How Can Outsourcing Help Better Position Your Practice for Pay-for-Performance?

Pay-for-performance programs are a great way of rewarding health care providers but do you have the time and resources to make your medical practice eligible for such rewards?
There is no doubt that these programs provide encouragement to doctors and better services to patients but several challenges are also related to pay-for-performance-

• In order to become eligible for these programs, you will be required to reduce variation in your clinical practice
  
• You will have to reduce errors by promoting effective medical safety practice and offering best care to chronically ill patients
  
• As per the present system for Pay-for-performance, factor like reduction in glycohemoglobin for diabetic patients is also a scale on which your performance will be measured
  
• Whether or not your practice will become eligible for P4P also depends on your patient’s hospital stay and emergency room visits. Care co-ordination of patients suffering from chronic diseases between home, hospital and office is also a criteria for rewards
  
• If you happen to use health information technology for improving health of your chronically ill Medicare patient, you will be rewarded under these programs. You will also have to devote enough time and energy to ensure that patients coming at your clinic are well-informed and empowered
  
• In case you don’t participate in P4P programs, you will not only lose patients but also your market share

For more information visit : http://www.medicalbillersandcoders.com/

How can pay-for-performance benefit you?
If your practice gets to win an incentive award under pay-for-performance program, it will give you an edge over other health care providers. This will result in increased flow of patients at your clinic which will eventually add to your income.

How to make it happen?

At a time when the US healthcare system is facing strain on finance and healthcare delivery due to inflation of medical cost, it has become imperative to offer high quality medical services at an attractive cost. This can happen only when you make your practice eligible for these P4P program by concentrating more on patient care rather than billing and account receivables.

Is AR management and medical billing restricting you?

You may have the capability to offer enhanced medical care to the patients and tackle P4P challenges but tasks like medical billing and account receivable management can eat up all your precious time that can be otherwise devoted in best medical care facilities.

Taking into consideration the complexities of healthcare industry in the US, many physicians are outsourcing these services and buying precious time to prepare their practices for pay-for-performance programs. So, if you also want to improve your services and get the competitive edge, why not make use of increased time and look into patient care?

Medicalbillerandcoder.com has been offering outsourced billing and AR management services to physicians across 50 states in the US. The expert team at MBC also provides consultancy to help doctors enhance their in-house practices and improve health care services to their patients.

Improving your AR by Switching to a Billing Service for Your Medical Practice

One of the most frustrating issues for a physician is delivering quality medical services and not getting paid for it. Your practice can become successful only when the receivables are captured at all times. In absence of follow ups, you will not be able to recover the deserved amount as the recovery process becomes close to impossible once the account receivables reach 120 days.

What causes long-pending account receivables?

If your staff is not efficient in monitoring and keeping the account receivables of your practice active, it can become extremely difficult to retrieve the amount after a certain period of time. Usually, the entire process of finding out reasons behind delays, claim denials, following up with insurance companies, resubmitting the claims is extremely tedious due to which a significant number of physicians in the US lose thousands of dollars in the form of long-pending account receivables.

Some of the challenges you might face with account receivables are:

• Denial of an insurance claim-
  If your patient is considered non-eligible by the insurance company, the claim will be denied and your payment will get delayed. In this case, claim (paper or electronic) will have to be resubmitted and regular following up will have to be done every time the claim is denied. If you file the claims beyond the claim filing limit, your account receivable will become next to impossible
  
  
• Coding errors-
  Revisions are being done to CPT and HCPCS Level II codes annually and with the growing number of patients, and in this scenario your staff happens to make any coding error, AR will get delayed till the matter isn’t resolved
  
  
• Delayed payments-
  Sometimes government aided insurance companies don’t make the payment on time which again delays the payment process for physicians. In this case, too much time goes in constant follow up with the payers
  
  
• Adjudication issues and documentation-
  There can be certain adjudication issues and requirement of additional documents or clarification for patients that needs to be catered in time to ensure that AR doesn’t get delayed

For more information visit : http://www.medicalbillersandcoders.com/

How can you improve your account receivable?

Account receivables will get converted in revenue only when you are dedicating enough time and resources into follow-ups, error-free claim resubmission, analysis of denials, maintaining past AR records, staying updated with new policies and procedures and so on.

To manage account receivables, you will have to perform:

• Timely follow-ups with patients as well as insurance companies
• Analyse the reasons for claim denials, fill the claims forms again without errors and submit them
• Keep updating the list of long-pending ARs and work towards getting the revenue

The entire AR cycle management demands substantial amount time which can distract physicians from offering quality patient care which very few can afford currently. Medicalbillersandcoder.com has been offering effective AR management services to physicians across 50 US states. We offer in-dept analysis-backed AR management solutions or customize parts of it to your practice needs so that while we help retrieve your revenue you can concentrate on offering medical services.

The Significance of HIPAA Compliant Medical Billing Services for Gastroenterologists

Gastroenterologists trade patient-centric information for a variety of purposes, and Medical Billing is one of them. While physicians clinical notes on gastroenterology procedures are made use of by coding and billing staff, there may be possibility, intentionally or accidentally, that vital patient-centric information being exposed to security and privacy breach in the form of theft or hacking.  As we know that any compromise with patients’ data security and privacy could lead to monetary as well criminal penalties. Therefore, with gastroenterologists’ practice credibility and reimbursements at stake, it is inevitable that Gastroenterology Billing partners or service providers become HIPAA compliant.

Fundamentally, HIPAA compliant Gastroenterology Billing services are required to be  integrated with various advanced systems to protect all health information that can identify a patient including name, dates, zip code, e-mail ID, telephone or fax numbers, medical record information, health plan and social security information, license numbers, and photographs. Gastroenterologists who happen to source HIPAA compliant medical billing services would invariably be assured of:

• Requirement-specific application of medical billing software
  
  
• Web based medical billing software with EMR solutions
  
  
• High security measures
  
  
• VPN system
  
  
• Frequent reports
  
  
• Insurance authorization
  
  
• AR follow-up
  
  
• Higher confidentiality
  
  
• Anti-virus and firewall software on each computer
  
  
• 24/7 response management

While gastroenterologists’ medical billing staff may have been using HIPAA 4010 platform until now, they certainly need to migrate to HIPPA 5010 in view of ICD-10 coding replacing the erstwhile ICD-9 system. ICD-10 being more specific and alphanumeric, HIPAA 4010 software platforms would certainly not support ICD-10 compliant gastroenterology coding and billing. Therefore, HIPAA 5010 version would invariably have to be introduced, and aligned with advanced billing software such as Lytec, Medic, Misys, Medisoft, Inception, IDX, and NextGen. Such monumental system-change can only be achieved with highly efficient workforce that is conversant with electronic medical records (EMR) and electronic practice management (EPM) systems – believed to be crucial in providing a complete and quality medical billing service as per the requirements of gastroenterology clinics, hospitals, and practitioners.

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Even as gastroenterologists try to bring about these HIPAA compliant gastroenterology billing changes, the extent of system upgrading and staff orientation may be too much to take in. As a result, they would have to depend on outsourced HIPAA compliant gastroenterology billing services that:

• Ensure periodic backup of data and critical facilities accessibility
  
  
• Are fortified with secure workstations, storage facility and authorized access
  
  
• See Firewalls and antivirus software on all systems are updated frequently
  
  
• Ensure technical evaluations are performed on a routine basis
  
  
• Come with affordable pricing: with 30 to 40% cost savings
  
  
• Provide free billing analysis
  
  
• Employ password protected lockers

Medicalbillersandcoders.com – by virtue of having nation-wide affiliation with a chosen pool of gastroenterology billing professionals attuned to HIPAA compliant Gastroenterology medical billing practices – can help gastroenterologists reap the benefits of HIPAA compliant  medical coding, medical insurance collection, medical paper and insurance electronic billing, charge entry, cash posting and reconciliation, management of old accounts receivable collections, and insurance verification and authorization.