IMPORTANT--Switching from Revenue Performance Advisor to ClaimMD

  This notice is only for our clients for whom we submitted through Change Healthcare's Revenue Performance Advisor.  This notice does NOT apply to TherapyNotes users for whom we submit in TherapyNotes. 

  We have just had a conference call with Change Healthcare/Optum about restoration and the info we received is not promising!  Below are some highlights:

• In Phase A they will restore Claim Submission only....There will be no ERAs, no claim status inquiries, no real time eligibility.  Restoration of Phase A begins this Friday, April 5th and will continue through April 11th.
  

• Although RPA will be available, Optum is switching the claims, etc to another Optum clearinghouse (I believe IEDI).  This is a much worse clearinghouse than the old Emdeon clearinghouse that Revenue Performance Advisor was built upon.  For example, IEDI does not have claim edits built in that improve accurate claim submissions and processing.
  

• Real time eligibility and claim status will return as part of Phase C in approximately 3 weeks.
  

• Then after that Phase D will happen (probably a month or so) in which ERAs will appear...but re-enrollments probably have to take place first so ERAs are routed to the new clearinghouse.  As for the past ERAs that Change Healthcare has, they are not sure about when those ERAs may be available.  For now, they are focused on new enrollments for ERAs in Phase D.
  

Because of the above we will be switching to ClaimMD for ALL of our clients for whom we had been submitting via Revenue Performance Advisor.  It is important to understand that ClaimMD's contracts are month to month so we will monitor Change Healthcare's RPA platform to see how things appear and also see how ClaimMD is...But for now all providers must switch to ClaimMD.

So if you have not already switched to ClaimMD, you have a few options.  You should first review pricing at: https://www.claim.md/pricing.html.

Providers will have to decide if you want access to the ClaimMD Portal (to view claim status, view ERAs and run eligibility checks). 

PROVIDERS SHOULD NOT SET UP THEIR OWN ACCOUNT AT CLAIMMD!  I will repeat that.  PROVIDERS SHOULD NOT SET UP THEIR OWN ACCOUNT AT CLAIMMD.

So send me an email and indicate if you do not want portal access OR if you do want portal access let me know if you want the Unlimited Access plan, Small Volume plan or Basic plan.

Note we will have to do enrollments for claims with some payers and for ERAs.

For providers for whom we had been sending through Availity during the past month, we will continue to send via Availity for those payers that require enrollment (such as Medicare) until we have approval for those payers via ClaimMD.

  Some good news, though.  For providers who sign up for Portal Access, you will receive the following monthly credits from us to help offset your ClaimMD fees:

• Unlimited Service:  $20/month credit
  

• Small Volume and Basic Service:  $10/month credit.
  

In addition, providers will no longer have the $11.95/monthly fee for access to Revenue Performance Advisor.

So, let's say you sign up for the Small Volume Service.  Although you are paying $50 to ClaimMD per month, the net amount is really only $28.05 ($50 less our $10 credit less the $11.95/month you no longer have to pay for access to RPA).

Good News 2

  Prior to the Change Healthcare cyberattack, we had planned on a modest fee increase later this year.  Our last fee increase was January 1, 2019.  However, because of this change to Claim MD, we are not increasing any fees and in fact will guarantee that our current fees remain in effect through at least December 31, 2027!

Will we ever go back to RPA?  Some providers may want to wait to see how RPA is.  DON'T WAIT!  Although we are not shutting the door on RPA, we also have no plans to return any time soon.  So if you have not already switched to ClaimMD, do so now.

REMEMBER DO NOT SIGN UP FOR YOUR OWN ACCOUNT.

• Send me an email and advise if you want portal access or not.  If you DO want portal access, let me know if you want the Unlimited plan, Small Volume Plan or Basic Plan.
  

• Once you do that I will set you up in ClaimMDs system.
  

• They will then send you an email with a link.  You must click that link to set up your user name and password, agree to their terms and enter your payment info for their fees.  I will also email you to let you know to look out for that email.
  

• Once you complete the above, I do NOT need your login and password.  However, you must email me to let me know it's complete so I can enroll you for claims and ERAs with payers.
  

• For some payers we may need assistance from you in enrolling for ERAs (for example, we may need a voided check).  CHECK YOUR EMAILS OFTEN AND PROMPTLY RESPOND TO ANY REQUESTS FROM US.
  

QUESTIONS???

• Have questions about the above?  Send me an email steven@mbpros.com and I'll be happy to answer your questions and make recommendations!
  

Thanks
Steve