ON-CALL
COMPENSATION

Meeting EMTALA requirements for physician call panels and emergent specialty care coverage has long been a challenge for hospitals participating in the Medicare program. Since 1992, EA Health has been the solution. Our innovative programs address call panel challenges by providing fair and timely fee-for-service reimbursement for on-call specialists, regardless of a patient’s ability to pay. Our performance-based approach provides hospitals with a cost-effective alternative to stipends while simultaneously reducing compliance risks.

EA Health’s decades-long experience with specialty call compensation has enabled us to collect utilization and reimbursement data from hundreds of hospitals and thousands of physicians nationwide. The insights we’ve gained from processing millions of healthcare transactions can help optimize your specialty physician reimbursement strategy.

ON-CALL PROCESS

Our call compensation programs give hospitals a compliant, cost-effective alternative to escalating stipends, and provide fair and timely fee-for-service reimbursement to call panel physicians.

Specialist Called to ER

ER physician evaluates patient and determines a specialist is needed. Call panel specialist is requested to evaluate the patient.

Patient Encounter

Specialist evaluates patient’s condition, performs necessary procedures, and admits patient to hospital, if necessary.

Claim Submitted

If patient is eligible for EA Program, specialist submits claim to hospital’s Program Liaison for processing.

Patient Eligibility Verified

Program Liaison receives claim and verifies patient eligibility (patient is unassigned and meets insurance criteria). Claim is entered into EA’s coding system.

Encounter Coded

EA coder accesses hospital EMR system and assigns procedural (CPT) and diagnostic (ICD-10) codes based on medical records.

MD Reviews CPT Codes

Coding summary is provided to physician for review. Physician is given the opportunity to approve or challenge coding.

Claim Filed with Payer

If insurance exists, claim is billed to payer using EA medical group in an attempt to recover any available reimbursement for hospital.

Payment Issued to MD

Reimbursement is sent to physician based on assigned CPT codes according to the hospital-determined disbursement schedule and payment rate.

REVENUE CYCLE
MANAGEMENT

As a medical group ourselves, we understand the challenges that healthcare providers face in managing the revenue cycle process. From contracting and credentialing to coding, billing, and collections, our medical group uses the very same services we provide to your practice. When it comes to revenue cycle management, we’re not just another vendor—we’re your colleague, your advocate, and your ally.

EA Health’s depth of experience and diversity of skills help optimize your practice’s financial performance. Our billing professionals monitor major developments and emerging trends impacting the healthcare industry, gaining valuable insight that can help improve your bottom line. And our exclusive web portal technology makes daily monitoring of your key performance indicators (KPIs) both simple and convenient.

RCM Process

Revenue cycle efficiency demands meticulous optimization of every step in the RCM process. EA Health partners with our clients to achieve peak reimbursement performance by streamlining the entire revenue cycle process.

Contracting & Credentialing

Billing fee schedule is verified; payer contracts and reimbursement rates are loaded; EDI enrollments are submitted.

Scheduling

Appointment reminders are sent; insurance eligibility is verified; required authorization is obtained prior to visit.

Patient Encounter

Patient information confirmed during check-in; co-pays are collected; charges are captured manually or electronically.

Claim Filed

Charges are coded and entered; claim file is validated and submitted for processing; rejected claims are corrected.

Payment Processing

Paper checks are scanned and deposited; EFT payments are confirmed. EOBs are posted manually; ERAs are posted electronically.

Claim Follow-up

Claim status inquiries are submitted at 30-45 days, denied claims are appealed; unpaid claims 60+ days old are reviewed.

Patient Collections

Patient statements are generated; collection calls are performed; accounts are placed with collection agency as needed.

Reporting/Analytics

Monthly financial and productivity summaries are generated; daily performance metrics are monitored via client web portal.

CUSTOMIZED
SOLUTIONS

We draw on our considerable billing and collection experience, robust infrastructure, and breadth of innovative capabilities to tailor custom, non-traditional provider reimbursement solutions for non-traditional revenue opportunities.

CUSTOMIZED
SOLUTIONS

We draw on our considerable billing and collection experience, robust infrastructure, and breadth of innovative capabilities to tailor custom, non-traditional provider reimbursement solutions for non-traditional revenue opportunities.

TELEMEDICINE
SUPPORT SERVICES

As demand for quality healthcare continues to outpace supply, telemedicine is becoming an increasingly attractive alternative. Despite immature and ill-defined payer reimbursement policies, EA Health is working to monetize these electronic encounters and get physicians paid.

TELEMEDICINE
SUPPORT SERVICES

As demand for quality healthcare continues to outpace supply, telemedicine is becoming an increasingly attractive alternative. Despite immature and ill-defined payer reimbursement policies, EA Health is working to monetize these electronic encounters and get physicians paid.

INTELLIGENCE
& ANALYTICS

The insights we’ve gained from processing millions of healthcare transactions nationwide allow EA Health a unique perspective that numerous regional healthcare systems rely on when managing their provider compensation and reimbursement challenges.

INTELLIGENCE
& ANALYTICS

The insights we’ve gained from processing millions of healthcare transactions nationwide allow EA Health a unique perspective that numerous regional healthcare systems rely on when managing their provider compensation and reimbursement challenges.

CODING &
COMPLIANCE

Our certified coders give hospitals and physicians peace of mind by ensuring compliance with complex regulations and coding requirements. We relieve our clients of the burden of coding while seeking optimal reimbursement for their services.

CODING &
COMPLIANCE

Our certified coders give hospitals and physicians peace of mind by ensuring compliance with complex regulations and coding requirements. We relieve our clients of the burden of coding while seeking optimal reimbursement for their services.

CREDENTIALING
& ENROLLMENT

Our team of seasoned credentialing professionals can assume the completion and maintenance of payer contracts with Medicare, Medicaid, and commercial payers alike, allowing your staff to focus on patient care, not paperwork.

CREDENTIALING
& ENROLLMENT

Our team of seasoned credentialing professionals can assume the completion and maintenance of payer contracts with Medicare, Medicaid, and commercial payers alike, allowing your staff to focus on patient care, not paperwork.

CONSULTING
SERVICES

Our industry experts are available to assist with everything from contract evaluations and fee schedule analysis to reimbursement trends and other challenges affecting the financial performance of your program or practice.

CONSULTING
SERVICES

Our industry experts are available to assist with everything from contract evaluations and fee schedule analysis to reimbursement trends and other challenges affecting the financial performance of your program or practice.

  • CLIENT TESTIMONIALS

    EA Health has provided excellent service to Scripps Health for many years. As the physician advisor to Scripps Mercy Hospital’s EA program, I rely heavily on the extreme detail and accuracy of their data, the timeliness of their response to questions, and their personal involvement in helping to solve many of our physician back-up issues.
    Davis Cracroft, MD, FACEP
    Senior Director of Medical Affairs, Scripps Mercy Hospital
  • CLIENT TESTIMONIALS

    EA Health has given us a stable compensation platform for our medical staff responsible for emergency coverage across a wide variety of specialties. As a public hospital, our mission requires us to provide specialty coverage for our Emergency Department. EA Health is the tool that gives our physicians the assurance that we value their service.
    R. Stephen Taylor, MD, MBA
    Chief Medical Operations Officer, Sarasota Memorial Health Care System
  • CLIENT TESTIMONIALS

    EA Health’s customer service for our providers and facility is the best in the business! Everyone we work with at EA Health values responsiveness, resolution, and supporting care providers at all levels. I know they do because their employees demonstrate it with quality and consistency across time.
    Debra Harris, MA, RHIA
    Director of Health Information Management, Salem Hospital
  • CLIENT TESTIMONIALS

    Partnering with EA Health has enabled us to continue to provide essential care to all patients while ensuring that we have the Emergency Department specialty physicians to meet their needs. Due in large part to programs like EA, we’re able to maintain strong partnerships with our physicians despite the many challenges of a volatile healthcare environment.
    Tim Hogan, FACHE
    Regional Hospital President, Meridian Health System
  • CLIENT TESTIMONIALS

    Having EA at our hospital enables our group to focus completely on patient care, knowing that we are fairly compensated for our time and effort. Equally important is the panel of on-call specialists with whom we can consult without worrying about a patient’s insurance status. EA benefits our physicians, our hospital, and our patients.
    Davies Wong, MD, FCCP
    President, Chest Medicine & Critical Care Medical Group, Inc.
  • CLIENT TESTIMONIALS

    EA provides excellent service – not only financially, but also with robust, timely, and clear reports that help us improve our metrics and operations. From real-time deficiency notices to monthly reports drilled down to the RVU level, we now have billing and collections knowledge at our fingertips at all times. Our EA representatives are always responsive, knowledgeable, and helpful.
    Ted Chan, MD
    Chair of Emergency Medicine, UC San Diego Health System

YOUR SOLUTION AWAITS

Talk with one of our experts to see how EA Health can partner with you to optimize your financial performance. Put our experience to work for you. Schedule a consultation today.

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