Bibb Medical Center (BMC) is in Centreville, Alabama. As the county's healthcare provider, BMC serves a population of roughly 22,000 people. This BIBB hospital provided inpatient care, post-acute care rehabilitation, intravenous therapy, wound care, and other high-quality services.

Because it was a major county hospital with a handful of high value claims, they needed software that could handle it, and it needed to be able 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

iTech's eMB, which included claim validation and a claim scrubber to ensure that only error-free claims were submitted to the clearinghouse and payers, addressed the key issues. 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 logons 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 had processed over 1000 UB-04 claims with aggregated charges of nearly $2.2 million.
  • Vast majority (49%) of the claims were submitted to United Healthcare with aggregated charges of $800K and the remaining (51%) of claims 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 highest value was for $51k with an average of $2.1K per claim.

They had used eMB for about 3 years (between Oct 2015 and August 2018) until they migrated to a different EMR / HIS / HMS system which had UB04 support.