Eye Clinics have long been left with few choices when it comes to claims processing. Many clinics have to choose between expensive systems, managing the claims process manually or using a patch-work of disparate systems that don’t communicate. The end result is often unnecessary duplication of work, inefficient use of employee’s time, and reduced claim payments and profits.
DSM has long offered it’s comprehensive claims processing software called ExClaims! to clinics and hospitals. We are now extending our claims expertise to ophthalmology clinics with the introduction of Eye ExClaims! DSM can help you maximize your profits and time with your patients by reducing much of your overhead on managing the claims process.
Eye ExClaims! is an eyecare specific, customized, turn-key cloud based electronic claims processing solution. A solution that accelerates cash flow, maximizes payments and reduces redundant coding, keying and inquiry processes.
- Eliminates outside coding expenses
- Commercial, Medicare and Medicaid electronic claims submission
- Automatic secondary claims submission
- Management cashflow dashboard
- Single interface to multiple payors
- Electronic Remittance Advice (ERA) integration
- Paperless workflow processing
- User notes and logs provide audit trail of claims
- Browser based cloud solution
- Turn-key installation, payor setup and training
For more information, questions or to schedule a demonstration call Al Theriot at 504-909-9387 or use our contact form.
In preparation for the October 1, 2014 ICD-10 Implementation, DSM is preparing to share the most up to date information provided by CMS to help promote provider readiness. In the months ahead, our team will highlight information specifically targeting issues requiring provider action or changes in billing practices.
The Medical Records Abstract will allow providers to enter both ICD-9 and ICD-10 codes for the purpose of split claims that span the implementation date.
Please access the link below for split claims billing instructions for Medicare Fee-For-Service (FFS) claims that span the ICD-10 Implementation Date (sample UBs provided by CMS).
CMS MLN SE1325-2-ICD-10
For further updates, please visit this site regularly as we move closer to the big date! We appreciate your business!
DSM users have more options than ever before with our recent addition to the Web Insurance System. ACCESS DDE is the newest tool in a series of solutions developed to promote denial management from within the Web Insurance System.
The DDE screens you are familiar with, integrated with a system you know and trust, work simultaneously to help users improve efficiency and increase productivity. Call our Support Team today to find out more about ACCESS DDE on the Web Insurance System.
Novitas Solutions offers educational opportunities for medical coders and billers at no cost to you or your employer. Depending on the class, interested participants can earn CEUs while they work and further their knowledge in this rapidly changing field. Click here to view a list of upcoming events offered by Novitas Solutions.
Novitas has published a newsletter for MS Part B providers in preparation for the upcoming JH Part B Transition. Included in the newsletter providers will find the Cutover Schedule, a Local Coverage Determination (LCD) Crosswalk, and other important phone numbers, dates and helpful hints for a successful transition. To access this information and more, click here. Please call Ursula Mercer at 601-925-6292 for more information on how to be prepared.
DSM is working this week to make the necessary changes to your system to send claims to Novitas beginning next Monday August 20. An update will be going out this evening with software changes to accommodate the difference in Novitas’ transmission system. Once the update is installed we will make configuration changes to your system with the new submitter id, user id, and password that were assigned to your facility by Novitas. All of this will be completed by the end of the day tomorrow. According to the Novitas bulletin at the link below you should stop sending claims to Pinnacle at 1:00 PM on August 16 (Box 1 on the second page). Starting at 2:00 pm on August 16 we will begin making the final changes to your system to send claims to Novitas and will have your system ready to begin sending claims by the end of that day. However, according to the link below, you should hold ALL Medicare Part A claims until after 5:00 pm Friday August 17 (Box 1 on the second page).
– This change will only affect Medicare Part A claims. The Part B claims will transition in October so you can continue to file them.
– You should STOP sending Medicare Part A claims at 1:00 pm on August 16.
– Do NOT begin sending Medicare Part A claims again until after 5:00 pm August 17.
The Enforcement Deadline for the 5010 Transition will soon be here. We may continue to see a few issues linger as our MAC’s perform “scheduled fixes” potentially causing unintended edits to fire. To stay up to date on these potential issues over the next few months, you may review the System Status Log for current Part A system issues.
AR/LA/MS Providers: Be on the look out for correspondence from our new MAC. In addition to a new EFT Authorization Form, providers should receive letters assigning new passwords to existing submitter IDs. These letters include dated material and failing to act by the deadlines will result in payment interruptions. Please fax EDI correspondence to Ursula Mercer at 601-925-2223.
For details about the J-H Implementation, click on “FAQS“.
DSM recently acquired the necessary infrastructure and connections to accommodate direct Medicare transmissions via high bandwidth connection. In addition DSM has received 5010 Approval from both Palmetto and Cahaba for direct transmissions. Transmitting claims through this new infrastructure eliminates the typical 3-day wait to get claims to Medicare through one of the large clearinghouses improving the turn-around time from claim transmission to payment. This in effect makes DSM your clearinghouse and removes one level of complexity as DSM provides the claim build and posting software as well as the transmission infrastructure. Only a few customers can take advantage of this direct connection at the moment but soon all customers will have this option.
On May 16, 2012 Novitas will mail letters requesting that each group/billing provider complete a new CMS-588 EFT Authorization Agreement. The revised CMS-588 should be sent in to Novitas no later than 30 days prior to August 13, 2012. Provider action is required to avoid payment delays.
Click here to see the “JH Implementation Alert”.