Improved Hospital Billing and Operational Benefits with EHR Adoption

The past decade has seen every major industry being computerized, including the medical industry and hospitals – which have moved on from hand written prescriptions to Electronic health record (EHR). According to various studies EHR implementation provides several benefits including improvement in the process of clinical care and overall patient experience. Along with it, EHR also has a potential to create opportunities in health care organisations as it can help with the cumbersome administrative processes. EHR adoption can create a better work flow and quality in mainly three fields – namely coding, chart analysis and records management.

EHR implementation has surprised many physicians to learn that tedious procedures like processing claims have become an electronic and highly automated process that doesn’t even require increase in personnel resources. The latest version of EHR software have, in fact, focused specifically on billing processes, that includes robust eligibility checking for preventing errors, updates with Medicare as well as with other payer reimbursement rates.

Usage of EHR can also cut down on inefficient and time-consuming paper works. Patient information flowing through the practice, like tests, diagnosis, prescriptions and procedures can be accessed with just a click. The other information for a patient like demographic data, appointments, scheduling, billing and other pertinent information can also be accessed from anywhere, be it home or office. This means that the information exchange between the various levels of heath care like labs, hospitals and imaging centre has become effortless and efficient, thus saving labour and a considerable reduction in hassle over billing. The patient is produced with an electronic bill which integrates all the levels into one paper slip.

MBC serving healthcare for over a decade across all states and specialities has also been assisting in EHR implementation providing vast term benefits to physician practices. Some key services MBC provides towards implementing EHR includes – choosing the right EHR for the hospital, mapping the process flow, figuring out the areas of the hospital which require support and helping the physician to set standards which can be achieved easily by using meaningful sources – thus helping physicians with the implementation of EHR, and also earning incentives and revenues.

As usage of EHR has positively revolutionised billing and operational system of a hospital, making it more organised and simpler, MBC in keeping with industry trends too have been providing consultancy and assistance EHR along with medical billing and coding services. With the help of our experts specialised in hospital billing services and vast knowledge acquired regarding the right EHR as per the organizational set up, Hospitals and Physicians can rest assured about their revenue management as they solely concentrate on providing health care to their patients.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services  according to their preferences of specialty, city, software and services performed.

New Staffing Roles with New Reforms at Physician Clinics – Getting A Billing Service to Fill in The Gaps!

With the introduction of the Affordable Care Act, medical practices on one hand need to gear up for an influx of patients, while on the other hand according to a recent survey physician shortage has been intensifying. This shortage along with increasing demand for physicians and healthcare reforms has led to an expansion in the scope of work of the administrative staff, nurse practitioners and physician assistants. According to the latest job reports as per health care jobs network, although the most sought after job remains that of a physician, there is an increasing trend of employing more NPs, PAs and health IT professionals.

Recent healthcare reforms like HIPAA, EMR and ICD 10 certification essentially introduced to improve the efficiency of health care organisations, have brought with them new responsibilities for staff like increased reports, increased documentation, increased denials and follow ups. Consequently, providers are in continuous need of more professional staff to handle documentation and reports, rather than concentrate on their core activity which is providing patient health care services. At the end of the day, with insurance payers also increasingly denying claims there is a considerable loss of revenue for the practices.

Amidst the changes billing service partners can efficiently undertake responsibilities like -

• Billing, documentation, reimbursements, dealing with insurance payers, RCM management etc., hence allowing the in house staff to handle effectively administrative functions of the clinic. This division of labour increases efficiency of staff improves quality of patient care and also increases revenue

• Medical billing partners solely concentrating on medical billing functions can accurately take care of all the billing and documents at every stage, with regular quality checks, analysis and the usage of correct modifiers thus avoiding any coding errors, misunderstanding or inefficiency also reducing the number of denials the first time itself

A Medical billing partner can provide undivided attention needed for the finances of a clinic, against the in-house management of revenues. Hence, hiring a medical billing and coding service is practically forming a new finance department for a practice which concentrates completely on all the procedures like billing, documentations, handling denial and underpayments, insurance claims.

MBC’s medical billing services expertise in the field of billing and coding, besides being in line with all the latest updates and strategies followed in the market. Our expert team of medical billers and coders are certified and well trained in all the upcoming healthcare reform trends and work together to assist physicians to help deliver exceptional services, while taking care of their billing activities involving insurance payers and government entities. MBC’s has been providing billing services to physicians across all US 50 states for over a decade now and have proven results showing their accomplishments.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Service according to their preferences of specialty, city, software and services performed.

Managing Payer Denials, Cuts & Delays at Your Practice with a Medical Billing Service

An increasing cause of worry for almost every doctor in USA is payer denials and delays which invariably result in potential loss of revenue for the physicians. With the introduction of reimbursement cuts in medical bills, physicians and medical practitioners now face various payment challenges and a more uncertain future. Considering the increasing expenses acquired with the recent health reforms, it is important for physicians to receive payments on time, so as to cover their expenses and also be able to efficiently provide necessary services to their patients.

Conversely, as health insurers tighten eligibility requirement, filing claims have become more complicated and the chance of claims being denied have increased substantially, consequently claims are filed with high possibility of being denied, with increased providers struggling to balance patient care and billing. Industry standards state that high performing practices depicted denial rates are below 5%; while other practices denial rates were between 10%-20%, reducing denials by 5% can increase a practice’s revenue tremendously.

The current economic climate in healthcare is that of ambiguity and uncertainty. The economic cuts proposed under the Medicare system by Congress is leading to economic crunches have forced such doctors to carry on their medical practice at the cost of their personal assets. On an average, one third of the patients who come to a clinic are on Medicare, in addition private insurers who follow Medicare rates prove to be plummeting further. This situation makes it very difficult for an independent practice to survive and may even result in closing down of clinics along with causing shortage of medical resources.

Additionally various documentation issues like -  incorrect patient details, inaccurate coding, incomplete claims, lack of communication, submitting claims to wrong insurer or not following up due to lack of AR process can lead to claim delays and denials. In the face of these numerous challenges large numbers of physicians to increase their bottom line are turning towards the facility of medical billing service. Being specialists in their field medical billing companies provide a safe and secure way to overcome all these issue and guarantee timely payments.

Hence outsourcing the denial process successfully creates a unique and safe platform for doctors as well as medical institutes to manage their billing cycles, and also allows practitioners to concentrate on their responsibility of providing healthcare. Industry experts believe that up to 40% of the costs of payments to hospital and physicians can be saved by using medical billing companies.

Medicalbillersandcoders.com serving healthcare community for more than a decade now across all 50 US states provides the advantages of medical billing services by offering a dedicated and specialised team of experts who excel in the denial management, along with coding specialists who ensure correct coding of claims in compliance with HIPAA norms. MBC’s specific billing model uses planned billing software and methods which are fast and accurate so as to deploy claims within a short span of time with minimum possibility of errors.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Things to Consider When Outsourcing to a Medical Billing Company

Choosing a medical billing company is a big decision, as it plays a vital role in the efficient management of records as well as submission of claims. With outsourced medical billing services, you can gain maximum reimbursement from your medical billing. As there are a number of medical billing service providers in the market, it is quite challenging for you to choose the one that best fits your need. This article will guide you in selecting a reliable medical billing outsourcing firm that can ideally meet your needs.

Some Important Tips

You have to carry out a complete evaluation in order to locate reliable Medical Billing Companies. The following tips will help you identify the right medical billing provider.

• Ensure that the firm has enough years of experience to meet the requirements of your medical facility.
• Evaluate the number of employees who support the account.
• The practice management system provided by the company must be useful and user-friendly.
• Check whether they provide a comprehensive medical billing package
• The company must provide easy access to information such as outstanding claims, charge data, user notes, follow-up information, and payments.
• Check whether they use the most up-to-date software such as NextGen, IDX, Medisoft, Inception, and Lytec.
• In addition, assess the security features the firm us
• Make sure that the billing company you approach will provide you the maximum returns.
• Check whether they follow HIPAA regulations and ensure strict confidentiality of data.
• Ensure whether the service provider provides timely billing.
• Ensure custom medical billing solution is available.
• Reports should be provided on a daily, weekly or monthly basis.
• Ensure that there are no hidden charges
• Figure out the quality of service
• Check for the provider's obligation to regulatory compliance
• Confirm the file transfer is done securely

Choosing the right firm based on the above factors will help you find the right billing partner for your service.

A medical billing company will work for any type of practice no matter what specialty in medicine you practice. Physician groups, individual physicians, free standing diagnostic facilities, clinics, long term care facilities, acute care facilities, multi specialty groups, hospitals and many others can benefit from Medical Billing Services.

Outsource your medical billing requirements to a reliable and professional medical billing company. Having the support of a professional medical billing outsourcing firm will not only reduce operating costs, simplify workload, cut down denials, increase reimbursement, save your valuable time and enhance your office efficiency but will also help you maintain a strong relationship with the clients and insurance companies.

Article Source: http://bill.ezinemark.com/things-to-consider-when-outsourcing-to-a-medical-billing-company-7d35c1a6ae03.html

ICD-10 codes and its Impact on Denial Management

The transition from ICD-9 codes to ICD-10 codes presents a huge challenge for medical billers and also affects health care delivery system and physicians’ revenues. The staggering number of additional codes makes the learning process complex. Moreover, the scope for error increases which is exacerbated by a harder denial management process. Insurers have a distinct opportunity to target the increased volume of ICD-10 codes for finding ample mistakes to postpone payment.

Here are some of the basic  impacts of the transition from ICD-9 to ICD-10 codes pertaining to denials:

Basic Difference

The basic difference between ICD-9 codes and ICD-10 codes is that they are more compact even when carrying in-depth information about the case. This helps in identifying the correct rules to be applied as far as reimbursement and insurance policies are concerned. Quantitatively there are more ICD-10 Codes compared to ICD-9 and this also means that the newer codes help in further clarifying the information at hand. However, denial management would face problems due to the increased scope of errors by insurance companies due to the new codes.

Insurance Companies

Claims and reimbursements may be delayed or rejected due to several reasons by insurers due to – differences in the codes sets that cannot be accounted for because of unavoidable compromises in the conversion, conscious efforts to take advantage of the more precise ICD-10 code set; hence Physician practices will be wise to include ICD-10 in their payer agreement negotiation discussions to decrease their risks concerning compliance errors and claims denials.

The Time Factor

The time factor can play a crucial role in deciphering the codes since the volume of ICD-10 codes is high compared to ICD-9 codes. This might mean longer waiting periods for reimbursements and more number crunching for medical billing and coding companies. Another hurdle facing a clinic or a provider is that medical billing and coding is a highly demanded profession and this transition of codes would make it more competitive, making it costlier than before.

The Impact on Patients

ICD-10 codes have been used in numerous countries and the United States was one of the few developed countries to use ICD-9 medical coding system. Although denial management consists of correcting errors and other important functions, the new health care reform has almost ensured that insurance companies and payers cannot deny claims on the basis of errors which can reach a staggering 19.7% out of total claims submitted. This high percentage of denial of claims is one of the biggest hurdles in denial management and it is difficult to predict whether ICD-10 codes would work in favor of denial management and if it would impact patients favorably.

For more information about denial management, EMR and EHR implementation, consultancy, revenue cycle management, please visit medicalbillersandcoders.com, the largest consortium of medical billers and coders in the United States. Medicalbillersandcoders.com billing and coding professionals are charged up for the change and to further this trend Medicalbillersandcoders.com is offering a training program to all medical billers and coders through this platform to a career revamp ensuring transition to ICD-10 with confidence.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services  according to their preferences of specialty, city, software and services performed.

Advocating and Practicing Best Practices in Medical Billing

For years, Medicalbillersandcoders.com has been synonymous with medical billing management – helping medical practitioners not only realize their medical reimbursements fully but also optimize their clinical and operational efficiency. While the medical billing complexities have consistently been escalating – owing to unprecedented increase in insured population and the risk associated with managing insurance reimbursements – we have been able to off-set its effect through consistently remodeling our medical billing Revenue Cycle Management (RCM) to the benchmarked industry standards. As a result, time and again, our ingenious medical billing processes have come to fore in mitigating adverse impact on our clients’ medical bill reimbursement, and ensuring optimal realization of reimbursements, clinical and operational efficiency.

Here is a rundown of the “Best Practices in Medical Billing” that we have been advocating and practicing in ensuring optimal realization of reimbursements, clinical and operational efficiency, and compliant processing of medical claims as per the Federal Healthcare norms:

• Eligibility Verification or Pre-Screening is the foremost on list of Best Practices in Medical Billing; the objective is to determine the patients’ eligibility for the insurance coverage for which the medical intervention is sought. Further, it also ensures knowing in advance what is covered or what in not before a patient is registered and admitted for clinical management.
• Understanding Coverage:  Understanding how the respective insurance carrier would reimburse the eventual cost of medical services is as important as verifying the patient’s eligibility for the insurance coverage for which the medical intervention is sought. As it is the insurance company that ensures the reimbursement on behalf of the patient, there should be clear communication and clearance from the respective insurance bearer.
• Billing Competence: Often medical coding and claim submission can go wrong owing to inherent errors while preparing medical bills for the medical services concerned. Therefore, due vigil needs to exercised while preparing bills that form the basis for eventual coding and claim submission.
• Coding Compliance and Competence: As much as billing competence, coding too hold its importance in flawless claim submission and realization. As the outcome of a medical bill largely hinges on coding compliance and competence, medical bills should invariably accompany ICD and HIPAA compliant coding procedure for medical procedures.
• Electronic Claim Submission and Follow up: As the system of IT-enabled claim submission and follow up becomes more common, medical claims submission need to be managed through electronic medium for seamless and faster realization.
• Managing the Revenue Cycle: As the incidence of claim submission become too voluminous, your claims may take a little while for realization. But, as the sustenance and growth of your practice largely hinges on your ability to minimize the Accountable Receivable days as less possible, an effective and efficient Revenue Cycle Managementbecomes inevitable. Medicalbillersandcoders.com’s (www.medicalbillersandcoders.com) ingenious and credible RCM – comprising Adjudication, Follow Up, Re-submittals, Payments, Adjustments, Secondary Claims, Denials and Appeals – invariably proves to be indispensable to successful Revenue Cycle Management.

The credibility earned from being perpetually committed to “Best Practices in Medical Billing” has been instrumental in expanding our reach to the length and breadth of U.S. Our diverse pool of qualified and competent medical billing professionals has been able offer result-oriented medical billing practices to diverse clientele (ranging from small practices to multi-specialty groups) in varied specialties including Allergy & Immunology, Ambulance Transportation, Anesthesiology, Behavioral Health, Cardiology,  Chiropractic, Dental, Dermatology, Family Practice, Gastroenterology, General Surgery, Hospitalist Billing.

As the success of investing in any business turnaround exercise is measured by the degree of its impact clients’ cost-optimization and revenue maximization, Medicalbillersandcoders.com (www.medicalbillersandcoders.com) too had to verify its executed solutions against actual benefits for its client. Remarkably, the transformation made by our “best practices” has been quite impressive with:

• HIPAA compliant medical coding ensuring highest authenticity
• Reduced operating costs
• Regular monitoring and auditing
• High accuracy in coding
• Feedback & custom reports
• Multi-level quality assurance
• Quick turnaround
• Reduced claim denials
• Faster reimbursement
• Accelerated revenue generation
• Ample scope for intensive focus on medical care

Therefore, if you are a medical practitioner seeking to turnaround your practice’s clinical and operational efficiency, Medicalbillersandcoders.com may well be your source.