How medical billing consultants are crucial to Credentialing with Medicare & Medicaid?

Over the years, Credentialing has become an indispensable thing to medical practitioners’ sustenance and growth; so much so that it is impossible to think of undertaking medical practicing without a valid credentialing from the authorized health agencies. Today, credentialing, as much as a mandatory requirement for commencing and running clinical operations, is also physicians’ passport to attract and retain patients. Moreover, unlike during the pay-for-service era, the job of Credentialing does not stop just with attracting and retaining but far beyond that.  Today, physicians have to contend with Credentialing of a different type – Credentialed with Healthcare Insurance Providers. 

Sometime ago, when medical practices had only to deal with either the Federal Government sponsored Medicare or state-wise Medicaid schemes, the process of getting Credentialed was seemingly manageable by physicians themselves. But, as the healthcare industry opened up to private insurance carriers, the task got a bit heavier as they had to deal with multiple insurance carriers along with Medicare and Medicaid. As physicians were treated to a multiple portfolio of reimbursement sources, they started to feel a decline in their ability to bargain positively with these multiple sources. Consequently, this started to reflect negatively on their revenue generation. Eventually, they had no recourse but to opt for specialized Credentialing services from Medical Billing Companies. 

While outsourced Credentialing has been able to nullify the adverse effects on medical reimbursements, its significance may once again be re-emphasized as Medicare and Medicaid reimbursement environment is going to be even more stringent post Federal Government’s decision to bring in quantitative and qualitative reforms to Medicare and Medicaid. Given the likely scenario, physicians will have to seek outsourced Credentialing  that  can effectively and efficiently steer them through laborious Medicare & Medicaid Credentialing process comprising: 

• Setting up of all Medicare and Medicaid applications 

• Proofing of submitted Medicare and Medicaid errors and omissions 

• Submission of the Medicare and Medicaid application 

• Setting up and submission of all provider assignment forms and documents 

• Following up with Medicare to insure the completion of all required processes 

• Following up with Medicaid / designated agent to insure the completion of all required processes 

• Archiving of all filed documents for future reference 

Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – by virtue of credible source for Credentialing with Medicare, Medicaid, and prominent private insurance providers – should be physicians’ preferential choice for outsourced Credentialing services. Our process follows tried and tested path: clients set up their account with our firm by utilizing our secure online form. Once the form is submitted, we will obtain the credentialing documentation from the Insurance providers (Medicare, Medicaid, and private insurance carriers) or directly from the Physicians. Medicalbillersandcoders.com will then set up all complicated, and laborious process till physician offices are credentialed amicably. 

For more information visit: Medical Billing Services

Shortage of General Surgeons and its Effect on Hospital Revenue - yooarticles.com

The acute shortage of general surgeons is evident in the Occupational Outlook Handbook of the Bureau of Labor Statistics which states that only 5% of physicians were general surgeons in the year 2007, and the situation has not improved since. In fact, the shortage of general surgeons is getting worse and is projected to worsen in the future. The role of a general surgeon cannot be underestimated in a country where the population is increasing and millions more are receiving health insurance due to the reforms. The population of the country is estimated to grow by more than 30 million by the year 2020 and the country’s baby boomer population and the population of old people would be very high. This would certainly put humungous pressure on general surgeons and have manifold consequences for general surgeons as well as for the health industry.

The problems of general surgeons don’t just stop at the shortage and the endless work hours but extends towards many challenges that are unique to this specialty. In rural areas as well there is a higher shortage of general surgeons. An article in the Archives of Surgery called The Increasing Workload of General Surgery gives some facts about the future of this specialty. According to the article, the workload of general surgeons will increase by 31.5% between 2000 and 2020 with the amount of workload growth varying among the five different types of surgeries that are taken into account from 19.9% to 40.3%.

This increasing workload is affecting hospital emergency rooms the hardest since most surgeries are performed in bigger hospitals and also due to the fact that general surgeons usually determine whether or not to operate on a patient in emergency rooms. This increased demand and shortened supply of general surgeons would not only cause detrimental health consequences for the general populace in the future but also cause huge financial damage to almost all entities involved in the healthcare system.

The challenges facing general surgery are numerous; however, all is not lost for hospitals and physicians, at least on the financial side, due to the helping hand provided by the government in the form of incentives for implementation of EHR/EMR systems, ‘Meaningful Use’, reforms in payment structures and such other incentives. However, implementation of these systems and policies completely depends on streamlining all the departmental processes such as revenue cycle management, selecting an appropriate EHR or EMR system, denial management, interaction with payers and Medical Billing and Coding. Outsourcing these processes would not only reduce the workload of the hospitals in general but also provide the opportunities, time, and resources for the challenges faced by general surgeons in aspects of healthcare delivery along with improving hospital revenue generation.

Medicalbillersandcoders.com is the largest consortium of medical billers and coders in the United States and provides services to physician practice and hospitals, that are not just limited to accounts receivables or Revenue Cycle Management or denial management but also encompasses various other services such as research and consultancy.

For more information visit :  Medical Billing Services

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.

Challenge of EMR deployment for Small Pediatric Practices

Challenge of EMR deployment for Small Pediatric Practices

Challenge of EMR deployment for Small Pediatric Practices

The use of  Electronic Medical Records  (EMRs) or Electronic Health Records (EHRs) in pediatric practices presents numerous challenges due to the dynamic nature of this particular specially. The reasons for these challenges are myriad and range from the changing nature of the body of children and also the medical care that is provided during childhood. This care can include immunizations, growth tracking, and other critical aspects such as obesity. Another advantage of EHRs is that children over 13 have to record their smoking status which may lead to positive health outcomes. The burden of all this EMR testing and implementation lies with the physicians and their assistance but this is usually possible in bigger settings such as hospitals and small practices have traditionally suffered due to lack of proper EMR facilities. Moreover, taking responsibility of such amount of work in pediatrics is costly as well as time consuming for novices in the field. 

It cannot be denied that there are numerous advantages of EHR implementation in pediatrics and the general medical history of the child can be continuously recorded. However, there are numerous challenges as well and these can range from financial to functional. Physicians are finding it hard to dedicate time updating their EHRs which in turn has dropped the productivity. Another factor is that since pediatric patients have a constantly changing BMI (Body Mass Index) and features, recording this also consume resources in the form of time and money. Hospitals are finding it easier compared to small practices to implement EHRs since they have the groundwork in the form of infrastructure to implements such EHR systems. 

The challenges faced by pediatrics in implementation of EHRs are similar to those faced by other specialties and these may include lack of adequate funding, lack of training, resistance to change and lack of resources. However, the biggest advantage is that there are numerous types of EMRs available in the market and many of these support pediatric services; but, the adoption of such EHRs/EMRs is not enough. The ‘Meaningful Use’ criterion needs to be met in order to qualify for the incentives offered by the government. 

The financial aspect of successful implementation of EHRs is not limited to the incentives provided by the government but is also in the form of increased revenue due to efficient departmental processes. The financial success of the practice depends on a holistic approach by not just implementation of EHRs or EMRs but also through outsourcing such essential departmental processes such as medical billing and coding, interaction with payers, and denial management in addition to other value added services such as pediatric EHRs and research and consultancy that are provided by www.medicalbillersandcoders.com the largest consortium of medical billers and coders in the country. 

For more information visit: Medical Billing Companies

Medical billing to assist Primary Care Physicians in streamlining their practice

The lack of primary care providers in the country is a topic which has been hotly debated among many circles and written about vehemently. Not many medical students are ready to enter primary care due to lack of great financial prospects in the future. This is resulting in even more shortage of physicians and problems when it comes to the reputation of this line of medicine. The remuneration problems along with other difficulties faced by Primary Care Providers (PCPs) is affecting the revenue of PCPs and bringing a disparity between other physicians who practice other specialties of medicine. Here are numerous reasons for the reimbursement disparities for PCPs and some possible solutions for countering this problem. 

One of the reasons for the lesser amount of remuneration for PCPs is that specialists who perform routine procedures such as some specific types of surgeries take lesser amount of time to complete their task compared to a PCP whose case can be of any nature. Another explanation for the comparatively lesser amount of pay of PCPs are that the majority of these are either solo practitioners or work in a small group whereas specialists like surgeons and cardiologists have a chance to work in a big hospital  with even bigger pecuniary benefits.  

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There are many problems that are synonymous with the problems of PCPs and of those faced by solo practices. The burden of supervising all the functions of a small practice along with carrying out the core aspects of medicine is also a hurdle that hampers efficient time and financial management. Moreover, the Medicare rates given to PCPs are causing resentment among PCPs where a group of people have a filed a suit against Medicare regarding their low reimbursement rates to PCPs. Medicare cuts are another problem faced by especially PCPs since they are responsible for treating a large number of elderly patients and act as an entry point for specialties if any particular problem is diagnosed, which is usually a possibility in elderly patients.  

The health reforms have provided a glimmer of hope for PCPs due to many policies that have been implemented. However, compliance of these policies is also a challenge that is faced by physicians and providers along with PCPs. The incentives provided by the government for the implementation of EMR and EHR systems can be a definite financial advantage, especially for PCPs. However streamlining all the departmental process to implement this cutting edge technology is perhaps the most important prerequisite for qualifying for the incentives through ‘Meaningful Use’.  

PCPs can take advantage of companies that provide assistance in the latest departmental processes required for maximizing the revenue and improving the quality of care. Medicalbillersandcoders.com is one such company that streamlines all your processes such as revenue cycle management, denial management and, of course, also performs medical billing and coding. We also provide other value added services such as consultancy and research. 

For more information visit: Medical Billing Companies, Medical Billing Services.