Posting update: We hear you!
The results of our second-quarter client satisfaction survey are in, and they indicate a dip in satisfaction with remittance services. We want to tell you what we're doing to improve your satisfaction and what has happened in the industry to get us to this point. Approximately 96% of all transactions athenahealth handles are posted automatically. Those "routine" transactions are usually non-issues. In the past six months, the industry move to electronic remittance advice (ERA) has accelerated and athenahealth, a leader in ANSI ERA, has been there to receive it. We are finding, unfortunately, that the information in ERA sometimes isn't as rich or doesn't match what would have been on the paper EOB. Our policy is to post the information in the ERA file, even if the paper is different. This has caused some consternation among clients with high percentages of ERA. Our payer outreach team is working with the carriers to improve their ERA formats, but, unfortunately, we expect minor ERA issues to continue for some time.
The 4% of transactions that aren't routine have their own set of issues. In most cases, what prevents those transactions from working with our automatic posting process is that the remittance advice lacks key information, like why the payer didn't pay the full amount. These cases require extra research and sometimes wind up in the client's unpostables bucket. We monitor the reasons transactions wind up as unpostable and have specific plans to address those we can affect.
In addition, we haven't done a good job communicating our paper EOB policy, which is that we post exactly what's on the EOB. We don't make interpretations on your behalf. This policy creates some follow-up work for clients who see patients but aren't contracted with the payer, for instance. We are evaluating ways of handling these types of claims better.
Not making matters any easier, Medicare created a huge distraction for us when it decided to send us 600,000 adjusted payments to retroactively implement a 4.4% rate increase. Each of these transactions has to be handled by us manually. Our operations managers who would otherwise be addressing ERA and unpostables issues have had to spend significant time absorbing a huge amount of unexpected manual work.
And, of course, we're not perfect. In April, we posted 98.8% of all transactions across all clients correctly. That means if you are a provider with a typical mix of routine and unusual claims, you could expect to find two or three errors. When we find those or you report them to us, we fix them and examine our process for ways to prevent those types of errors in the future.
We are working hard to ensure your satisfaction in this area, and we expect improvement in the next survey. Account managers will be contacting those clients who expressed dissatisfaction and answering their questions about our efforts to improve matters. If you would like to schedule a call and haven't heard from us yet, please contact your account manager.