Medical Billing Service in Michigan

Traditionally Michigan has been amongst one of the economically stronger states in the US, but in the area of healthcare this strength is often not reflected courtesy of certain inadequacies like – lack of nursing home and chronic care measures, resulting in poor access to healthcare services to Michiganders. Also, Michigan has a population which is economically disparate and a large pool of this population is either not economically-sound to afford insurance (small-income self-employed groups) or not provided insurance coverage by their employers. This results in a sizeable part of the population falling out of the insurance net. Additionally contributing to the lack of access to healthcare in Michigan is that the state is faced with paucity of physicians. 

To address these problems, the office of Michigan governor has proposed a two-pronged approach, one is self regulatory which recommends Michiganders to follow certain health-related best practices, like maintaining healthy diet, doing physical exercise; and the other is to develop a primary-care system with a patient centric medical home to provide patients with treatment which combines care coordination and appropriate preventive services for patients with safe and secure transfer of medical data through electronic means. Alas, this is aggravating the plight of physicians. 

If the coordinated-care scenario, discussed above, is deconstructed, it leaves primary care physicians more to worry about than to rejoice. While well-intended, coordinated care is leading to nonclinical paperwork for physicians and adding to their woes is electronic data transfer, meant for claim submission via HIPPA 5010 to Medicaid and Medicare agents, which leads to rejected claims due to minor errors in data entries. This is affecting physicians financially and leaving them with reduced time for patient care. 

As a result physicians in Michigan have been found to leave hospitals and return to their independent practice, further contributing to the ‘limited access to healthcare’ crisis in Michigan by withdrawing from organized healthcare net while failing to do away with their earlier administrative responsibilities given that the services provided under primary or physician healthcare, with or without a partnership with hospitals, come under insurance coverage requiring the same administrative work for claim submission and reimbursement. 

To tide over the challenge of mounting administrative activities including paperwork leading to claim denials and affecting the operating revenue and profitability of physicians and hospitals and also be ready to meet the changing trends of a dynamic and highly regulated industry, physicians and hospitals in Michigan need to strengthen their Revenue Cycle Management with a platform to facilitate electronic Medical Billing based on revised human practices and appropriate software applications. 

Medicalbillersandcoders.com can help you build a paperless and agile RCM process by performing an end-to-end study of your RCM process and environment and recommending an appropriate EMR software application. 

Through its Outsourced Billing and Coding Services, Medicalbillersandcoders.com has helped several clinics in all cities of Michigan (Detroit, Grand Rapids, Warren, Sterling Heights and Flint as also the smaller countries and cities) to improve their finances and increase their focus on healthcare though a group of experienced billers and coders who have sound knowledge of insurance collections in a timely manner and good relationship with key insurance payers, like BCBS, United Health, Workers Comp and government payers across Michigan. 

For more information visit: Michigan Medical Billing Services

Increase revenue by improving billing functions

The excessive administrative work healthcare organizations are having to deal with due to reforms in the US healthcare has begun to take its toll on the revenue of healthcare organizations across all the states of the US due to several reason, like claim denials by insurers and hospitals involved in increased non-clinical activities like claim preparation and their follow-ups consuming resources, financial and man power, of care providers without adding, in the least, to the quality or delivery of their healthcare services. 

HIPPA 5010, the electronic medium to transact medical data for claim submission to Medicaid and Medicare, has further compounded the problem for care providers by forcing upon them  a series of data handling activities which, if not handled with complete accuracy, lead to rejected claims. 

The reform-induced administrative responsibilities have affected profitability and operating revenues of healthcare organizations in the US healthcare industry. The increased paperwork and other compliance activities have exposed hospitals to the possibility of a two-fold monetary penalty: claim denials due to inaccurate submission and penalties incurred due to noncompliance and undetected overpayment not returned to Medicaid and Medicare on time, in a post-imbursement scenario. 

Apparently, the current scenario is changing the dynamics of the US healthcare industry without helping improve the quality of healthcare services. However, to blame the reforms for not helping improve healthcare quality is a futile exercise given that the reforms are not meant to ensure quality of care per se, but availability of care through insurance and reimbursement, albeit through a maze of procedural activities, which, incidentally and to a certain extent understandably, have fallen to the organizations involved in the delivery of care and, being cumbersome and outside their area of expertise, have managed to cause them considerable woes, financial and otherwise. 

However, the non-healthcare responsibilities, if left to people who are better equipped to handle them, should not muddle up the core healthcare activities, leaving hospitals with more time and focus for care and helping them to ensure improved finances through proper claim submission and reduced rate of claim rejections either through an improved in-house Revenue Cycle Management (RCM) process or through an outsourcing model. 

A sound RCM process helps address areas like inaccuracy in claim preparation and post-submission follow-ups, done in a methodical and scientific manner, through a close scrutiny of areas of concern to identify outdated and cumbersome processes, inadequate software applications, under-utilized workforce with inadequate knowledge of coding details and industry regulations. The RCM consulting services Medicalbillersadncoders.com provides have helped healthcare providers have a robust RCM process that helps meet the current financial and administrative responsibilities helping them to reduce cost through optimized work force and leading them to improved revenues. 

Many medical practices, in the US, have improved their finances due to accurate claim development, intricate procedure coding, electronic filling and timely follow ups thanks to the Outsourced Billing and Coding Services  provided by Medicalbillerandcoders.com, the largest consortium of billers and coders in the US.

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.

Improving Patient Collections via Medical Billing

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If the insurance-driven nature of US healthcare is leaving care providers to sort out administrative issues to ensure successful claim submission and reimbursement is one side of the problems US healthcare providers face, the other side is patients unwilling or unable to pay the share of the medical bill that’s not covered by their insurance, leading to unrealized patient collections for care providers affecting their revenue and crippling their profitability. However, unlike the unpaid-insurance-claim problem where the larger part of the blame can be laid on cumbersome healthcare policies and procedure, with unpaid patient collections healthcare policies are out of the equation leaving healthcare providers and their patients to share the blame. 

While patients’ part of the blame is simple – inability or reluctance to pay- the care provider can be indicted on several fronts, like lack of prior verification of the patient’s insurance coverage; absence of a clear written policy about the financial responsibility of the patient; non-identification of time lost between delivery of service and date of charge entry; absence of data on reasons of payment denials by patients leading to lost opportunity to train employees on how to avoid mistakes made in the past; lack of cross-training of billing staff so that, say, a person being on leave doesn’t interrupt the process with another person stepping in to continue it; use of obsolete billing software applications, etc. 

After being denied payments on time by patients, when care providers try realizing them by sending out patient collection letters, they meet with disappointments with the letters not eliciting any response from the patients and the letters being aggressive in tone, additionally, exposing care providers to the risk of disrupting their relationship with patients which in a competitive environment with other care providers always on the prowl for poaching patients can have the potential to lead to loss of clients. 

A cursory look at these problems will tell you that none of them is part of core healthcare, but issues that – however important for a care center to operate profitably – should be left to people best equipped to handle them. 

A strong Revenue Management System (RCM) will address all the areas of concern, enabling the care provider to build and maintain a data gathering and management system which will net the entire set of medical data starting from accurate verification of insurance coverage through such medical details as are required to prepare and submit claims, which although not a part of patient collection is inseparably intertwined with the overall financial process of an organization and require medical details that are identical to patient collection. Additionally, a good RCM process will identify and address training needs that, in the case of patient collection, will ensure the in-house personnel are not just familiar with procedural details of their own line of work but are also proficient in cross-functional responsibilities ensuring, as a result, the continuity of a process in the absence of a staff. 

Medicalbillersandcoders.com has helped set up and strengthen the RCM process of many a healthcare provider through its RCM consulting services that perform a thorough study of your environment and help you have an RCM process which runs parallel with your treatment procedure without interrupting it but absorbing and maintaining medical details quietly and efficiently and helping your organization to respond to any administrative responsibilities, either reimbursement or collection. 

Medicalbillersandcoders.com, the largest consortium of billers and coders in the US, has a network which spans across all the states of the US bringing healthcare providers a unique platform which combines the range of a national network and immediacy of a local operator. The billing and coding outsourcing services offered by Medicalbillersnadcoders.com combine this network with a team of specialists with years of experience in dealing with intricacies of billing and coding to ensure an end-to-end support for your patient collection responsibilities, leaving you to do what you do best – healthcare. 

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.

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

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.