealth. No problem!
For those who may not know, AdvancedMD did the following for its clients:
- Prepared the application to be NPI-compliant more than 2 years ago
- Kept all clients on the current compliant version (since we're web-based!)
- Offered a free opt-in service to have all your carrier files automatically updated on the night of May 22nd
- Mined our EDI data (with RelayHealth) to identify non-compliant claims before the deadline and worked with each client individually to be prepared
- Created an excellent NPI FAQ that answered questions and helped our clients understand how to prepare for the changeover
- Continually monitored our claim flow through the transition to identify and solve any remaining issues
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