Thanks to all our wonderful partners! Our 2005 User Conference was a wonderful success. This year we focused on increasing the involvement of our insurance company and vendor partners. We believe this enhanced the value of the conference.
We want to give everyone a little synopsis of the content from this year’s conference as reference for those who attended, and to encourage everyone to attend next year to take advantage of the wealth of information available.
The first day of our conference was dedicated to Gateway EDI working with our Practice Management Vendors so that we both better understand the procedures involved with our mutual clients. Much time was devoted to our new Vendor Web Portal which is a new vendor resource tool. Gateway EDI also delivered presentations on all aspects of setting up and continued support of our customers.
After the vendor conference, awards were given to vendors who have done great work helping their providers in regards to their EDI transactions. That presentation was followed with a Gateway EDI hosted cocktail hour and networking reception to thank our wonderful vendor partners.
The second day of our conference was the first day devoted to customers. Monday morning started with a presentation on Health Saving Accounts. Jim Denning from Discover Vision Centers and Dominique Wilson from Aetna explained Health Saving Accounts benefits and implications. The rest of the morning consisted of Payer Breakout Sessions . The payer breakouts included Aetna, Arkansas BCBS, Coventry Health Care, United Healthcare and Wellpoint.
After lunch, providers attended breakout sessions focused on new services offered by Gateway EDI. The New Product Breakout Sessions included presentations on Patient Friendly Statements, Pre-Collection Letters, ERAs, Real-time Products and EMRs.
Also a big hit was our Gateway EDI Customer Service Room. We had a room open all day for customers to sign up and receive one-on-one training from our Customer Service Representatives. With computers connected to the Internet, clients and reps were able to log on to the Gateway EDI website and do personalized training on how to most efficiently use our web tools. Everyone who attended these sessions should be recognized at next year’s conference as a 99% club member!
To wrap things up, Gateway EDI hosted a networking happy hour and awards ceremony. After a few words from some key Gateway EDI personnel, we honored those attendees that have been in the 99% club. Then we all traversed to the Funny Bone Comedy Club for a relaxing evening. Our keynote speaker for Day Three, Diana Jordan, got us going with some funny life stories and introduced our headliner, Mark Sweeney. Mark kept us rolling in our seats and made it an enjoyable evening for all.
Day Three was all Gateway EDI, all day. The day started with John Heidy, presenting an Overview of the Board of Healing Arts. The rest of the day was devoted to Gateway EDI training. Gateway EDI representatives gave presentations on Gateway EDI Continuing Education Training, the Gateway EDI Medical Payer List and Managing Changes at Your Practice and NPI (National Provider Identifier).
We surveyed our attendees, and overall the conference was rated 4.5 on a scale of 1-5. So we are happy it was worth everyone’s time, as we know how busy offices are these days.
Thanks again to all those who participated. Watch for information on the next conference and we look forward to seeing everyone there!
PRESENTATION DETAILS:
Health Savings Accounts
Jim Denning, CEO of Discover Vision Centers, has first hand experience with Health Savings Accounts. Discover implemented this coverage in his office for their employees. Jim’s presentation on Consumer-Driven Health Care discussed how these plans help consumers learn the real cost of health care (it’s not just the $30 co-pay). They offer choices and more consumer involvement. In order for these plans to work, they also need an FSA (Flexible Spending Account) as a safety net for high deductible plans, broad provider networks, and informed docs and patients. In Jim’s experience at Discover Vision, each year the number of employees in CDHP has increased and no one has dropped it. The benefits of these accounts include tax-free accumulation of interest or investment earnings, rollover of unused funds, and flexible funding the accounts don’t have to be funded every year giving the consumer options and choices.
Jim’s presentation was followed up by a representative from Aetna, who offers these accounts and encourages their employees to participate. Dominique Wilson from Aetna explained how these plans increase consumer management and responsibility. Companies can also implement health risk assessments at work. As the employees work to better their health, an option is to reward them or increase their pay. Dominique also reiterated how these plans increase the knowledge of the true cost of healthcare (not just a co-pay).
Payer Breakout Sessions
Sara MacLeod from Aetna discussed their resources available to providers. Gateway EDI providers can access Aetna eligibility and claim status directly from our website. Sara also promoted the value of Electronic Remittance Advice (ERA’s). These benefits include less cost, less time, less paper, and less hassle for the provider office. Other resources on the web site were discussed such as Office Links, the Aetna newsletter.
Jessica and Laura from Arkansas BCBS traveled literally through the night to the conference in order to present important information to our providers. Arkansas BCBS is the Medicare Part B (physicians’ benefits) contractor for Louisiana, Oklahoma, eastern Missouri and New Mexico. Arkansas Blue Cross also administers the Medicare Part A (hospital benefits) and Part B programs in Arkansas. The presenters discussed with our providers the 4 levels of reports/edits provided for their claims. They explained that the 4th level is done through Medicare and how the pre-pass edits change quarterly. The NPI (National Provider Identifier) was also discussed. AR BCBS also emphasized the value of ERA’s.
Coventry Health Care’s representative was Kurt Ringo. Kurt was able to provide vast information about Coventry and Gateway EDI. Kurt discussed the transactions available via the Gateway EDI website, including ERA’s with eligibility and claim status coming soon. Kurt encouraged providers to direct their members to the Coventry website to increase their knowledge. Coventry also offers training web casts which provide good information for new employees at practices. Kurt was also able to field specific claims questions from provider offices and discussed the recent purchase of First Health by Coventry.
Caroline and Laura presented at the conference for United Healthcare. They promoted electronic claims processing emphasizing the benefits faster, cleaner claims and decreased costs. Other EDI initiatives were discussed such as COB (coordination of benefits) with Medicare primary claims and the types of claims that can be sent electronically.
The Wellpoint Family of Companies includes Anthem BCBS serving members in Colorado, Connecticut, Indiana, Kentucky, Maine, Nevada, New Hampshire, Ohio and Virginia, BCBS of California, BCBS of Georgia, BCBS of Missouri and BCBS of Wisconsin, Healthlink, Unicare and other affiliates. Charlotte Lake talked to providers about how Wellpoint is now the largest health plan in the country. With the recent changes in the plans listed above, Wellpoint wants to create a consolidated claims front end, increased interaction with providers, and decreased days payable. This includes doing more up-front edits to get the claims paid faster and how Gateway EDI will help with those efforts.
New Product Breakout Sessions
Patient Friendly Statements
Mark Snow from PSC talked about the electronic patient statements setup process. First, paper work must be completed. Then, a test file must be sent to Gateway EDI. Gateway then forwards the file to PSC for mapping so that it can be customized as the client wants. Mark also discussed PSC’s company history, their HIPPA compliance and the additional services they offer like post cards & follow up letters.
Pre-Collection Letters
The Outsource Group specializes in pre-collection letters for the healthcare industry. They are an accounts-receivable management company that deals with collections from patients or payers.
They have the flexibility to take out sensitive cases and their letter refers the party back to the practice so interaction is monitored (discussion isn’t with the collection agency so it is in the practice’s control). Benefits include third party interaction and saving the practice time and money. TOG is working on more software interfaces.
ERAs, Real-time Transactions, EMRs
Gateway EDI representatives discussed the new products available. Eligibility – United Healthcare and Aetna are available directly from our website, and we are testing with others. We are also testing batch eligibility and claim status.
ERAs are available for many of the payers we connect with. Certain payers have enrollment for this and others do not. The enrollment forms are available to download from our web site. Once we receive the ERAs, clients can print complete or single EOBs from our web site.
We are working hard on our Coordination of Benefits process. COB applies when a patient is actively covered by more than one insurance company at the DOS. For Gateway EDI to process these claims, the office has to be able to mark carriers as primary, secondary, tertiary, etc. Gateway EDI can now accept electronic secondary claims – and we would love more test files.
There is a government initiative called the National Health Information Network which is a plan for health information technology to increase quality and to decrease medical errors. The government sees the need to accelerate the diffusion of knowledge, reduce variability of care, and to strengthen privacy and data protection. Electronic Medical Records (EMR) can help this initiative since systems can better talk to each other. Incentives need to be offered to practices to adopt EHRs. Although practices have to change business processes in the office as EMRs get set up, the new systems will benefit patient care management.
Overview of the Board of Healing Arts
John discussed how the Board is designed to protect citizens through licensing, assessing competence and moral character of physicians, and investigating all complaints in a fair manner. John explained how licensure takes place. He also shared information on the source of complaints, how the investigative process occurs and what actions the board may take. He also talked about how the board can be used as a resource, and that their goal is to be proactive rather than reactive.
Gateway EDI Continuing Education Training
Presenters: Connie, Jackie, and Brenda from Gateway EDI
First, the client home page was covered in detail. Then the focus was the reports – such as safety net, rejection analysis and claim file reconciliation. The group went over the eligibility and remit products. Training was given on the Gateway EDI Best Practices for offices to keep A/R down and to increase efficiency. We also shared our customer service statistics to show how we are working to keep our service levels up. Please remember to contact us because ongoing training is always available to our clients. We also included tips we have received from members of the 99% Club.
Gateway EDI Medical Payer List
Presenters: Jan and Linda from Gateway EDI
Linda first showed how to navigate through the Gateway EDI Payer List to find the right payer. She explained how we work a paper claim report to see if there is a high volume of paper claims for a particular payer and then try to establish an electronic connection. We want to help clients send everything electronically since it is more time and cost effective. Jan emphasized that clients need to notify Provider Enrollment of any changes such as adding or removing a doctor, changing a tax ID, new provider #’s, etc. We don’t want any interruptions to our clients’ service. We can help you with paperwork or any questions.
NPI (National Provider Identifier)
Presenter: Stacy from Gateway EDI
The NPI is a unique identifier meant to replace all legacy provider numbers, and it will be a lifetime assignment. The format of the identifier is ten characters. All covered health care providers are required to obtain an NPI by May 23, 2007. Stacy recommended applying soon because turn-around time is very fast currently, but could change. The goal of the NPI is to improve efficiency and effectiveness for electronic healthcare transmissions.
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