How Practice Insight Works Behind the Scenes With the Gastroenterology Practice Management System, gPM™


Practice Insight Shares the Benefits of Using EDIinsight®

This is a sponsored and guest blog post by Practice Insight. Visit Practice Insight during MOMENTUM.

At the end of the day, your gastroenterology practice is a business and you need the right technology and vendors in place to help put you on the path to success. That being said, did you know that behind the scenes Practice Insight’s solutions interface with Modernizing Medicine® Gastroenterology’s practice management software, gPM™, to help manage claims? The heart of EDIinsight, which is a claims manager software, lies in its ability to manage claims resulting in fewer errors, easier tracking and faster payments. Far more than just a clearinghouse, EDIinsight offers claim scrubbing and claim status tracking that doesn’t require printing a paper report and numerous tools to help practices manage their complete revenue cycle.

So how does it work? What’s going on behind the scenes? Let’s dive a bit more into each of these features and how they can work for you and your gastroenterology practice.

  • Claim Manager. This works with gPM, which is the system you use to create your claims. EDIinsight then loads the claims, checks them for errors and displays a list showing which are valid and invalid. So behind-the-scenes, what does the EDIinsight Claim Manager actually do?
    • Scrubs and edits claims (including custom edits and clinical claim scrubbing), sends claims to the payer and reviews payer responses
    • Gets real-time claim statuses instantly—just click on a claim to see its complete history and current status
    • Easily creates and edits electronic secondary claims
    • Challenges underpayments before it’s too late with detailed, accessible payment and denial information
    • Proves claims were filed on time with a “timely filing letter,” created with a single click
    • Accesses whatever you need from wherever you are— as a user, you don’t have to exit and re-enter multiple screens to check a status, make a correction, create a statement and more
  • 100% Electronic Remittance Advice (ERA) Solution. What if you could end the paper chase in your office? The EDIinsight 100% ERA Solution converts paper explanation of benefits (EOBs) to post-able 835s, which both eliminates a paper-based workflow and speeds up the claim management process. The numerous benefits provided include:
    • One workflow for all remittance advice
    • Paper remits scanned, imaged and matched with claim data to generate 835s—functionality exclusive to EDIinsight
    • Save time opening, sorting and processing mail
    • Eliminate archival storage expense associated with physical EOBs and other correspondence
    • Enhance reporting through consolidation of data
    • Better accuracy through a reduction in human intervention
    • Greater efficiencies in secondary and tertiary claim filing
    • More rapid turn-time on your money
  • Eligibility. As patients continue to be responsible for a larger portion of their medical bills, your practice’s ability to determine insurance benefit details in advance has never been more important. EDIinsight Eligibility lets you know how much you need to collect from patients or if you need to have them sign an Advance Beneficiary Notice (ABN) during their office visit. You’ll be able to submit eligibility requests in a flash, see the response displayed instantly and correct and resend requests that display as “invalid” or “rejected.”
  • Electronic Statement. EDIinsight includes a Statement Manager designed to simplify the creation and printing of patient statements. A statement file is created in gPM and then uploaded into EDIinsight to be sent for printing and mailing. The uploaded statements go through testing to check that billing and address information is complete. The system will flag invalid addresses and patients with forwarding addresses. Users can just click “select invalids” to see a list of statements in need of correction.

So the next time you’re working in gPM, think of how Practice Insight helps make the process even more efficient. On a similar note, I also wanted to give kudos to the great support staff at Modernizing Medicine as they are ready and willing to help clients with questions, concerns and challenges.

While you’re at Modernizing Medicine’s users conference, MOMENTUM, this year, please visit our booth in the exhibit hall to learn more about the solutions we provide. I would love to meet you in person!

About Practice Insight

Practice Insight’s principals have been deeply immersed in providing services to the healthcare industry since 1977. Together they founded Practice Insight in 2003. Since then the company has grown rapidly by providing fast, secure, robust, integrated EDI solutions through its industry-leading proprietary software, EDIinsight®.

Practice Insight brings the power of EDIinsight to more than 100 different practice management software brands, and has partnered with many of the best-known healthcare IT vendors and resellers in North America.

More than 60,000 providers in all 50 states rely on the power of Practice Insight’s technology, which does much more than connect them to thousands of commercial and government payers to submit claims.

Practice Insight’s software also enables users to track every single claim in real-time, customize claim edits, create secondary claims, manage their claim workflow, verify patient eligibility, process electronic and printed patient statements, post patient payments through the Practice Insight portal, recover ERA accounts receivable, monitor user productivity, analyze all EDI transactions, manage their customer support, and much more.

The company is headquartered in Houston, Texas.

Dave Henshaw

Dave Henshaw

National Accounts Manager at Practice Insight

David currently holds the position of national accounts manager for Practice Insight. In this role, he works with many of Practice Insight’s partners in the areas of marketing and sales to assist in their efforts. Prior to this, Dave was a regional sales manager for the Eastern portion of the US.

Dave came to Practice Insight with over 10 years of experience of sales, marketing, service, support and product management in the healthcare industry.  Dave has held marketing, management, and sales positions for a major publisher in the government marketplace working with local, state and federal entities in their communications needs.

Dave holds a bachelor of business management and a master of business administration from St. Bonaventure University.

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