OpenEMR has officially released version 7.0.3, and it’s one of the most significant updates yet. As the world’s leading open-source electronic medical record (EMR) platform, OpenEMR continues to evolve to meet the growing demands of modern healthcare. This release delivers enhanced interoperability, smarter clinical tools, and new functionality across billing, telehealth, and patient engagement. At ClaimRev, we work closely with healthcare organizations that use OpenEMR. We’re excited about this release—not just for what it brings to the table, but for how it can improve revenue cycle management, billing workflows, and overall efficiency for providers. What’s New in OpenEMR 7.0.3? Here’s a breakdown of the key new features and improvements that come with this release: ✅ ONC Decision Support Interventions (DSI) OpenEMR now supports B11 Decision Support Interventions, a critical component of the ONC Health IT Certification. This feature helps providers deliver safer, evidence-based care by surfacing actionable alerts and recommendations during patient encounters. ✅ Why it matters: Better clinical support leads to fewer errors and improved documentation—two key drivers in reducing claim denials. 💊 WENO Exchange ePrescribing Module This release introduces integration with WENO Exchange, an ePrescribing network that simplifies the prescription process for small and rural practices without traditional access to major networks. ✅ Why it matters: ePrescribing streamlines medication orders, reduces phone calls to pharmacies, and minimizes delays in patient treatment plans—all while staying compliant with eRx mandates. 📞 Expanded Module Support: Telehealth, Fax, SMS, and More Version 7.0.3 brings enhancements to a range of functional modules that are critical to day-to-day operations: Telehealth: Smoother video visit capabilities Fax & SMS: Better patient and provider communication Claims Clearinghouse: Improved integration for electronic claims submission Payment Processing: Easier collection of patient co-pays and balances Prior Authorization: Workflow support for securing payer approvals ✅ Why it matters: These tools are directly tied to revenue cycle efficiency. Missed authorizations or clunky communication workflows lead to denials and delays in reimbursement. 👥 Enhanced Patient Portal Patient engagement gets a boost with design and usability upgrades to the patient portal. Expect a more intuitive layout, easier access to documents, and better support for mobile users. ✅ Why it matters: Patients who engage with their health data are more likely to show up for appointments, pay bills on time, and respond to follow-up care—which keeps your revenue cycle healthy. 🔗 FHIR & API Enhancements OpenEMR 7.0.3 strengthens support for FHIR (Fast Healthcare Interoperability Resources) and expands existing API capabilities. This makes it easier for providers to connect OpenEMR to other tools—like clearinghouses, analytics platforms, and billing software. ✅ Why it matters: For ClaimRev clients, this means smoother integrations, better data syncing, and opportunities to automate claim tracking, eligibility checks, and more. 💡 What It Means for ClaimRev Users If your practice runs on OpenEMR and uses ClaimRev to manage insurance claims, eligibility, or denials, this update is a step forward. These improvements set the stage for: Faster reimbursements Fewer denials from missing auths or coding gaps Cleaner integrations between clinical and billing tools Improved communication with patients and payers In short: fewer bottlenecks, more automation, and better outcomes for your bottom line. 🔧 Planning to Upgrade? We encourage all OpenEMR users to review the installation and upgrade guides before moving to 7.0.3. If you’re unsure how this update may affect your current ClaimRev setup, we’re here to support you every step of the way. 👉 Need help optimizing your claims process with OpenEMR 7.0.3?Contact our team 📚 Learn More 🔗 OpenEMR 7.0.3 Full Release Notes 📄 Release Features Overview ClaimRev proudly supports healthcare practices using open-source tools like OpenEMR. We believe in empowering providers with secure, scalable, and affordable RCM solutions—so you can focus on delivering care.
Top Financial Tips for Small Business Owners
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5 Key Strategies for Scaling Your Business in 2024
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Maximize Your Revenue with Customized Analytics: 8 Essential Reports for Healthcare Providers
In the competitive landscape of healthcare, maintaining financial stability is crucial. One of the most effective tools for achieving this is leveraging customized analytics and reports. These tools can significantly optimize revenue, reduce denied claims, and enhance operational efficiency. This blog post will delve into how healthcare providers can maximize their revenue using customized analytics and reports, offering actionable tips along the way. Understanding Customized Analytics Customized analytics involve collecting, analyzing, and interpreting data tailored to the specific needs of a healthcare provider. Unlike generic reports, customized analytics provide insights directly relevant to the unique operational and financial context of the provider. These insights enable healthcare providers to make informed decisions that can drive revenue growth and operational efficiency. Benefits of Customized Analytics: Actionable Tips for Maximizing Revenue with Customized Analytics Essential Reports for New Healthcare Practices For healthcare practices new to using analytics, here are some essential reports to request: Leveraging Analytics and Reports A robust analytics and reporting platform designed to meet the unique needs of each healthcare provider is essential. Customized analytics and reports are built on advanced technology and a deep understanding of the healthcare industry’s intricacies. Key Features of an Effective Analytics and Reporting Platform: Conclusion In today’s competitive healthcare environment, maximizing revenue and maintaining financial health are critical. Customized analytics and reports are invaluable tools that can help healthcare providers achieve these goals. Tailored solutions not only streamline medical claims processing but also provide the insights needed to drive revenue optimization and operational efficiency.
How to Use Data to Boost Your Small Business
How to Use Data to Boost Your Small Business WASHINGTON, Aug. 20, 2024 – To succeed in today’s fast-paced data-driven business environment, small business owners should use performance metrics and KPIs (key performance indicators) to guide decisions and sustain growth. SCORE, a resource partner of the U.S. Small Business Administration (SBA) and mentors to America’s small businesses, encourages small business owners to quantify and track performance benchmarks in order to refine operations and facilitate growth. Small business metrics can be both qualitative, meaning they are described using words, or quantitative, meaning they are framed as numbers. In some cases, the most specific KPIs and metrics for your business might be a combination of both types of data points. What’s the purpose of this data? Business metrics and KPIs allow you to measure how well your company is performing against set goals for different areas of your operations, and how you can adjust to exceed expectations. There are metrics available for measuring customer satisfaction, employee retention, and understanding what products are selling the fastest and from what channel. There are also different ways to develop situational or highly specific KPIs to track cash flow, quality, gross profit, the long-term value of specific customer demographic groups, and many other things. Every area of your business from people to products and processes can be measured, tracked and optimized through the use of data analysis. “Verify your key metrics by periodically tracking both individual and aggregate results,” recommends SCORE mentor Nabil Freij. “With individual and total metrics, you can identify meeting your revenue goals, see who needs help improving, and learn who is pushing boundaries and raising the bar.” Sales performance KPIs To start building a more data-centered organizational culture, you need to start measuring success and qualifying shortcomings. For many small business leadership teams, sales performance metrics are the most logical place to start when looking to build on current success and sustain growth into the future. These metrics could include gross profit, cash flow forecast, inventory turnover and more. These different indicators can provide actionable insights into the choices your management team should make to optimize successful business outcomes. However, sales performance data is not everything and as your business matures, you will want to consider many other areas as well. Human capital performance metrics For many small businesses, one of the single most variable costs is connected to the expense of human capital, or the value of your employees to your business. To develop a better understanding of the costs associated with human capital expenditure, your business may want to track KPIs such as turnover rate and human capital return on investment (HCROI). Key logistics KPIs Small businesses that are involved with e-commerce and are consistently working with shipping partners can benefit from using key performance indicators to evaluate success. Areas such as supply chain management, production, fulfillment and customer service all have metrics associated with them that your business should be tracking. These metrics can include freight cost per unit shipped, transit time to distance, and warehouse space. Driving successful business outcomes Measuring success is one of the most important ways for your business to optimize performance and consistently deliver better and more cost-effective operations. In today’s challenging business environment, the key to developing the agility needed to sustain success is found in harnessing the full power and potential of data-driven decision making. Looking for more guidance? Find a SCORE mentor who can help you decide what’s right for your business. “SCORE is free – utilize your free resources because as a startup, it’s hard to pinch all of those pennies,” said SCORE client Amber Sharp, CEO and owner of Claim Revolution. “They’re remarkable and always there for you.”
7 Essential Steps to Reduce Medical Claim Rejections and Boost Your Healthcare Practice’s Financial Health
In the intricate world of healthcare billing, claim rejections represent a significant barrier to efficient revenue cycle management. These rejections not only delay payments but also add administrative burdens, diverting attention from patient care. Addressing the root causes of claim rejections is not just about enhancing operational efficiency; it’s a critical strategy for safeguarding the financial health of healthcare practices. This comprehensive guide outlines actionable steps for healthcare providers aiming to minimize claim rejections, streamline billing processes, and ensure a steadier cash flow. Audit Your Current Process The first step towards minimizing claim rejections is a thorough review of your billing and claims submission process. This audit should aim to uncover any recurrent errors or inefficiencies. Engage with your billing team for insights and consider an external audit for an unbiased overview. Look for patterns in the rejections and identify common mistakes. This proactive assessment is vital for setting the stage for more targeted improvements. Implement Staff Training Programs Human error is a frequent contributor to claim rejections. Regular, comprehensive training programs for your staff can significantly mitigate this. Focus on areas such as ensuring patient information accuracy, understanding the nuances of insurance policies, staying updated with coding practices, and emphasizing the critical role of prior authorization. Tailored training sessions based on common errors identified in your audit can enhance the precision and efficiency of your billing process. Leverage Technology Modern billing software and Electronic Health Records (EHR) systems offer sophisticated features designed to prevent common billing errors. From real-time alerts for potential mistakes to automatic verification of patient data and up-to-date coding information, these technological solutions are invaluable for reducing human error. Investing in such systems not only improves efficiency but also helps in maintaining compliance with ever-evolving healthcare regulations. Develop a Rejection Management Strategy Despite your best efforts, some claims will inevitably be rejected. However, a structured approach to managing these rejections can help you address them more efficiently. Analyze every rejection to understand its cause, correct the issues, and promptly resubmit the claims. This cycle of feedback and improvement is crucial for reducing future rejections and enhancing the overall claims management process. For example, submitting the same claim more than once, whether due to administrative oversight or misunderstanding of a previous rejection, leads to unnecessary rejections. Engage with Insurance Companies Building strong relationships with insurance companies can provide you with insights into common rejection reasons and policy changes that could affect your claims. Regular interactions with insurance representatives can help you stay ahead of policy updates, understand coverage intricacies, and make the prior authorization process smoother. These relationships are invaluable for anticipating potential hurdles and proactively addressing them. Monitor and Adjust Implementing changes to your billing process is only the beginning. Continuous monitoring of how these changes affect your claim rejection rates is essential. Use analytics to track improvements or identify new areas of concern. Adjust your processes, training, and technology use based on this data to ensure ongoing optimization of your billing operations. Encourage Patient Participation Your patients play a crucial role in the billing process. Educating them about the importance of providing accurate and comprehensive information is fundamental. Encourage patients to verify their insurance coverage details and understand which procedures require prior authorization. Informed patients are less likely to contribute to billing errors, making the process smoother for everyone involved. Conclusion: A Proactive Approach for a Healthier Bottom Line Reducing claim rejections and streamlining your billing process requires a comprehensive, proactive strategy. By auditing your current processes, investing in staff training, leveraging technology, developing a structured approach to rejections, engaging with insurers, continuously monitoring your progress, and encouraging patient involvement, you can significantly reduce billing errors and claim rejections. This not only stabilizes your practice’s cash flow but also enhances the patient experience by minimizing administrative delays and errors.
Navigating Clearinghouse Changes: Insights from a Seasoned Healthcare Biller?
Transitioning to a new clearinghouse can be a pivotal move for any healthcare practice. With over 20 years in healthcare billing, I’ve navigated several transitions, each with its unique challenges and lessons. Here, I’ll share practical advice to ensure your clearinghouse change is as smooth and effective as possible, combining industry best practices with real-world experience. Evaluate Your Needs Thoroughly Before making a switch, understand why you’re moving. Is it due to pricing, customer service, or functionality? Analyze your practice’s specific needs. For example, if you’re a specialist, ensure the new clearinghouse can handle the nuances of your specialty billing. Create a checklist based on your practice’s volume, typical claim complexities, and the most common issues you face with your current service. Research and Select Carefully: Don’t rush the selection process. Look for a clearinghouse that offers robust reporting features, real-time claim tracking, and proactive denial management. Compatibility with your existing Practice Management System (PMS) is crucial to avoid workflow disruptions. Consider the clearinghouse’s track record with practices similar to yours, and always ask for references. Plan the Transition: Develop a detailed transition plan, outlining every step, from data migration to staff training. Establish realistic timelines, and don’t forget to account for potential setbacks. Coordinate with both your old and new clearinghouse to ensure a smooth data transfer, particularly for open claims and Accounts Receivable (AR). Communicate and Train: Clear communication is key. Inform your team about the upcoming change well in advance. Invest in comprehensive training sessions for all users, focusing on the differences between the old and new systems. Hands-on training with actual claim scenarios can be particularly effective. Conduct a Pilot Test: Before going live, Before going live, conduct a pilot test with a controlled group of claims, this is sometimes called the test file phase. This will allow you to identify any issues with claim submission to the new clearinghouse. Addressing these issues before full-scale implementation can save you a lot of headaches. Monitor and Optimize: Once you go live, monitor the performance closely. Pay special attention to the first few batches of claims. Check for increases in denials or delays in payments and address them immediately. Continuous monitoring is crucial regardless if a switch has been made or not because it allows you as the biller to be proactive in revenue cycle ensuring there are no hang ups with claims not being work. Review Your Financials: After the transition, conduct a thorough review of your practice’s financials along with any offered analytics or reports from the new clearinghouse. Look for any changes in your key performance indicators (KPIs), such as the average days in AR, denial rates, and payment turnaround times. This will help you gauge the impact of the new clearinghouse on your revenue cycle. Finally gather feedback from your team on the new system. What’s working well and what’s not? A good clearinghouse will work with you to implement needed and doable changes. Changing clearinghouses is more than just a technical switch; it’s a strategic move that affects every aspect of your billing operations. By taking a thoughtful, structured approach, you can ensure a transition that not only minimizes disruptions but also sets your practice up for improved efficiency and financial health. Remember, the goal is not just to change clearinghouses but to enhance your overall billing process, making it more streamlined, transparent, and effective.
Enhancing Cybersecurity in Small Healthcare Providers’ Offices: Practical Steps for Immediate Action
Understanding the Risks Before diving into the solutions, it’s essential to grasp the types of cybersecurity risks facing small healthcare offices. These risks include phishing attacks, ransomware, data breaches, and unauthorized access to patient information. Such incidents can lead to significant financial losses, damage to reputation, and legal repercussions, not to mention the potential harm to patients’ privacy and trust. Actionable Cybersecurity Steps 1. Conduct a Risk AssessmentActionable Item: Start by identifying where your patient data resides and evaluate the potential vulnerabilities. Tools like the NIST Cybersecurity Framework can guide you through this process. Understanding your vulnerabilities is the first step toward addressing them. 2. Implement Strong Access ControlsActionable Item: Ensure that only authorized personnel have access to sensitive patient data. Use strong, unique passwords and consider implementing multi-factor authentication (MFA) for an additional layer of security. Regularly review access permissions and adjust as necessary. 3. Educate Your StaffActionable Item: Cybersecurity awareness training can significantly reduce the risk of successful phishing attacks. Train your staff to recognize suspicious emails and the importance of not sharing passwords or clicking on unknown links. Making cybersecurity training a regular occurrence is not just about compliance; it’s about creating a culture of security awareness within your practice. Leveraging optional free resources for this training can make a significant difference in your team’s ability to thwart cyber threats. 4. Keep Software Up to DateActionable Item: Cyber attackers exploit vulnerabilities in outdated software. Implement a policy to regularly update all systems, including operating systems, antivirus software, and any applications used in your office. Enable automatic updates where possible to ensure you’re always protected against the latest threats. 5. Secure Your Wi-Fi NetworkActionable Item: Use a firewall to protect your network and encrypt information sent over the internet. Change the default name and password of your Wi-Fi network to something unique and secure. Consider setting up a separate network for guests to protect access to sensitive data. 6. Develop a Response PlanActionable Item: Having a cybersecurity incident response plan in place can minimize damage in the event of a breach. This plan should include steps to isolate affected systems, notify affected individuals, and report the incident to relevant authorities. Practice this plan with your team to ensure everyone knows their role during an incident. 7. Secure Mobile DevicesActionable Item: With the increasing use of smartphones and tablets in healthcare, it’s vital to secure these devices. Implement policies for the use of personal devices for work purposes (BYOD policies) and ensure that any device accessing patient information is equipped with security software and encryption. How It Will Affect Your Practice Cybersecurity in healthcare is not just about protecting data; it’s about safeguarding the trust and well-being of patients. Small healthcare providers, while facing unique challenges, can take significant strides in cybersecurity by implementing the actionable steps outlined above. Starting with a thorough risk assessment and moving through to employee training and the adoption of strong security practices, small offices can create a robust cybersecurity posture. Remember, the goal is to make cybersecurity an integral part of your healthcare practice’s culture. By taking proactive steps today, you can protect your practice and your patients from the cyber threats of tomorrow.
