Home Forums Discussions Feedback and Recommendations The Adventures of Timmy the Preauth Number and His Foray Into EZClaim

Stunned.

That?s the best way I can describe my latest revelation from Tech Support. I normally just keep my mouth shut and figure that things will be addressed n due time but I?m finally to the point of frustration with things that are just plain slow, clunky or in this case just don't work.

The issue: Preauthorization Numbers and their export to EZ Claim.

Before I begin my story, I would like to state that Andrew in Tech Support was courteous, knowledgeable and friendly. Interfacing with tech support is never the issue. I?ve worked tech support in the past and it is a thankless job. Kudos to the people who have to deal with irritated jackasses like myself.

That being said?..

I?ve been waiting a couple of years now for the ability to export various pieces of data into EZ Claim. Most of it would just be nice but not critical but with the continuing rollout of the ACA and with insurers looking for more ways to limit access to healthcare (or at least throttle it), pre-authorizations are a way of life for many of us. So why hasn?t AC realized this? You can enter preauth info into AC via the ?Other Insurance Info? button when generating a superbill (though proper workflow would dictate the button should be on the Billing Info screen via patient demographics being that you are getting the auth before you treat the patient lest one runs the risk of not getting reimbursed). You can generate a 1500 form from within AC and the preauth is there. When you export to EZClaim, it isn?t even written to the export file. Huh?

Come on AC, this is pretty basic insurance 101 stuff. EZClaim is pretty standard and many offices use it. All the documentation from EZ Claim states that field 23 should export. According to them, it is a done deal. Is anyone at AC talking to EZClaim? EZClaim, are you talking to AC? Is ANYONE testing? Geez, after a couple years of waiting, I finally just got CPT modifiers to export. Should I expect preauths by 2020?

I have been doing the math and my staff wastes about 2 hours a day on transferring manually the preauth information between AC and EZClaim because every procedure we do requires preauthorization.
?
Any decent database admin or developer could correct the issue with a nominal about of input. Find the appropriate data field name, alter the app to account for the placement, create the text output field with the correct data field and don?t screw up the comma placement. I have just a basic understanding of how it works?..but still. The attitude of the relayed response from the ?interface designer? was pretty much. It doesn?t work. It won?t work. We have no plans of making it work. You can request it and we?ll put it on a very long list of things people want that we have no real intention of getting to. Make sure you pay your $1200 so we can update the letter writer some more and infuriate you with features that should have but don?t.

OK?..maybe beyond the ?you can request it? I added my own spin but that?s how I feel as a customer and it is a valid sentiment that was conferred based on their response.

The real issue isn?t that they can?t do it; the issue is they don?t want to do it. I have a sneaking suspicion that were It to function, it may be one more reason not to pay the $250/mo for their practice management nodule. There may be some out there thinking that $250 a month is peanuts to save 10 hours of labor a week. It may be; however, why should I be paying more for a feature that is so basic that it should be working ?out of the box? AND if the feature actually worked, I could save the 10 hours a week and the $250/mo. With reimbursements continually spiraling around the toilet bowl, I?ll save whatever I can wherever I can.

Rant over?.. but other than the upgrades in April, I really wonder why I?m paying $1200 a year for support I rarely use, Guardian Angel support that doesn?t call back during critical work stoppage situations (after their normal hours, not mine), corporate communication that is rare (unless you consider e-mails wanting to sell you conferences), and a development team that seemingly is out of touch with the product and the industry it serves.
<sigh>

I have to get back to manually transferring 50 preauth numbers now.

Shocked, shocked, to discover that simple fixes are eschewed in the corporate world. How else are the CEO's to earn their money, if it isn't to convince us all that the world is too complex without their priceless assistance?

Agree with what you say about the folks on the line at tech support -- they, like the doctors they are trying to help, are working hard in a very intellectually and morally hostile environment.

However, there is just too much money on the table- and the insurance companies have all of it, and they want to keep it.

If there were any sense to "prior authorization" it would be in some kind of "risk sharing" model with patient, physician and insurance company all sharing both the risk and the rewards.

Of course, insurance companies are too smart by half, and they have cleverly figured out how the doctors can share the risk (and pay for the privilege) while they pick up the chips. And if there is any problem with the arrangement, well, it's the doctors' fault -- they didn't do the PA procedure properly. Patients get mad at my office, not their insurance company if there are glitches.

This will not stop until doctors wise up and refuse to do PA without adequate reimbursement or honest risk/benefit sharing.
This "healthcare system" is completely dysfunctional and needs to be brought to a complete halt.

I used to believe you could cooperate with the sociopaths that run the world, (being of an essentially liberal persuasion), but I have belatedly seen the error of my ways.

Oh, Tom.....get ready for the next phase. We are starting here in this corporate entity very soon. Humana reps sitting in on patient visits. God help us all!

Leslie -- I don't know how old you are, but probably you don't really have any choice (or you wouldn't be where you are.)

I am 72, and just trying to hang on to my loyal patients and my sanity for a few more years. I gave up trying to make a living in this business.

(Well, actually, I am able to make enough to pay the help, so I am a "job-creator" and therefore a useful member of society.)

Tom,

I am closing fast on retirement and then thinking of retiring in Oregon!

Tom, I think Leslie is 42. Looks like it, anyway.

42 is always the right answer.

I don't speak for either of those parties, but if it is valuable to you, and it is your data, we can make it happen.

42 is the Answer to the Ultimate Question of Life, the Universe and Everything. This Answer was first calculated by the supercomputer Deep Thought after seven and a half million years of thought. This shocking answer resulted in the construction of an even larger supercomputer, named Earth, which was tasked with determining what the question was in the first place.

Yes, Oregon would be a good place to retire.
But bring your own doctor!

Put a 1 in front of it and it is also my weight!
What??? Doctor shortage in Oregon??? Hmmmmm, may have to consider part-time work.
Go Ducks!!

Actually, I thought Leslie was 24, not 42

Oh, Wendell!!!

You may not remember that they wanted to card Leslie in Tahoe, so I had to buy the beverages. Takign Leslie out on the town is always big adventure!

Oh, Indy......you are such a sweet talker!! Just keep the Tequila handy.

Oh, Indy......you are such a sweet talker!! Just keep the Tequila handy.

I guess that means Leslie is looking for a double of that Tequila.

No names, but it has been mentioned that this summer there you and Martin have inspired a specific bottle sampling area - we will be alerting the duty-free facility at Denver International.

Never stand between a Physician and their choice of libation - it's dangerous to someone's health.

If I recall correctly, Martin is a fan of bourbon. Denver?????

Easiest way to fly into Laramie. From there it is a shuttle or a 2.5 hour drive (2 if you are feeling western).

Sounds like a plan

I have had the same frustration with AC not doing a simple export to EZ Claim. In my case it concerns the exporting of the PAYMENT TYPE (cash, checks, visa, MasterCard, American Express). That information is important to do daily accounting reconciliation. As a result, we still have to use paper superbills and manually fax them to our outside billing service. This wastes a lot of time and paper. The response we get from AC is that no one seems to be interested. I am told that they do not export it at all, not even to their own PM system.

Would anyone else find this capability to be useful?

Norm