If Marion Hayes could offer one piece of advice to fellow office
managers about PCC's Autopost Insurance Payments program, it would be, “give it a try.”
Pediatric and Adolescent Care of Silver Spring, where Hayes works, was one of the first PCC practices to sign up for the program that takes incoming payments and adjustments, posts all the simple ones, then creates a separate report for claim responses that need manual attention.
A year later, the billing process at PACSS has become a lot easier and more accurate, according to Hayes.
Before autopip, it would take staff all day to post a Blue Cross and Blue Shield voucher of 34 pages. Now, the same process can be completed in two hours, sometimes less, said Hayes.
Hayes said anyone using autopip should run it in conjunction with Partner's allowedit program, which monitors each payer's contracted fee. If a CPT code is not paid according to the practice's contractual fees, it won't post.
“We have already caught one insurance company changing our fees without notice, and anothernot living up to the contract they signed,” Hayes said. “Would this have caught if we did not have autopip? Perhaps, but we caught it immediately with autopip. It helps us keep an eye on the insurance company and keeps them honest.”
Since its launch in October 2009, 56 practices have signed up for autopip. Current users include large practices that employ several billers; smaller offices,where the office manager might play multiple roles; and practices in between.
“Autopip frees your time up by removing the most mundane aspects of posting insurance payments,” said Justin Ballou, project manager for PCC's Electronic Data Interchange team. “Anything with the slightest discrepancy goes to manual posting.”
When a biller runs autopip, he or she can be sure that only those payments and adjustments that match outgoing claims will be cued up on the autopost list, said Ballou.
Anything else – a claim that was denied; a CPT code or charge amount doesn't match a charge history; a claim total is negative; a payment or adjustment is not attributed to a specific charge – will appear on the manual report.
At PACSS, the number of checks that automatically post versus those that need manual attention is about 50/50, said Hayes.
Ballou said the average practice using autopip will see anywhere from 50- to 75 percent of its ERAs autoposted.
As more practices sign on to the program, Ballou added, PCC's exposure to the nuances of different payers will help developers improve the speed and accuracy of the system.
At PACSS, the use of autopip has freed up billers to spend more time reviewing unpaid claims. Autopip has also decreased the types of billing errors that were common with manual posting, said Hayes.
When processing ERAs, Autopip takes into account the payer fee schedules that are posted in Allow Edit. Prior to Autopip, Hayes said, it was easier for a biller to mistakenly post an EOB that included the wrong fee for service.
While using allowedit to maintain up-to-date fee schedules for every insurance company is not necessary for Autopip to run, it is well worth the effort, said Hayes.
“Keeping fee schedules up-to-date is a little time consuming, but you're also making sure you're getting paid correctly,” Hayes said. “I love Autopip. I think it's a great tool, and I wouldn't do without it.”
Hayes encourages any practice that is manually posting to consider Autopip.
“I would say take time to see how the system works,” said Hayes. “Once you do that and see that it's posting correctly, your confidence in autoposting will build.”