Bibb Medical Center (BMC) is in Centreville, Alabama. As the county's healthcare provider, BMC serves roughly 22,000 people. This BIBB hospital provides inpatient care, post-acute care rehabilitation, intravenous therapy, wound care, and other high-quality services.
Because it was a significant county hospital with a handful of high-value claims, they needed software to handle it, and it needed to process UB-04 claims submitted to a handful of payers. As they were working on migrating to another EMR / HMS / HIS software, they decided to use expEDIum Medical Billing® (eMB) for processing high-value UB04 claims in the interim.
expEDIum eMB addressed the key issues, which included claim validation and a scrubber to ensure that only error-free claims were submitted to the clearinghouse and payers. The solution streamlined their high-value UB04 billing processes and increased transparency throughout the claim life cycle, resulting in a more effective billing operation.
The hospital had secure provider logins to access their data and had access to a variety of reports. This installation used Office Ally® as the clearinghouse seamlessly supported by eMB.
Return on Investment (ROI)
Since the system's inception, the biller has processed over 1000 UB-04 claims with aggregated charges of nearly $2.2 million.
Most (49%) of the claims were submitted to United Healthcare with aggregated charges of $800K. The remaining (51%) of shares were submitted to payers such as Humana, Cigna, Aetna, Health Spring of Alabama, Tricare South, UMWA & United Health One with aggregated charges of $1.4M.
The claim with the highest value was $51k, with an average of $2.1K per claim.
They used eMB for about three years (between Oct 2015 and August 2018) until they migrated to a different EMR / HIS / HMS system with UB04 support.