The following white papers are available to anyone who wishes to know more about certain aspects of our data conversion process.  Each white paper is summarized, then followed by a link to the complete article.  Enjoy!

Our White Papers...

2010 The Case for Electronic Remit Advice (ERA)

2010 Auto Posting of Insurance Payments Must Handle Zero Payments From Insurance Companies

2010 The Economics of Automation

2010 Exit strategy for implementing a new Electronic Health

2010 Data Parsing for eZine

Medicare's Recommendations on ERAs

Advantages of accepting EFTs from Medicare

The ECONOMICS of AUTOMATION (Do the Math, the Results are Compelling)

The Real Value of Electronic Solutions-Connecting Dissimilar Systems

The Data Conversion-Manual or Electronic

Complete the “Electronic Claims” process.

Details Concerning Discontinuation of SPR

Data Parsing Algorithm

Converting Utility Billing System Data Files

Decoding and Translating Data

2010 The Case for Electronic Remit Advice (ERA) Click Here

Much has been said and written about the Electronic Remit Advice (ERA) not the least of which has come to us through Medicare. Their web site has a plethora of information and disinformation (meaning less than helpful NOT necessarily erroneous). What has yet to happen is mass adoption of either delivery of ERA files to clinics or electronic posting of ERA files by clinics who do receive them

2010 Auto Posting of Insurance Payments Must Handle Zero Payments From Insurance Companies Click Here

In a medical office that does not have an ERA auto poster, each zero payment received from a payer is reviewed manually to determine among other things, if the insurance company correct. If so, the billing clerk has a number of options for handling the balance: mark the claim as paid and write off the balance, or apply the deductible and then write of the balance, or several other options.

2010 The Economics of Automation Click Here

Bankers don’t make routine withdrawals and deposits, they have the ATM. Banks are not open late at night. ATMs are. Bankers don’t manually record inter-bank and intra-bank transfers. They have sophisticated EDI systems that make all the transfers, record all the deposits and withdrawals, and make all the payments.

2010 Exit strategy for implementing a new Electronic Health Click Here

If implementing a new Electronic Health/Medical Records (EMR) system includes converting data from an old system, there are several questions you will want to ask before getting started. Will your current vendor assist in the transition by providing the data for conversion; in what format can you get it; how much will it cost; can you use your own conversion team? If you don't know the answers to these questions you are probably better off to stop looking at new software or to put your project on hold until you can get the answers. If the answers are not acceptable, what then?

2010 Data Parsing Click Here

Get at the roots of your data conversion problems by designing a custom data parsing algorithm. This is an iterative process which requires a knowledgeable programmer and a user who is well versed in the actual data, what is looks like, its anomalies and how they came about. The business decisions that are required depart from the typical standard applied to programming work because the data to be parsed is generally passed from one system to another only once. That being the case, some parsing will be manual. It being the least costly solution.

The ECONOMICS of AUTOMATION (Do the Math, the Results are Compelling) Click here

Bankers don’t make routine withdrawals and deposits, they have the ATM. Banks are not open late at night. ATMs are. Bankers don’t manually record inter-bank and intra-bank transfers. They have sophisticated EDI systems that make all the transfers, record all the deposits and withdrawals, and make all the payments.

Medicare's Recommendations on ERAs Click Here

 "Medicare recommends that providers accept ERA [Electronic Remittance Advice] transmissions in lieu of mailed SPRs [Standard Paper Remits or EOB], and that they accept EFT [Electronic Funds Transfer] payments rather than paper checks. The amount payable for each claim as well as each adjustment applied to a claim can be automatically posted from an ERA, eliminating the time and cost for staff to post this information manually from an SPR. ERAs generally contain more detailed information that there is not space to report on an SPR. SPRs do not contain any information that is not available on an ERA, and where the same fields are reported on an SPR as in an ERA, the information in those fields is identical.”

Advantages of accepting EFTs from Medicare Click Here

“Electronic Funds Transfer (EFT): With EFT, Medicare can send payments directly to a provider’s financial institution whether claims are filed electronically or on paper. All Medicare providers may apply for EFT.

Advantages of Electronic Funds Transfer (EFT): EFT is similar to other direct deposit operations such as paycheck deposits, and it offers a safe modern alternative to paper checks. Providers who use EFT may notice the following benefits:

• Reduction to the amount of paper in the office

• Valuable time savings for staff and avoidance of hassle associated with going to the bank to deposit Medicare check

• Elimination of the risk of Medicare paper checks being lost or stolen in the mail

• Faster access to funds; many banks credit direct deposits faster than paper checks

• Easier reconciliation of payments with bank statements.

How to Enroll in EFT: All Medicare contractors include an EFT authorization form in the Medicare enrollment package, and providers can also request a copy of the form after they have enrolled. Providers simply need to complete this short form, mail it to their Medicare contractor, and include a voided blank check to facilitate the transfer. Medicare payments will be made directly to the financial institution through EFT, in as little as two weeks.”

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The Real Value of Electronic Solutions-Connecting Dissimilar Systems  Click Here

Efficiency and error reduction are two of the most often discussed “values” of electronic solutions. Experience and empirical data support these as two of the most important benefits. However, the increasing propensity with which small to medium sized businesses purchase multiple electronic solutions has drastically amplified the need for exchanging data between systems.  The data exchange software is commonly referred to as a database interface or simply and an interface. Let’s add “interface” to our list of important benefits of electronic solutions.

The Data Conversion-Manual or Electronic Click Here

We’ve all heard the phrase “garbage in-garbage out”. It is usually quoted in reference to computer generated information in an unfavorable context. Derogatory comments are also heard often about human data entry errors. Regardless of its source, erroneous data distort summarized information drawn by computer programs on which a business depends to render mission critical decisions such as whether to send a $300.00 unpaid medical bill for collection or how much the business is worth to a potential buyer.

Complete the “Electronic Claims” process. Click Here

Most practices have embraced electronic claims filing and are realizing significant benefits by reducing filing errors, saving staff time and dramatically improving turnaround time for payment.

There are two other steps in the “Electronic Claims” process that should be seriously considered: Electronic Remittance Advice files (ERA) and Electronic Funds Transfer (EFT).

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Details concerning discontinuation of SPR

http://www.cms.hhs.gov/ContractorLearningResources/downloads/JA4376.pdf

Provider Types Affected

All Medicare providers, physicians, suppliers, and qualified non-physician practitioners billing Medicare carriers and durable medical equipment regional carriers (DMERCs)

Key Points

• The implementation date is June 1, 2006.

• CR4376 provides notice that beginning June 1, 2006, carriers and DMERCs will stop sending standard paper remittance (SPR) advices to you (or a billing agent, clearinghouse, or other entity representing you) if you have been receiving 835s or electronic remittance advice (ERA) transactions, either directly or through a billing agent, clearinghouse, or other entity representing you, for 45 days or more.

Medicare Remit Easy Print Key Points

• The Medicare Remit Easy Print (MREP) software was developed in response to comments CMS received from the provider/supplier community that they need a paper document for accounts reconciliation, and claim submission for secondary/tertiary payments.

• The output of MREP is similar to the current SPR format.

• Providers/suppliers who use the MREP software package can print paper remittances and reports that can be used to reconcile accounts receivable, as well as to create document(s) that can be included with claim submissions to secondary/tertiary payers.

Benefits of MREP Software

The benefits of using MREP software include the following:

• Save time and money by printing remittance information directly from your computer the day the HIPAA 835 is available without waiting for the mail.

• Create and Print Special Reports. With MREP, you can run, export, or print several useful reports including the following:

• Deductible Service Lines Report: Shows claim service lines that have deductible amount;

• Adjustable Service Lines Report: Shows claims within a single remittance that have a claim status 22 (reversed claim);

• Denied Service Lines Report: Shows only claim service lines that have an allowed amount of zero and are associated with a claim that does not have a claim status 22 (reversed claim).

• Print and Forward Claims for Other Payers.

• MREP provides the ability to print remittance information for individual or multiple selected claims, and it allows you to forward only those claims that are needed by other payers for secondary payment.

• You may view and/or print as many or as few claims as needed.

• This eliminates the need for you to darken individually identifiable data on the SPR, as you may do today, that does not pertain to the claim for which you are requesting payment.

• Navigate and View Remittance Information.

• MREP organizes and presents information in a manner that makes it easy for you to view.

• It also provides separate tabs to access the following:

• A list of claims;

• Details for individually selected claims;

• Summary information;

• Glossary information containing Claim Adjustment Reason Codes, Remittance Advice Remark Codes, and their definitions;

• A data view that allows you to look at the various loops and segments containing data in the HIPAA 835; and

• A search function to find claims containing specific information.

• Search for Claim(s) Information Quickly and Easily.

• MREP’s search function can help you find a claim (or multiple claims) based on your customized search criteria.

• Using it, you can search by names, numbers, and even portions of information such as:

• Health Insurance Claim Number (HICN);

• Beneficiary Last Name;

• Internal Control Number (ICN);

• Beneficiary Account Number;

• Procedure Code;

• Service Date; and

• Rendering Provider Number.

• MREP’s search capability provides a powerful way to save time and money when examining remittance information.

• Eliminate Need for Physical Filing and Storage Space.

• MREP software imports a HIPAA 835 (once you have received it from your carrier/DMERC) and saves the information as a separate Import file to help ensure that the original HIPAA 835 file remains intact.

• It also provides an easy-to-use method to archive, restore, and delete these Import files as you maintain your remittance records (further reducing the need for physical filing of printed copies and additional storage space).

• As you gain familiarity with the MREP software, you will be able to take advantage of the numerous keystroke shortcuts designed to streamline use of the software and save you time while viewing you remittance information.

• MREP software will be revised three times per year to accommodate Claim Adjustment Reason and Remittance Advice Remark Code set changes.

• You can sign up to be notified automatically when a new version of MREP is available at your carrier’s/DMERC’s web site.

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Data Parsing Algorithm Click Here

The data migration process often involves transforming data from the format and rules of the source system to a different set of rules and formats in the target system. The process of evaluating, standardizing and interpreting the source data so that it can be properly reformatted and stored in the target system is referred to as "parsing". Parsing is required for many data elements.
 

Converting Utility Billing System Data Files Click Here

If your utility agency is planning to implement a new system now or some time in the near future, you may be concerned about moving data from your current system into your new system. Technology Consultants, Inc. has been doing utility billing and financial system data conversions since 1996.  This article is to share with Association members some of the things we have learned that may help avoid pitfalls common to many data conversions.  There are a number of common problems that can be avoided with informed pre-conversion planning.  There are also some questions which, asked at the right time, can be a great asset to the utility agency.

Decoding and Translating Data Click here

Specially designed data tools are available that will translate data from its existing format or representation to a selected format or representation. This paper discusses these tools in general and identifies specific skills required to perform data translation effectively. Other terms that generally refer to data translation are: data migration, data conversion, data manipulation, data mining, etc.