How Streamlined Medical Billing Protocols Can Help Fight Challenges for Hospitals in 2014?

Not just small practices but hospitals in the US are also facing the pressure caused by healthcare reforms. Many hospitals are closing down, merging with bigger hospitals or experiencing major financial problems. It is being expected that 2014 will also bring various challenges for hospitals in the US for which, they will have to be prepared.

Challenges to be faced by hospitals in 2014:

• Strong preparation will be required by hospitals for ICD-10 that will come into effect this year. As per a study, various hospitals are moderately to very confident of meeting the deadline; however, some hospitals noted risks to successful implementation of the new coding system like, issues related to working with technology vendors and payers and successful adoption of EHRs

• Hospitals might face challenges under health insurance exchanges such as, low reimbursement under the exchanges, signing patients up for exchanges and dealing with effects of high-deductible plans. A huge collection burden might be placed on hospitals, forcing the management to upgrade collection capabilities. However, if they are well prepared, they will be able to reduce bad debt if high-cost patients will be gaining coverage under the exchanges

• Hospitals will have to revive their strategic plans and decide on how many projects they will be able to complete with their current resources

• Hospitals will have to train physicians, maintain quality clinical care because the small supply of primary care physicians will not be enough to fulfil high demands for specialists

• In 2014, non-profit hospitals will have to take care of charity care, especially with newly insured patients

• Community hospitals will have to decide if clinical affiliations should be formed or if specialized services should be left to advanced providers

How can hospitals handle these challenges?

With so many challenges, hospitals are finding it difficult to balance between hospital billing, coding, physician training, EHR implementation, HIPAA and so on. These challenges are especially daunting for small rural hospitals that face lack of staff and money.

A large number of hospitals are outsourcing billing and coding tasks in order to ensure efficiency in revenue cycle management. By streamlining, they are not only strengthening cash flow of their hospital but also improving the level of patient satisfaction.

By hiring a billing partner, hospitals are eliminating the headache of balancing patient care and billing amidst lack of skilled staff. Since a medical billing company will make use of latest technology to handle billing tasks, hospitals won’t have to invest in health IT.

Medicalbillersandcoders.com has been offering medical billing services to various hospitals across the US. We have the largest consortium of billers and coders who are experts at handling RCM, denial management, consultancy for large as well as small hospitals. Our well-trained team can handle all your hospitalist medical billing requirements. At MBC, we strive to streamline billing tasks to ensure improved cash flow and enhanced patient satisfaction for hospitals. While our team handles the challenges, your hospital can concentrate on provision of quality patient care.

Overcoming Recent Billing Challenges with Efficient Medical Billing Services

Overhaul of codes, forms, rates and standards: the current year is going to be very eventful for care providers from a medical billing and coding standpoint. But whether you will emerge through these challenges 11 months later with your revenues stronger or weaker - depends on how well you can prepare your practice to meet the challenges.

If you closely look at the four challenges cited at the beginning, you will understand the wide-ranging impact they will have on cross-sections of your practice. This article will closely look at the specific issues, but it will first explore Healthcare exchanges (HIXs).

HIXs are meant to implement the principle of Affordable Care Act (ACA) which seeks to expand the base of insured Americans by making insurance policies cost effective. In practice, HIXs will allow a large number of insurers to sell policies at affordable rates to American citizens increasing the number of insured Americans to 40 millions.

This is highly commendable, but how HIXs will set the lower rates of insurance policies to facilitate this huge leap in number of insured Americans is not known; but that this will lead to plummeting reimbursement rates for physicians is easy to foresee. And this follows a two percent slash in Medicare rates, affected in April 2013.

But the good side of this rate decrease is that it’s going to a huge base of Americans (about 35 to 40 millions) to the current patient increasing the number of patients per care provider substantially.

Additionally, transition to ICD 10 from the ICD 9 platform has kept care providers concerned, especially with the effective date of 1st Oct. 2014 nearing. The wide-spread concern is justified for various reasons. ICD has 13000 diagnostic codes while ICD 10 includes 70000, which leaps to 155000 if you include the procedural codes. Not only that. Medicare & Medicaid Services introduced a new form which practices have to use to submit their claims.

Moreover, ICD 10 will also require practices to move to a new HIPPA platform, which means additional operational adaption and cost for them. No wonder ICD 10 is being seen as the biggest ICD code overhaul in years.

MBC has been helping many care providers, both in small and big cities of the US, to overcome their billing and coding challenges. We have guided many practices in setting up EHR so that they can handle larger number of patients and leverage the current HIX-caused patient influx. We have also helped practices with ICD 10 transition.

Our Revenue Management Consulting services can help you to fix and optimize your revenue management cycle. To help you do this, we assess it and identify it through training, installation of proper software applications etc.

Medicalbillersandcoders.com the largest consortium of billers and coders in the US, has also been helping many practices to overcome challenges of slashed rates and ICD 10 with its outsourcing medical billing services handling the entire range of activities involved in billing and coding, starting from preparation of claims through submission to post-submission follow-ups. Our service modules are flexible and you can pick and choose only those pieces of our services that meet your coding needs so that you can avoid paying additional cost.

Hire a Medical Billing service to Streamline Patient Flow

Efficient patient flow is extremely important if medical practices want to achieve timely patient care and high levels of patient satisfaction. Long waiting time is the biggest complain patients have and if this problem is not solved; your practice might start losing revenue due to poor productivity, lost referrals, lost patients and employee turnover that is caused due to dissatisfaction at the workplace.

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If your practice is experiencing the following issues, you need to work hard to improve patient flow. Efforts will have to be made to enhance staff scheduling and appointment scheduling as these two issues cause long wait times.

• High appointment cancellation rate
• No-shows
• Frustrated patients
• Rise in employee turnover
• High rate of patient record transfers
• Decline in referrals
• Less rooms to accommodate rise in number of patients 1
• Unsatisfactory reviews about your practice on the Internet

How can you solve these issues?

You will have to identify the problem areas and decide if patient flow is poor due to lack of skilled staff, bad patient scheduling system or something else. In case there is lack of staff, hire a skilled front desk person who will ensure that all the patient appointments are scheduled in the right manner.

Your billing department should also be prepared to step in if your front desk employee needs extra help in maintaining patient flow. Length of time to return patient phone calls will have to be improved along with development of standardized order sheets for common procedures or conditions. Through this, clinicians will be able to communicate orders easily and quickly, saving time to concentrate on patient care.

Tasks being handled previously by specialists should be transferred to other professionals like nurse practitioners or physician assistants. This intervention will enable physicians to spend more time on patients.

In conjunction with standardized order sheets, patient information and instruction sheets will also have to be developed which will help in the streamlining process of patient education.

Do you have the required time to enhance patient flow?

Rise in work pressure, compliance and billing requirements leave providers with less or no time to focus on improving patient flow. To ensure that no revenue is lost because of this, many practices are outsourcing patient scheduling tasks to an external company.

Patient scheduling solutions provided by a billing partner offer various advantages to a medical practice such as, enabling doctors or staff to access patient schedules from anywhere and anytime, getting informed about upcoming appointments, reduction in no-shows and missed appointments, ease in identification of vacant time slots and so on.

Medicalbillersandcoders.com has been offering effective solutions to streamline patient flow to practices across the US. We have the largest consortium of billers and coders who make use of the latest technology to ensure that you focus on provision of quality patient care rather than worrying about heavy patient influx. MBC also handles tasks like timely claim submission, HIPAA compliance, error-free coding and so on.