The Impact of Staff Turnover on Physician Medical Billing

Staff turnover in any medical practice or hospital can have detrimental repercussions financially as well as qualitatively when it comes to providing healthcare. However, it cannot be denied that staff turnover or attrition would always be present in any practice or hospital; keeping it in control is important for ensuring long term pecuniary benefits and improving the quality of the service that is provided. There are various reasons for staff turnover and how it affects medical billing and provider revenue and there are solutions to turnover problems that can optimize the quality of care, efficiency of workflow processes, improve Medical Billing and also increase your bottom line. 

Health care systems as well as certain facilities where there is nominal investment in healthcare have grave concerns with attrition and turnover, working environment and wages. Reimbursement might be meager or absent, with staff having no say in the improvement of these conditions of care. Consequently, employees and staff frequently leave the practice or hospital in such conditions, leading to numerous problems in keeping the practice afloat or in increasing your revenue or in expanding the practice or facility also disturbing the medical billing process and revenue management cycle of the practice. The brunt of turnover turns out to be far grimmer when there is a scarcity of competent employees and the health requirements of the population exceed the capability of health human resources. 

The shortage of staff and the high turnover rate in the country is causing tremendous problems in many processes such as in medical billing where the scope of error has increased due to lack of expertise in physician or hospital staff. Moreover, as mentioned before, the demand for healthcare is increasing due to the fact that there would be more than 30 million newly insured Americans and the turnover rates along with the shortage of supply signifies a bad omen for the health industry. The increased pressure to comply with the recent reform guidelines and qualify for incentives offered by the government has also brought turnover into the limelight since it is one of the major causes of financial leakage and soaring costs. 

There are numerous ways and reports that have been put forward by experts to reduce turnover in the healthcare industry. Some of the most significant of these are to create a pleasant working environment, addressing employee issues, rewarding good work, paying appropriate remuneration, and ensuring job satisfaction of employees. However, some of these methods do not always work and there is an urgent need to streamline various departmental processes to brace for the impact of increased demand in the health industry. 

This work of reducing errors in medical billing and coding, error free denial management, HIPAA compliance, and keeping up-to-date with the changes happening in the health industry can only be carried out by specialists in this field who are experienced and can perform efficiently. Outsourcing the various departmental processes can not only increase the quality of your Medical Billing and RCM but also eliminate turnover affecting the medical billing process besides ensuring that you as a physician or provider need not worry about staff turnover and have the time and energy to concentrate on the major aspects of medicine. 

Medicalbillersandcoders.com is one of the largest consortiums in the United States that offers departmental services such as RCM, Denial Management, and consultancy in order to ensure that the staff turnover in your hospital or practice does not have a negative impact on your other processes and the revenue.

The Role of Medical Billing Consultants in Assisting Physicians

The recent dynamism in the healthcare industry has not just revolutionized the way in which various medical processes are carried out but have also led to an explosive information boom due to new policies, regulations and a complete overhaul in the health care industry. The ability of providers and other healthcare professionals to keep up with such changing regulations and policies is becoming increasingly limited due to escalating workload and demand in addition to shortage of supply of providers. Moreover, the steep learning curve required in some aspects that have accompanied the health reform has made it clear that physicians can benefit due to external billing consultancy services as far as their financial and departmental processes are concerned. 

The requirement for external consultancy services arises not just due to the changing healthcare industry trends and increasing workloads as well as reduced time to keep up with the changes taking place in regulations and laws. The huge expenditure and financial losses on a national scale in the healthcare industry also makes it imperative that such fiscal losses be avoided by employing consultancy services that can boost providers’ bottom line as well as assist on a macro level to reduce costs of healthcare. These services can support in achieving regulatory compliance and ensure that provider revenue is not affected due to glitches in complying with policies and procedures in addition to ensuring that billing compliances such as, but not limited to, HIPAA compliance and ICD-10 implementation are accurately achieved. 

The analysis of revenue cycle management (RCM) and providing customized solutions is also a part of RCM consultants. Medical billing consultants can analyze and pinpoint the areas where improvement can be achieved and losses curbed. This type of scrutiny and analysis can assist in preventing errors such as those in registration or pre-verification of insurance coverage and ensure accurate collections in deductibles or co-pays. Moreover, analysis of Accounts Receivables (A/R) is an important part in optimizing the revenue of providers through a holistic approach involving patients, payers and other entities involved In A/R. Moreover, medical billing consultancy service providers have the advantage of specialization and are aware of the financial as well as legal trends in the industry. This advantage of specialization and up-to-date knowledge of changes in the health industry can reduce cash flow problems and provide a complete solution to providers’ RCM and A/R needs. 

Medical consultants can assist in many fiscal sectors as far as provider revenue is concerned and avoid losses, legal actions, and numerous other hurdles arising out of errors or otherwise. For instance, the Affordable Care Act extended the RAC program to Medicaid, Medicare Advantage (Part C) in addition to the Medicare prescription drug program (Part D). In order to avoid RAC audits, medical billing consultants can point out cases when overpayment has been done and avoid complications when it comes to such other technicalities. Medical billers at Medicalbillersandcoders.com can perform all these functions related to consultancy in addition to streamlining processes related to denial management, interaction with payers, and integration of innovative IT functionalities such as Electronic Health Records (EHRs) in order to ensure compliance and also to smoothen out various departmental processes. 

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The new coding system expected to bring huge changes: Learning how to transit form ICD-9 to ICD-10!

Medical Coders prepare for this change…

Learning New Codes and getting specific: According to the Centers for Medicare and Medicaid Services (CMS), the transition to ICD-10 is occurring because ICD-9 produces very limited data about patients’ medical conditions and hospital inpatient procedures. Medical coders need to be prepared with these new codes as:

• The ICD-10 transition includes seven-character codes from the three to five-digit ICD-9 codes to be able to capture the full nature of disease
• The 17,000 different codes currently used in ICD-9 will grow to more than 140,000 when ICD-10 is fully implemented
• The new codes will require more specificity in coding and documentation- for example one code currently used for acute otitis externa, becomes 28 potential codes
• Moreover, the U.S. is the only country using the ICD-10 system for billing purposes as most of the other nations use it mainly for epidemiological reasons. Canada is among those countries that use it only in hospitals.

Charting and Documentation for ICD-10 is a huge concern with laterality being introduced hence Medical coders and physicians in this case can assess the new codes and the current existing charts to see if their current documentation supports the more in-depth requirements of ICD-10 and start preparing for this change.

Training: Besides the Medical coding & billing staff but also the physicians need to be trained and educated. However care needs to be taken that training begins not more than six to nine months before the new codes are used as they will likely be forgotten by the time they are needed.

Physician concerns:

Implementation is likely to be very costly and a big financial concern amongst practices and a typical small practice of three physicians can expect costs of more than $83,000 by the time the changeover is complete, while a practice of 10 providers may spend as much as $285,000 to fully implement ICD-10. Besides these costs computers, software and staff training is a major financial concern during the transition to ICD-10. Payments flow is also a major concern post implementation as payments are not entirely in the practice’s control. Moreover every part of the practice will have to be assessed in tandem with ICD-10 along with assessment of vendors.

Practices need to start gathering enough information on ICD-10 and Billers and Coders proficient in ICD-10 transition are the need of the hour and highly demanded. Physicians amidst the transforming healthcare environment as a feasible option are opting for services of medical billers and coders who are proactive and prepared with material-requisites for ICD-10. Personnel updated at Medicialbillersandcoders.com are viable option for physicians in smooth transition to ICD-10; equipped with experience in HIPAA, ICD-10 and other compliances.

Moreover the unique ICD-10 Training Program encompassing 34 weeks of ICD-10 training and updates – strives to outline at no cost to medical billers and coders information & training- right from how ICD-10 will affect healthcare to how ICD-10 needs to be implemented within different specialties to ensure optimum revenue cycle management post ICD-10.

The Role of EHRs towards Physician Productivity and Medical Billing

Electronic Health Records (EHRs) definitely have an impact on physician productivity; however, little research has been carried out in this field compared to the other sectors such as the manufacturing sector where IT implementation has proven to be a successful booster of productivity. Measuring the impact of EHRs or EMRs on physician productivity and billing presents numerous other challenges and not just lack of research on the subject. Moreover, the challenges that are faced while calculating the impact on the productivity of physicians due to EHR implementation are encountered in numerous aspects of a particular practice or a hospital environment.

The biggest challenge for calculating the impact of productivity in the field of healthcare is that productivity differs by specialty and other factors and ought to be calculated considering the parameters accordingly. For instance, an hour operating on a patient may not be the same amount of work or finances as an hour spent examining a common cold patient. Researchers have used work relative value units (WRVUs) for uniformity in measuring the productivity across some selected specialties. A study called Electronic Medical Records and Physicians Productivity: Insights from Panel Data Analysis and Design Implications further states that the measurement of productivity is also different according to the setting, type of organization providing healthcare, the carrier of the patient and such other parameters that can make it difficult to measure the accurate impact of EHRs on productivity of providers.

The fact that information makes individuals or organizations more productive is a good feature for measuring the impact of IT on healthcare in the form of EHRs. Moreover, correct information at the right time can reduce uncertainty and delays, causing an improvement in decision making. The alignment of system functionalities and the task needs can lead to increased performance and when technology is compatible with the task at hand, it leads to efficiency in performance (Goodhue 1995). This implicates that the use of EHRs which target the need for information by providers can enhance the performance of providers along with their revenue. Therefore, streamlining of various processes involved in health care delivery is a prerequisite for successful installation and utilization of EHRs which in turn would lead to increased productivity in a holistic manner.

Research has shown that productivity drops for a certain period of time immediately after EHR adoption due to the initial shock of changes in workflow processes and the steep learning curve involved in successfully implementing EHRs and qualifying for the ‘Meaningful Use’ (MU) incentives. However, the productivity slowly increases over a period of time due to streamlining of various processes involved and due to the increased familiarity with health IT and EHRs. Moreover, the incentives play a major role in boosting the productivity and revenue of providers who successfully demonstrate MU. However, while making such changes in workflow processes and in numerous other aspects of healthcare delivery the future is also going to bring immense pressure on providers due to a sudden increase in the demand for healthcare and the shortage of supply.

The various departmental processes involved in healthcare delivery play a huge role in the productivity of physicians and with EHRs and other changes in medical billing and coding procedures, and changes in health insurance policies due to the reforms. Without matching the technology with various workflow processes such as revenue cycle management, denial management, payer interaction, and successful implementation of EHRs, the revenue would drop considerably keeping in mind the penalties for non compliance of reform policies. Moreover, increased demand implicates increased revenue and workload as well, and outsourcing such departmental processes to professional that have experience in this field and are updated about the recent changes in the health care industry can bring about positive revenue changes.

Medicalbillersandcoders.com, the largest consortium of medical billers and coders in the United States has such professionals who can not only solve the problems faced due to the increased workload in medical billing and coding but also in other processes such as revenue cycle management, denial management, successful interaction with payers and assistance in the streamlining of these processes for EHRs.

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Factors Affecting Hospital Employment and Physicians’ Revenue

There has been an increasing trend in the healthcare industry where physicians are opting for hospital employments and the reasons and repercussions of these seem numerous. It cannot be argued that there are many positives for ‘being your own boss’ in a private practice. However, due to numerous reasons and changes taking place in the health industry, physicians are seeking hospital employment not just for the financial benefits but also due to numerous factors such as increased responsibility, risk, high overheads,  and a host of other reasons that come with managing a private practice.

The health care reforms taking place in the country are also profoundly affecting the way in which delivery of healthcare is carried out. Physicians seem to be caught in this maelstrom of the choice between a private practice and hospital employment and are seemingly struggling to stay financially afloat; especially in private practices. One of the motivating move hospitals are making for physicians is shelling out a salaries to fresh graduates that are considerably high compared to what they would earn in a private practice and the promise of financial stability along with incentives provided by hospitals to physicians. The risk factor involved in starting a private practice is also slowly but steadily pushing solo and small group physicians to seek employment in hospitals. 

Inevitably, this increasing trend of physicians abandoning their private practice and choosing hospital employment is also having an effect on hospitals. Moreover, the demand for healthcare is dramatically increasing due to millions being newly insured and hospitals require physicians to slake this demand by pouring in more physicians in the facility in a short period of time. In addition to these factors, the steep learning curve involved in the implementation and maintenance of Electronic Health Records (EHRs) and other compliance issues regarding government policies in health care has driven a small part of physicians to completely close their practices and find hospital employment. 

Hospitals are increasingly hiring more staff and providers in face of increasing demand but it is a fact that the amount of workload would dramatically increase not just in the core aspects in hospitals but also in administrative and in other departmental processes. The challenges faced by hospitals are not just limited to providing quality care but also includes getting paid for the services that they provide.  Moreover, increased internal workflow and departmental processes due to this increased demand for services can lead to high costs which has a direct affect not only on the revenue but the quality of care as well. The changes in the health industry are affecting almost all the entities and processes involved in health care delivery and departmental processes are no different. 

The changes in various processes and departmental protocols due to the recent reforms have challenged many professionals who carry out such processes. The changes in medical billing and coding, stricter insurance policies by the Federal government, and the extensive implementation of Health IT have made these processes more cumbersome and highly skilled, more than ever before.  Medicalbillersandcoders.com is the largest consortium of medical billers and coders in the United States that provide medical billing and coding services that are not just limited to medical billing and coding but also encompasses Revenue Cycle Management, interaction with payers, denial management and streamlining of these processes for IT adoption. The consortium has adapted to the new changes in policies and processes to provide optimized solutions to business needs and increase your bottom line.