Case Studies

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Many billing companies across the USA have been relying on older systems with less automation and more moving parts to perform RCM / Medical Billing activities for the roster of clients they have. One such biller from California wanted to implement a secure, state-of-the-art, HIPAA-compliant cloud- based system that can handle a handful of their clients effectively performing RCM workflow and Payment Postings efficiently to handle their increasing customer base and claims volume. To meet their requirements, expEDIum Medical Billing® (eMB) was chosen by this biller as a viable and cost- effective solution.

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Gastroenterology's distinctive clinical workflow and billing requirements necessitated a transition from outdated PMS/RCM systems. Implementing expEDIum Medical Billing (eMB), a cutting-edge, HIPAA-compliant cloud-based solution, addressed these needs effectively. eMB optimizes GI workflow across PMS, RCM, Claim Life Cycle Management, and Payment Postings, resulting in enhanced reimbursement and revenue transparency for GI practices and ASCs compared to legacy systems.

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expEDIum is currently being used by Public Health Departments/Counties across various states in the United States of America. As most EMR+PMS systems were designed for private clinic/hospital workflows, public health clinics were in search of secure, cloud-based systems that could accommodate their specific workflows, the nuances involved in various claim billing lifecycles, and at an optimal cost of ownership.

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Bibb Medical Center (BMC) is in Centreville, Alabama. As the county's healthcare provider, BMC serves a population of roughly 22,000 people. This BIBB hospital provided inpatient care, post-acute care rehabilitation, intravenous therapy, wound care, and other high-quality services.

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For a smooth operation, an EMS company chose expEDIum and its services. Their claims were turned down, and they needed to get paid more. Their problems were resolved after they switched from their old system to iTech Medical Billing. Clients were happy with the product and the revenue they collected.

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A Clinic provided inpatient/outpatient consulting and used an outsourced billing company to process claims. Their claims were consistently rejected and paid late because of error claims. expEDIum solved their issues by migrating them to the expEDIum Medical Billing solution. The client is happy with the excellent support and 100s of thousands of dollars they have received in ROI.

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A Hospitalist provided inpatient consulting and used an outsourced billing company to process claims. Their claims were consistently rejected and didn’t have secondary claim visibility and follow-up. expEDIum solved their issues by migrating them to the Medical Billing solution. The client is happy with the excellent support and 100s of thousands of dollars they have received in ROI.

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A California-based TPA manages funds for a number of physician practices that are under capitation contracts. They became unhappy with their system, which needed to meet their ongoing requirements to run the practice. The software was slow, and the maintenance was very costly. With the help of expEDIum, the biller has processed over 40000 claims with total charges of about $20 million and reduced the work hours by 35%.

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The District Health Department has 45 users, including practice managers, nurses, providers, and others. They were frustrated with their paper-based legacy system, which was not robust and lacked many features. The biller processes over 1300 HCFA claims a month with a reduced denial rate. The integrated solution presently has 500 providers in 48 counties and processes over 600K claims.

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The District Health Department has 45 users, including practice managers, nurses, providers, and others. They were frustrated with their paper-based legacy system, which needed to be more robust and lacked many features. The biller processes over 1300 monthly HCFA claims with a reduced denial rate. The integrated solution currently has 500 providers in 48 counties and processes over 600K claims.

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A Philadelphia-based Ambulance biller processes over 4000 professional claims a month. They didn’t have an integrated electronic claims processing and submission solution. iTech migrated this client from their legacy system to an eMB solution. The biller processes over 3,200 HCFA claims a month with a lower denial rate. The auto posting helped them to save 100s of hours of data entry savings every month.

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For further information, reach out to one of our experienced team members.

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