Growing trend in medium size clinics referring to medical billing outsourcing

Small and Medium size Clinics: Great Expectations 

Small and Medium sized clinics face unique type of challenges in almost all functions of physicians and staff such as administration, revenue cycle management, Electronic Health Records (EHR) implementation, and the challenge of keeping pace with the recent health reforms. The nature of the core functions as well as the other departmental processes that were efficient in a small clinic are found to be lacking in mid-sized and growing practices due to various reasons. However, the most important factor that has influenced the need for change in almost all the processes in a medium sized clinic is due to the reforms in addition to the change in the structure of the clinic or practice. 

The Overdose 

The recent health reforms aim to insure almost 32 million uninsured Americans and this demand overdose is one of the reasons for adoption of EHRs and stress on a paperless office and such other changes. Moreover, the increase in the aging population, lack of specialized geriatric physicians, and a booming population has added fuel to the flames. What is more, coping with such increased pressure even with EHRs and the incentives is a difficult and cumbersome task that requires training and a paradigm shift in the way various processes are carried out in clinics, whether small or mid-sized. 

Under the Microscope 

Small & Medium sized clinics usually have simpler administrative processes and these become more and more complex requiring a microscopic analysis of such processes in order to understand the errors and pitfalls that may bring about gloomy financial outcomes for providers. Areas such as EHR implementation, medical billing and coding, and other back-office functions also become complex and voluminous requiring the support of professionals who can provide adequate assistance in the form of training, the streamlining of various back-office processes and the handling of various pecuniary concerns such as Accounts Receivables, and Collections. Small mistakes can cost growing clinics a big chunk of their remuneration and therefore requires a microscopic study and a scientific approach towards various back-office functions including interaction with payers and error free coding. 

Developmental Care 

The health industry in the country is changing at a rapid pace and it becomes important for physicians to ensure that the stress caused by financial or administrative errors does not affect their core functions and to an extent require “Developmental Care” in order to cope with the financial as well as core aspects of their practice. Such care can be provided by back-office professionals, and medical billing and coding companies that are backed by various other professionals carrying out functions such as RCM, consultancy and research in order to create an ideal environment for small clinics to operate efficiently and thrive under such a dynamic environment. 

Medical billing outsourcing 

Medical billers and coders at Medicalbillersandcoders.com are not just armed with the latest ICD-10 codes but are also backed by a team of research professionals who can find the errors in various medical billing processes and diagnose the problems leading to loss of revenue and also keep you up-to-date with the changes taking place in the health industry. With the assistance of cutting edge technology, experience, and skill,Medicalbillersandcoders.com also assist in placement of such medical billers and coders in small to mid-sized and growing clinics in order to assist in increasing the bottom line of such providers along with the quality of the care that is delivered. Clubbed with these functions are other vital services such as effective RCM, research, consultancy, payer interaction, and HIPAA compliance which can bring about a positive change in the various processes involved in managing a small to mid-sized clinic.

Advantages of Utilizing Medical Billing Services

These days most doctors prefer cost-effective medical billing services as opposed to maintaining in-house billing staff to obtain maximum profits. Out-sourcing their billing to a reputable and knowledgeable billing service allows them to increase their revenue without spending their precious time collecting insurance and patient balances. It is important to consider several items that will help you evaluate the contract between you and the medical billing service provider. Important points to keep in mind are the work quality, level of customer service as well as the pricing of these services.

A few advantages of out-sourced medical billing services are as follows:

• You can utilize billing services on a percent of collections which means that the billing company is motivated to collect for you as they too will increase their revenue.  It also means that the money you pay out monthly is solely dependent on the revenue generated, keeping billing fees in direct alignment with collections received.  In-house billing costs are hard costs as they are the same each month regardless of how well the collections are. Outsourcing also allows you to concentrate on your clinic and your patients’ care. Having a medical billing company which uses a team of knowledgeable people to complete your billing ensures accurate medical billing services that fit within your budget.

• Utilizing a medical billing company can lead to higher profits as such companies are skilled in reviewing billing for correct coding and reimbursement rates for CPT codes, reviewing EOBs for correct reimbursement and can be aggressive in collecting monies owed to the doctor.   Having more than one pair of eyes looking at your billing is essential in having a check and balance system for your billing.  A good medical billing company means many billers on the back end to manage your billing efficiently.

• Hiring medical billing services allows a physician to concentrate on their business.  When the worry of how the money is coming in to run the practice is eliminated, the doctor’s energy can be directed at patient care, which is why they became a doctor to begin with.

• Some billing services also offer consulting to help train in billing procedures and changes in coding and billing.  Such knowledge may help you to increase practice productivity and project a positive image to your patients thus encouraging an increased number of patients to visit your hospital or clinic.

• The patient interaction with the billing service is crucial.  Having a healthy billing service as part of your practice cannot be stressed enough.  Bad billing can inhibit current patients from returning and certainly impact new referrals.

 Source By : http://lasvegasmedicalbilling.wordpress.com

Inviting Medical Billers And Coders

Electronic Medical Billing, a preferred way improve your collections

As the insurance reimbursement environment becomes increasingly stringent, the incidence of denials, delays, underpayments, and lost or ignored claims seems to be on the rise. Consider this interesting statistics compiled by the Centers for Medicare and Medicaid Services (CMS: 70% of claims are paid the first time they are submitted; 30% of claims are either denied (20%) or lost or ignored (10%); 60% of denied, lost or ignored claims will never be resubmitted; 18% of claims will never be collected. Therefore, it is obvious that physicians are losing a substantial portion of their reimbursements unable to keep pace with medical billing challenges. But it is not a thing that can be neglected as medical reimbursements happens to be the life-line of medical practices.

While it is certain that the dwindling reimbursement rates are the resultant of inadequate medical billing and RCM practices, it is also true that physicians have not been fully responsive to web-based medical billing and practice management software, which are deemed to be far superior to manual billing practices. The fact that physicians can expect today’s medical billing technology to adapt to situational demands of medical billing reimbursements makes these web-based medical billing and practice management software indispensable to resurrect the dwindling reimbursements, which on an average aggregate to  $125 billion yearly.

The first step in claim realization begins with accurate coding without scope for denials. Therefore it is imperative that physicians’ medical billing is intuitive enough to forecast and adapt in such way that would negate the chance of denial. But, because billing staff’s ability is limited, billing software with proactive rules engine has become more reliable. The significant thing about proactive rule engine is that it can automatically identify claims that are likely to be denied and correct them before being submitted for claims. Consequently, you can expect an increase in first pass resolution rate, acceleration of claim realization, and considerable reduction in workload for your in-house staff.

It is strange yet true that practices are reimbursed far below than what they are entitled for. Moreover, the reimbursements tend to be different despite the procedure being the same. While these discrepancies in reimbursements rates may emanate from payer contracts, it is highly unlikely that physicians will be able to figure exactly which payer contract is yielding underpayment. Fortunately, they can turn to software that can automatically compare the actual payments received with the payments specified in each payer contract, and alerting them when discrepancies occur. Such software module that is capable of tracking discrepancies in reimbursements will eventually augment collection rates, promote physicians’ efficiency and growth, and make accurate financial prediction.

The efficiency of claim realization has always hinged on how best physicians handle A/R Management. Time factor is the crucial thing in A/R Management: less time your claims stay in A/R bracket, better your practices’ financial health. But, of late physicians have been complaining of their A/Rs consuming more than the admissible time limit of 90 days and eventually ending up as bad debts. Therefore, it is imperative that physicians respond to the challenges in A/R management through seamless integration of claim generation, submission, follow-up, and remediation. Electronic medical billing – built on sound Practice Management systems – promotes harmonious integration of claim generation, submission, follow-up, and remediation aimed at speeding up the Account Receivable Cycle.

While physicians contemplate on turning around their practices’ revenues with new found technological platform (electronic medical billing), cost and method of installation may be matter of immediate concern. Assistance from a medical billing service to help install an electronic billing system integrating with the areas most required by the practice and handle the A/R will help improve collections. Medicalbillersandcoders.com – by virtue of being credible, competent, and self-sufficient in offering cost-effective – comes across as a leading name. Its strategic partnership with leading PMS and EHR vendors lends its medical billing services the technological edge.

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.

How medical billing services contribute to retaining patients at your facilities

The intense competition in the healthcare industry is triggering unprecedented benefits to the patient fraternity. While the quality of medical care has improved by leaps and bounds, patients now, have choices and alternatives just in case they feel deterioration in the perceived level of medical care. This sudden shift in favor of patients means physicians will now have to devise ways in not just attracting patients but also retaining.

One of the prime factors in patient-retention has always been the quality of medical care. However, with most of the physician practices conforming to the benchmarks in quality, support services are emerging as differentiators. Therefore, as much as keeping their quality of medical care unblemished, physicians will need to engage their patients with complementary services throughout their stay at the facilities. Consequently, a full-pledged and competent support staff becomes inevitable in complementing physicians’ efforts to promote retention and engagement of patients. Amongst chores of clinical and operational duties that these support staff attend, following are deemed more pertinent to the objective of patient engagement and retention:

• Scheduling an appointment:
  Patients often feel it difficult to schedule an appointment with their doctors owing to doctor’s busy schedule. While it may be true that doctors are always pre-occupied with some medical emergency or the other, yet it is the duty of the support staff to accommodate slots so that patient need not go disappointed with not having to schedule an appointment with the doctor/s they feel more secure with.
• Making their stay comfortable:
  Patients often complain of support services during their stay in the medical facilities. This will have a serious impact on patients’ decision to come back again. Therefore, support staff, along with administering clinical duties as per doctor’s advice, should also make patients feel at home.
• Follow up on the progress post discharge:
  Most physician support staff deems it complete once the patients are discharged from the facility. But, medical care concern goes beyond that; patients will be happy if they are enquired of the progress post discharge. Moreover, it kind of restores their faith in the medical facility from which they had derived medical care.

Physicians would not have been concerned if they had only to assign these services as part of their endeavor to engage and retain patients. But, the fact that most of the support staff’s energy is spent on billing and negotiating claims with insurance companies, there is a likelihood of adverse impact on physicians’ main objective of patient engagement and retention to augment dwindling practice revenues. The thought of expanding the base of support staff to augment medical billing too is losing its relevance owing to heavy implementation cost associated with mandatory EHR, and the ensuing ICD-10 & HIPAA 5010 compliant clinical and operational practices.

In such a scenario, physicians would do well to entrust their support staff with only clinical functions, and outsource medical billing, and Revenue Cycle Management (RCM) services from competent and credible sources. Medicalbillersandcoders.com – being the largest consortium of medical billers and coders in the U.S – is resource-rich in dispensing valued-added services in medical billing and RCM. Its comprehensive suite of medical billing and RCM – comprising patient scheduling and reminders, patient enrollment, insurance enrollment, insurance verification, insurance authorizations, coding and audits, billing and reconciling of accounts, account analysis and denial management, A/R management, and financial management reporting – is ample proof of its competence.