ET&T, a California Corporation, was founded in August, 1991, to develop an
electronic data interchange service bureau. The original and primary focus has been on
electronic medical, dental and institutional claims transmittals. The
founders of the corporation have been involved with computer software research and
development in the electronic billing arena since 1985. Our philosophy is that data can be
translated FROM any valid format TO any format, i.e. FROM raw medical claims
data TO payable electronic medical claim data.
ELECTRONIC BILLING INDUSTRY
The object of electronic billing is to eliminate paper generated medical claims, to
submit cleaner claims to payors/carriers, provide faster payment, and to help providers
and payors/carriers cut the costs involved in processing paper and erroneous claims. The
average cost to submit a paper claim is $5.00 and normal payment is 60 to 120 days. The
cost of an electronic claim runs less than $.45 and payment can be received in 7 to 14
working days. Both the government and insurance carriers are moving toward requiring
electronic transmittal of claims to help reduce costs.
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SERVICES AND BENEFITS OF ET&T
The
primary benefits to the provider are monetary--the bottom line. Save time - Save money -
Faster insurance payment!!
Ease of electronically transmitting medical claims via customer modem with only a few
extra keystrokes.
Transmit via 800 number to ET&T's BBS OR via the Internet - phone lines are available 24 hours a
day, 7 days a week.
Automatic recognition of customer's raw data.
Full editing of each claim and creation of ACCEPTED, SUSPENDED and REJECTED claims.
Daily transmission and rejection reports available for customer transfer via report module
generally within 30 minutes. Special summary reports available for Billing
Services.
Reformatting of accepted claims according to each carrier's specifications and nightly
transmittal.
Tracking of confirmation reports from each carrier to make sure all claims have been
received.
 Daily
backup of claims and storage for 6 years on CDs.
Creation of paper claims for insurance carriers not offering electronic billing.
Qualified personnel to assist in customer setup in both the clerical and technical arenas. |
Frank J. Haraksin,
President and co-founder
Mr. Haraksin has a BS degree in Computer Science for Business from DeVry Institute of
Technology.
He has 20+ years of experience in analysis, design, and programming major applications.
The major areas of emphasis have been in Accounting, Real Estate Acct+Mgmt, and Electronic
Medical Billing. Prior to founding ET&T, Mr. Haraksin had worked with Electronic
Billing for 5+ years. |
Anne M. Knicely, CPA,
Vice President and co-founder
Ms. Knicely has a BA degree in Mathematics from Muskingum College, a MA degree in
Accounting from Arizona State University, and Doctoral work in Information Systems. She
has experience as a Junior High Math Teacher, an Accountant in both the public and private
sector, a College professor in Accounting and Information Systems, a College Dean of
Computer Information Systems and Accounting. In addition, she has served as an accounting
and application design consultant for Aureus Computer Systems. Ms. Knicely is a Certified
Public Accountant in the state of Arizona.
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| 1. ET&T computers do all
the work. Once the claims and supporting data
are received by the ET&T computers, several automated unformatting routines may be
applied to each file depending upon what type of computer system and computer software
were used at the provider site.
Added to the generic unformatting routes (mentioned above) are various provider-specific
translation procedures that have been coordinated with the Provider's staff during
setup/testing.
a+b=Value Added Translation of raw data, proprietary
to ET&T.
The resulting data is stored in our unique format, regardless of claim type or insurance
carrier.
All electronic claims received by noon "Arizona time" (and pass all edits)
are transmitted to appropriate payors that evening.
2. Error Detection
Each claim transmitted to ET&T is processed through the ET&T system which
contains an initial comprehensive edit check of all fields. This process checks for
missing or invalid data and produces a high rate of error detection. During claims
processing, ET&T will actually solve some claim problems that have been identified and
coordinated between the provider, ET&T and the payor/carrier. ET&T eliminates many
causes for claim rejection by the payor/carrier, providing more accepted claims being
processed through to payment.
3. Suspense "fixit" file
Claims that have minor errors or questionable data are placed in a suspense file for
review and correction. Erroneous fields are corrected or questionable data approved and
re-transmitted to ET&T. No need to re-submit the entire claim, AND
no extra charge.
Here's one of the many
reasons to use our services:
The HCFA/CMS printed form does not have all of
the available fields necessary for HIPAA mandates, and never satisfied the NSF realm
either. Our suspense 'fixit' feature has the capability to capture new data elements that
your claims software and "print image" is lacking. |
Our services can translate "print image"
and "nsf" into "ANSI 4010" claims !
Call for tech support @ 480-325-0901 |
4. Reporting to the Provider
Providers are able to monitor their cash flows and the status of transmitted claims by
using ET&T reports. Several types of reports are provided: These reports are retrieved
from their E-mailbox.
Sample reports are in the User Guide.
a. Transmission Report
Lists all claims that have been received at ET&T from the provider per phone call,
showing: the patient and his/her identification, the number of charges, the dollar amount
of each claim, and a ACCEPTED, SUSPENDED or REJECTED notification. This report serves as a
record of transmission and a posting document. It tells the provider how much revenue to
expect based on historic payment turn-around time.
b. Rejection Report
Lists all rejected claims in a format conducive to the client being able to fix the faulty
claim area(s) and re-transmission to ET&T. (No charge for rejected claims)
c. Billing Service Itemization Report
Summary of acceptable claims grouped by doctor, created every 12 hours at
noon and midnight.
d. Payor Reports
Copies of payors’ electronic reports are placed in provider’s E-mailboxes when
available.
5. Audits
Audit information is always available through ET&T. Federal, State and local
regulatory agencies, as well as payors/carriers, may require periodic audits. Claims are
archived on CDs by ET&T for up to 6 years for possible audits, and to allow claim data
to be regenerated or retransmitted if necessary.
6. Fees
A one-time setup+testing fee of $125. No
annual fees - we won't send you a bill on the anniversary of your startup.
A per-doctor/supplier document processing fee of $10 (waived for your first 10 setups
during your first year).
Low monthly minimum charge of $20 for your entire account (waived during periods of
inactivity).
Note: postage for claims printed+mailed does not figure into the
monthly minimum.
Standard monthly per-claim costs:
1 - 500 claims per month at $ 0.45 per-claim
(first 500 claims p/month),
501 - 1000 claims per month at $ 0.40 per-claim
(next 500 claims p/month),
1001 - 2000 claims per month at $ 0.35 per-claim
(next 1000 claims p/month).
** Call for prices on higher volumes
Paper claims: Standard claim cost plus first class postage.
7. Minimum Hardware Requirements
486 PC running DOS or Windows 95/98/98se/2000/XP/NT,
(Laptops can be used, but modem drivers can be difficult),
9600 baud modem or faster,
For BBS:Modem must be installed with/in PC and
phone line connected to PC transmitting the claims.
For Internet:Compatible with
DUN,DSL,ISDN,CABLE,SATELLITE,SHARING.
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