Zymeda Provider Solutions

05/11/2023

Looking forward to connecting with colleagues at the 2023 CAMGMA Annual Conference and sharing information on our analytics platform and revenue cycle management services!

03/14/2023

A big Zymeda welcome to our 2 newest Team Members! Jennifer Clayborn and Deidra Smith, welcome to the team. We are happy to have you with us!

02/17/2023

Congratulations Roshan and Dulka on your new bundle of joy. We had so much fun celebrating with you!

01/06/2022

This past year has stressed the healthcare industry like never before. Pandemic issues and economic woes challenged every aspect in healthcare.

01/01/2022

12/28/2021

Check us out at https://zymeda.com

12/16/2021

In observance of the Holiday Season, the Zymeda office will be closed tomorrow at 12 pm for our Holiday Office Party.

12/02/2021

2022 - Setting Your Revenue Cycle Goals

A solid plan is the best hedge against surprises down the road. The best managed practices benefit from annual reviews and goal setting, allowing you and your team to establish benchmarks that help you determine if you are succeeding.

Goal setting is a process that starts with careful consideration of what you want to achieve, followed by specific steps, and some hard work + elbow grease. Once you have established your goals, experts suggest three important ways to prevent obstacles from appearing in your path:

1. Have an action plan for success. Don't forget due dates for each step.
2. Schedule all your action items. Add them to your calendar.
3. Evaluate your progress. Making changes or adjustments as your project takes shape is expected.

Let’s say your first revenue cycle goal is to improve the patient financial experience and increase patient payments. This is an important goal considering how patient financial responsibility continues to expand and become a larger source of revenue.

To gain staff acceptance, stress why this goal is important – it will result in happier patients and more on-time payments. Outline how you want to improve the patient financial experience, perhaps by providing more payment options that appeal to a variety of patients.

Next, you want to track your progress by setting benchmarks or milestones for success. For example, you can track the patient financial experience by following the number of self-service payments (and how they are paying) as well as call volume, patient complaints and the number of bills sent before payment is received. Make this an office wide routine.

Keep Your Goals in Focus
You will have plenty goals depending upon the issues you’re facing in your own practice. You may want to improve denials, make collections more efficient or tweak your percentage of bad debt. Be careful to keep your eye on these big picture goals when you are working on routine activities and putting out daily fires. A good way to do this is to have a team communication plan in place.

Why Goal Setting Matters
Setting revenue cycle goals will help your practice become successful in the coming year.
Whether it's increasing patient satisfaction, automating billing activities, leveraging business partners, or being more intentional with your weekly schedule, your goals will be your guide.

Working with the Right Partner
Working with Zymeda is an extension of your practice. We bring a comprehensive portfolio of practice management and strategic consulting services to your practice. We engage physicians in the decision-making process and subsequent ex*****on of strategic and operational initiatives. What remains consistent is our unwavering commitment to achieving goals using sound logic and data-driven analysis, in support of the long-term vision of the practice.

11/26/2021

Wishing everyone a wonderful Thanksgiving!

11/18/2021

Your Medical Practice: Managing Denials


For many medical practices, claim denials are a frustrating cost of doing business. Automated technology can help optimize all stages of the revenue cycle so claims are right the first time, saving headaches down the line, and streamlining the billing process so you can ensure timely payment for maximum revenue.

An ounce of prevention might be the cure. Below are 3 simple steps to help you manage claims denials at your practice and improve timely reimbursements.

1. Accurate Patient Information:
Ensuring patient and payer information is accurate from the start is the first step to successfully billing claims and avoiding denials. Insurance companies will check this information against their records during the claims reimbursement process and may deny claims if demographic or insurance information is incorrect. Use shared systems to connect front and back office staff more effectively to capture and enter this information as accurately as possible.

2. Insurance Authorizations:
Most insurance payers require prior authorization for primary care services and prescription drugs. By obtaining authorization information from the carrier prior to billing the claim will help ensure that the claim has all of the information needed to be paid and will reduce the chance of a claim denial. Having a streamlined process for your billing team to obtain prior authorizations is an important step towards successful claims management.

3. Improve Denial Workflows:
Implementing a process to proactively identify and work denials is critical in the denial management process. Request that a member of your billing team run denials reports and check claims statuses frequently to ensure denials are worked and resubmitted in a timely manner. It is important to make sure denials are worked quickly so payments can be received as fast as possible for maximum reimbursement.

There are a number of steps you can take to reduce claims denials and get paid for the services your practice provides.

Zymeda’s goal is to minimize compliance issues while maximizing practice revenue. We carefully close the feedback loop between the providers and the billing team with active communication — educating providers about documentation requirements.

It’s another goal that may sound simple, but it’s not. We just make it feel that way.

11/12/2021

Zymeda thanks our Veterans!!

11/11/2021

Escaping The Box: Case Studies with successful outcomes in out of the box medicine.

Translating a customized care model for a specific demographic of patients into improved patient care outcomes, reduced cost of healthcare, and increased revenue is no easy task, but with the right team establishing the outline, identifying patients through analytics, submitting encounter data, flagging patients and providing detailed clinic status reports, payors will see that patients are receiving the level of care that prevents hospital admissions and improves the health of the whole patient, especially with a population of patients with multiple chronic illnesses.

Phase I - Write a letter of intent that showcases your abilities and appeals to payors' goals.

Phase II - Utilize analytics to identify a population health need.

Phase III - Identify and propose specifics about how you can meet that need and what your resource requirements are.

Phase IV - Implement a wholistic patient care approach and be sure to record and monitor progress and successes.

A medium sized pediatric group with offices in 4 locations felt that a high percentage of their patient population had multiple chronic conditions and consumed a lot of resources for the PMPM agreement. We ran some analytics and performed some market analysis to determine the degree to which this notion was prevalent and discovered that the practice did, in fact, have a high chronically ill population. We approached the payor and suggested that we start a Chronic Care Clinic and set aside a specific set of resources on a dedicated schedule and track and monitor progress with a very intentional set of measures to determine outcomes. The payor agreed to a fairly large grant to help fund the clinic and if the outcomes presented success, the clinic would be reimbursed for the treatment of these patients beyond the PMPM.

Patient outcomes were astonishing! Patients that frequented emergency rooms and inpatient hospital stays were no longer taking those unnecessary trips. Patient care was coordinated between 8 or more specialists and patients were able to make progress that had not been possible before. Patients' mothers sent tearful "Thank You’s". This was more rewarding than the newly negotiated agreement. This is truly managing population health by thinking outside of the box.