H&A Healthcare Consulting runs medical billing and revenue cycle management for practices that use eClinicalWorks (eCW). Our in-house team of 150+ billing specialists handles claims, coding review, denial management and appeals, patient statements, collections and monthly reporting, all inside your eCW. We also configure eCW for a living, so we fix the setup problems that cause denials before we start working your claims. Most practices are fully transitioned in 2 to 4 weeks.
Does eClinicalWorks do billing?
Yes. eClinicalWorks includes practice management and billing tools: insurance eligibility checks, claim scrubbing, electronic claim submission, electronic remittance (ERA) posting and denial reports. Practices on eCW usually run billing in one of three ways:
- An in-house billing team working in eCW's billing module.
- eClinicalWorks' own RCM service, where the vendor's team runs billing. eCW also offers optimization consultants for practices that keep billing in-house, according to eClinicalWorks' own blog.
- An outside billing company that works inside your eCW. That's what H&A does.
The software is the same in all three. What changes the results is how eCW is configured and who works the claims every day.
Where eCW billing breaks: 10 settings we check first
When a practice on eClinicalWorks tells us collections have stalled, these are the ten things we look at before anything else. Most of them are setup problems, not effort problems.
- Eligibility runs before the visit. Batch eligibility checks run the day before appointments, and the front desk re-checks at check-in. Coverage changes during the year, so a check at the first visit isn't enough.
- Eligibility is tied to scheduling. A failed check flags the appointment before the patient arrives, not weeks later as a denial.
- Scrubber rules match your payers. Claim edit rules are tuned to your top payers and your specialty instead of being left on defaults.
- Every documented service becomes a charge. Someone owns turning documented services into charges every day. eCW doesn't do this on its own.
- The diagnosis supports the procedure. Templates prompt for the diagnosis detail your most common procedures need, so the note and the claim agree.
- Modifiers get checked. Visits with more than one service get a modifier check (for example 25 and 59) before the claim goes out.
- Denials live in a worklist inside eCW. Each denial has an owner, a reason code and a deadline, and the appeal window is tracked. A spreadsheet or a separate portal hides them.
- ERA posting is automated. Electronic remittances post automatically, and only the exceptions go to a person.
- Four numbers get reviewed every month: first-pass acceptance, denial rate by payer and reason, days in A/R and net collection rate. More on these below.
- Billing knowledge is written down. Payer rules and workarounds live in a shared document, not in one biller's head. When that biller leaves, the practice keeps the knowledge.
If several of these come back as a no, adding staff rarely fixes it. Fixing the configuration does. That's why every H&A billing engagement starts with an audit of your eCW billing setup. For the configuration side on its own, see our eClinicalWorks optimization services.
Why claims pass the eCW scrubber and still get denied
eCW's scrubber checks each claim against its edit rules. Payers apply their own rules on top of those, and payer rules change. A claim can be clean by eCW's standard and still fail a payer-specific rule on modifiers, prior authorization, medical necessity or timely filing.
The fix has two parts. First, add payer-specific edits for the payers that deny you most often. Second, review denials by reason code every month, and turn each repeat reason into a new scrubber rule or a front-desk step. Over a few months the same denials stop coming back, instead of being reworked one at a time.
What our billing team handles
H&A covers the full cycle between the visit and getting paid, not one piece of it:
- Claims and coding. Coding review, clean-claim submission and scrubbing tuned to your eCW configuration and payer mix.
- Denial management and appeals. Denied claims are worked and appealed before the appeal window closes. We track denial rate by payer and reason code, not just totals.
- Patient statements and collections. Clear statements that go out on time, and follow-up on what's owed.
- Revenue cycle reporting. A monthly view of your net collection rate and days in A/R, so you can see where money is stuck, not just what came in.
- The eCW setup underneath. Our billing team and our eCW implementation team are the same company, so a configuration fix doesn't get lost between two vendors.
The four numbers to see every month
Total revenue collected hides where the leaks are. These four numbers, broken out by payer, show them:
| Number | What it tells you | What to do when it slips |
|---|---|---|
| First-pass acceptance | Share of claims accepted on the first submission | Check scrubber rules and front-desk data capture |
| Denial rate by payer and reason | Which payers deny you, and why | Turn the top repeat reasons into new rules or steps |
| Days in A/R | How long money takes to arrive | Look for claims stuck unsubmitted or denials not worked |
| Net collection rate | How much of what you're owed you actually collect | Review write-offs and aged balances by payer |
Healthy ranges depend on your specialty and payer mix. Our revenue cycle management guide lists general reference ranges, and MGMA publishes practice management benchmarking data for comparing against specialty peers.
In-house billing vs eCW's RCM service vs H&A
| In-house team | eClinicalWorks RCM service | H&A | |
|---|---|---|---|
| Who works the claims | Your staff | The vendor's billing team | Our in-house team of 150+ billing specialists |
| Who fixes the eCW setup | Your staff, or an outside consultant | eCW's separate optimization consultants | The same company: our eCW team |
| How you pay | Salaries, benefits, training and turnover | As quoted by eClinicalWorks | A percentage of collections, scoped on a free call |
| When a biller is out | Depends on your team size | Covered by the vendor's team | Covered by our team |
| Best fit | Practices with an experienced billing lead and time to manage eCW | Practices that want the software vendor to own billing | Practices that want billing and the eCW setup handled by one accountable team |
Ask eClinicalWorks directly for its current RCM terms; we've only described what it publishes.
What eCW billing services cost
Most outsourced billing companies charge a percentage of what they collect. One industry cost guide puts it at about 5% to 10% of collections, with flat fees of about $4 to $6 per claim as another model (ADSC, 2022). The right model depends on your specialty, claim volume and payer mix.
H&A prices billing as a percentage of collections, so we're paid when you are. We set the exact rate on a free consultation, based on your volume and payer mix. When you compare quotes from any billing company, check three things:
- Whether the percentage applies to gross or net collections.
- Whether setup, patient statements or credentialing are billed separately.
- What the contract says about notice periods and getting your data back if you leave.
In-house or outsourced: how to decide
Keeping billing in-house works when you have an experienced billing lead, enough people to cover absences, and time to keep eCW's billing setup current. Outsourcing tends to make sense when denials are worked late or not at all, when one person holds all the billing knowledge, or when nobody can tell you your denial rate by payer. Many practices start with a review of their current setup before deciding either way.
How switching to H&A works
- Free consultation. We go through your current eCW billing setup and numbers with you.
- Billing setup audit. We check your eCW configuration against the ten settings above, so we catch existing leakage before we start working new claims.
- Transition. Most practices are fully transitioned within 2 to 4 weeks.
- Ongoing billing and reporting. We work your claims, denials and statements, and report the four numbers every month.
Want to speak with a current client before you sign anything? Ask on your consultation call and we'll connect you.
Why practices choose H&A for eCW billing
- Only eClinicalWorks. We don't learn your system on your time. Claim scrubbing, eligibility and denial worklists are built around how eCW actually works.
- One company for billing and setup. The people who work your claims and the people who configure your eCW sit in the same company.
- People you can meet. We're based at 20008 Champion Forest Dr in Spring, Texas (Greater Houston), and support practices nationwide, remotely or on-site. Engagements are led by Eddie Zakaria, Muhammad Sultan and Tahir Javed.
- A partnership you can check. H&A is an official partner of Riceland Healthcare, a Southeast Texas healthcare network.
H&A is not an official eClinicalWorks partner or certified reseller. We have no vendor quota and nothing to upsell. See our FAQ for more.