This is the complete 2019 clearinghouse review for eSolutions. CH.org does its own primary research and interviews the clearinghouses personally with standardized criteria important for billing managers to obtain accurate data. The information below is provided directly from eSolutions to Clearinghouses.org and is reliable.

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eSolutions Billing Manager EDI Survey

Call Wait Times: — How long do I have to wait to speak with someone in support?

The average wait time for phone support is typically 1-3 minutes.

Payer List w/ Direct Connections: — Do you have direct connectivity to the payers I need to send claims to? (Direct payer connectivity means less reliance on other clearinghouses, less future problems, and higher customer satisfaction.)

eSolutions has direct connections with 5,500+ payers.

Knowledgeable Support: — How knowledgeable is your staff regarding payer rules, claims errors, and Practice Management (PM) Systems?

eSolutions has a team of EDI experts who have extensive knowledge of and experience with payer rules and claim errors. Our 98 percent clearinghouse client retention rate speaks for itself, as our claim experts become your reimbursement partner, helping you get paid faster. We have working vendor partnerships with several Practice Management System vendors and are willing and capable to work directly with any PM system and their support organization whenever necessary.

Patient Payments: — How well does your service help me estimate patient responsibility to determine the patient portion in advance so that our Front Office staff can collect patient payments at the time of appointment.

The eSolutions clearinghouse has the fastest, most comprehensive eligibility verification on the market. Thanks to our unique connection to payer portals, users will usually find patient responsibility in the payer’s eligibility response. Providers will receive an eligibility response that includes patient responsibility in less than 5 seconds. eSolutions processes more than 500 billion eligibility transactions each year.

PM Interface: — Does your EDI system integrate tightly with my Practice Management (PM) System (or vice-versa) so that eligibility can be checked automatically from our patient scheduler? Is your support staff knowledgeable enough about my PM to assist me in using your EDI system.

eSolutions’ clearinghouse is a cloud-based SaaS platform that integrates with several PM systems utilizing our second-to-none, real-time eligibility web service. Our preference is always to integrate as tightly as possible with all our PM partners, and we go to great lengths to ensure our staff is kept current on PM integrations. For our larger PM system partners, we have staff who are especially knowledgeable about those integrations, workflows, reporting capabilities, and more.

Claim Scrubbing & Validation: — What are your rejection rates?

Too high means too many payer denials. Too low means too many claim rejections at the clearinghouse level. In our experience, +-3% is just about right. Our claim rejection rates are +-2.5%.

Missing Claims: — My payer does not show as having received my claims. I don’t want to wait 2-3 weeks to find this out. How do I tell in minutes if I have missing claims on your system?

Our system allows users to see if the claim has been paid or a response has been received. We also support more than 150 Claim Status Inquiry payer connections within our portal or through our real-time web service. This means your staff has reliable, transparent data about claims as they make their way through the reimbursement cycle.

Claim Dashboard: — How well does your service help me manage unattended claims, rejections, and denials? Does it report back errors merely as numeric codes or as understandable explanations? Does your service report back to my PM with error messages, with ERAs, with alerts on slow payments and potential cash-flow issues, such as excessive unpaid claim days?

Users can easily manage claims, rejections and denials from an easy-to-use dashboard. The reports show both numeric codes and explanations of these codes. We return 999, 277 and 835s to our Direct customers and PM partners. We offer robust ad hoc reporting within our portal, and we notify customers of important time-sensitive (timely filing/appeal filing limits), actionable, and informational automated alerts to prevent lost revenue. These alerts can be pushed automatically into any PM system. We offer several alerts you won’t find in any other clearinghouse.

Real Time RCM Reporting — Revenue Cycle Management (RCM): — How long do I have to wait to detect blocked cash-flow, or lost or unattended claims? Do you offer Proactive Revenue Controls? How well does your system proactively/continuously monitor key performance indicators (KPIs) that enable us to act in real-time to address revenue leakage before it significantly impacts our cash-flow?

Our clearinghouse delivers robust reporting and automated preventative alerts available to the customer that enables them to review and proactively correct any issues with suspected claims.

Productivity Analytics: — How well does your service and technology give us insight into financial and operational performance across our organization against similar provider benchmarks?

At eSolutions, we’re passionate about delivering powerful business intelligence that allows providers to make informed, impactful decisions. Users can get the data they need, how they want it and when they want it. Clients can measure their productivity from every angle – from a single staff member to state, regional and national peer provider comparisons. Users can set benchmarks related to claims, errors, certain payers, denials and much more.