We take many conveniences for granted. Yet, when it comes to implementing proven technology for greater efficiency and cash flow, many are reluctant to make the switch. Business owners will say, "I don't want the government in my checking account!" They use online banking and purchase items on eBay, but they will not take advantage of a clearinghouse or electronic funds transfer (EFT) for their business.

We cannot be slow to embrace and adopt new technology. Nor should you be anxious to be on the leading edge. Business owners and manager need to find the right balance.

We are all well aware of the constant threat and realities of reimbursement cuts. In an effort to hold back the effects of these cuts, providers must recognize the benefits of electronic claim submission (ECS). Benefits include: faster submission of claims, quicker response for the carriers, reduced activity costs, automatic payment posting, rapid claim corrections and resubmissions, and faster payments.

The first benefit we receive from ECS is the ability to submit claims within seconds. Most software packages provide a report of the claims to be transmitted. Reviewing such a report prior to submission increases the accuracy of the claims submitted. And it is significantly faster to send claims electronically than it is to print paper claims and review them one by one.

Your software needs to be able to prevent most edits published by the carriers at the time of data entry. Waiting until you prepare the claims for submission is a bit late.

For years, experts have been emphasizing the need for determining the cost of doing business. Activity-based costing is one popular method. In fact, it has been the most recommended process in preparation for bidding. Assuming you took the time to determine your activity cost for preparing and sending paper claims, your benefits will be easily identifiable.

Eliminating the bulk of paper claim submission reduces postage and the time necessary to print these claims. With the implementation of ANSI X12 837, we are now given a file generated by the receiver indicating the file has been received. This report, the 997, gives you the assurance that the file was more than simply transmitted successfully; it was received and either accepted or rejected. Following this report is the front-end edit report that provides specific information about the claims in the file.

The front-end edit report identifies each claim in the file that has errors, along with an error message. Using this, you are able to fix these errors and resubmit the claim or claims. Many times these errors are simple and can be corrected causing only a delay of 1 day. Sometimes these error messages seem cryptic or misleading. Knowledgeable and experienced billers can see through this and address the problem accurately.

Secondary to faster claim submission and response is the payment cycle for ECS. The payment floor for electronic claims is reduced by half when compared to paper claims.

Whether you are submitting electronic claims directly to the carrier or through a clearinghouse, payments will be made quicker than a claim submitted on paper. Consider that mailing a claim adds days before the claim is received by the carrier. Then, it must be loaded by hand or OCR.

Take the actual cost of using a clearinghouse and compare it with the cost of paper claims. In the long run, what is less expensive? The point is that any claim you are sending via paper negatively impacts your cash flow.

Another benefit of abandoning paper claims is having your payments automatically posted. Clearinghouses will provide you with an 835 file allowing you to post those payments automatically too. This autoposting capability also means your rejection/remark codes will be posted to the appropriate claims. You do not need a third-party application to print your remittance notice. Autoposting does work easily. If you are having problems with posting an 835 file, the problem most likely resides with your software vendor.

With automatic payment posting comes automatic deposits. These deposits, like a wire transfer or using a check card, are accomplished without the added burden of preparing a deposit. The ERA you print from the 835 provides you with the details of what was paid and when. You simply compare your deposit with the ERA. The simplicity of comparing these two numbers is much faster than matching a manual deposit to the ERA, which arrives days before the physical check.

Duane Ridenour has provided training and consulting services throughout the United States. He is vice chair for the NSCAC executive committee and serves on multiple DME MAC Advisory Committees. Ridenour can be reached via e-mail: .