Are your Claims Being Paid?

Are They Paid Promptly?

Are They Paid Completely - And According to Your PPO Contracts?

   The EOB (Explanation of Benefits) Analysis program is a management information and decision making tool which Physicians Financial developed to help practices more fully understand, and improve, the performance of their medical claims management functions.

   Physicians Financial collects data from EOB's to determine how the various carriers are looking at and responding to, the claims that have been filed. This information helps identify the strengths and weaknesses within a clinic.

   Physicians Financial uses this system as the basis for all programs in the same manner that a physician must perform a comprehensive examination of a patient, in order to determine the nature of the illness and the course of treatment.

Goals of the EOB Analysis

• Identify strengths & weaknesses of the practice's medical claim management system.

• Determine changes that could improve reimbursement rates from carriers.

• Identify any changes that could reduce the collection time for insurance payments.

• Minimize the Practice's Outstanding Accounts Receivable (Backlog).

• Determine causes of cash flow problems or fluctuations.

• Track insurance carrier's compliance with your PPO Agreements.

• Improve the efficiency of your staff by streamlining operations.

Source of the Information

• The information is gathered from current EOB's, for a 'slice' of time, as they are received from the various carriers. Each EOB is reviewed and the detailed information is entered into the Physicians Financial EOB Analysis system.

• A preliminary EOB Analysis requires a review of 500 to 1,000 patient visits to properly and accurately represent claim payment activity. The more data reviewed, the more accurate the reports.

Benefits from EOB Analysis

• Increase Cash Flow!

• Decrease Average Days Outstanding for Unpaid Claims!

• Increase Staff Efficiency!

• Reduce Staff Stress!

• Extensive Report Archives!