Medical Billing Companies: Electronic Health Records spurring hiring of staff besides adding to costs at physicians practice

Medical Billing Companies: Electronic Health Records spurring hiring of staff besides adding to costs at physicians practice

Electronic Health Records spurring hiring of staff besides adding to costs at physicians practice

Electronic Health Records (EHRs) are complex systems and a dedicated team of professionals are required for handling and maintaining these systems for smooth operation of such records. The drawbacks of paper based records, the projected advantages of EHRs, and the incentives offered along with the penalties for non-adoption of EHRs are driving hospitals and small practices towards implementing EHR related policies. There are numerous reasons for the slow rate of adoption of EHRs and range from reluctance to accept new technology, the changes brought about by government intervention and practical causes such as financial burdens, increased amount of work and shortage of time. 

Although there are challenges in the initial stages of implementing EHRs, the benefits in the long run are holistic in nature and can benefit physicians as well as consumers. One of the important aspects of the financial and professional growth of the practice is the maintenance of the viability of the equipment and the resources available for efficient operation. One of the important steps in ensuring such efficient operation is the hiring of reliable staff that are not only educated in their own profession  but are also computer savvy and familiar with EHRs and such other systems required for everyday activities. 

Some other factors that may add to the costs are health IT services which are a recurring one along with some other costs such as upgrading the system and keeping the systems secure as per HIPAA guidelines. However, the fact that the initial cost of EHR would be offset due to the incentives provided and the benefits in the long run, financially or otherwise, cannot be denied. The costs of EMR or EHR implementation and maintenance can be reduced by using various methods to streamline the departmental processes by optimizing services such as revenue cycle management and denial management along with numerous other services. These processes require accuracy in order to reduce duplication and rejection of claims, and errors while billing and coding. 

Professional medical billing and coding companies can provide dedicated services such as payment posting, where accurate comprehension of Explanation of benefits (EOB) is required, and accounts receivable where time is the most crucial factor in receipt of accurate reimbursement. Moreover, the advent of EHRs and numerous new polices, physicians are trying to hire more staff for health IT support which is in short supply. Costs of health IT services for upkeep of successful EHRs are rising and some of the ways of cutting costs is to outsource as many departmental processes as possible in order to find relief from some financial burden. 

Medical billing and coding companies that offer specialized services in this field not just cater to physicians’ billing and coding needs but also provide numerous other services. Medical billers and coders at www.medicalbillersandcoders.com offer other value added services such as physician credentialing, consultancy and denial management.

Simplify EHR Systems by Restructuring Your Medical Billing

EHR systems have changed over the last decade and the health reforms have given new meaning to such systems by making rules regarding ‘Meaningful Use” (MU) of such systems. Older versions of EHRs were simple digitized versions replacing paper based records and did not have the specific guidelines in MU to be implemented for the incentives. However, almost all EHR vendors now are MU compliant but only 10.1% of physicians in the country have a fully functional EHR system. This is due to the fact that those who have a basic system are not equipped with features to handle MU compliance along with the changing face of the health industry including the attitudes of payers towards billing processes.

A report prepared by the University of North Texas on providing – Guidance in Documentation, Coding, and Billing of Medical Services for Compliance-  clarifies the documentation and billing requirements and also the general rules to be followed while documenting. For instance – the medical record should be complete without any errors and the documentation of each patient should include the reason for encounter, relevant history, prior diagnostic test results, and physical examination findings. The past and present diagnoses should be accessible to the consulting or treating physician, the patients progress is to be documented and appropriate health risk factors identified. The code reported on the claim form or billing statement needs to be supported by documentation in the medial record.

Hence the requirement for a separate billing system can be felt and is one of the solutions for such complex compliance requirements and the above subset of information can be sent to a billing system designed to specifically handle such information. There are numerous other documentation standards that need to be observed and these standards are easily handled by EHRs and can be made to fit the billing system. The information corresponding to all the documentation standards mentioned above can be sent directly to the billing system at the time of the visit, making the whole process smoother. Moreover, HIPAA compliance can be easily observed because the medical documentation is stored in the billing system and does not require the clerical staff to access the actual EHR.

Billing and related processes need to be reorganized to fit the requirements of not just MU compliant EHR systems but also for accurate and timely reimbursements. These documentation standards and compliance are extremely important in light of the way in which payment models are changing in the industry. Physicians would be paid according to the quality of the service provided and the outcomes rather than the traditional per-patient method. For more information about medical billing processes and to restructure your billing and assistance with EHR implementation, visit www.medicalbillersandcoders.com, the largest consortium of medical billers and coders in the United States that also provides services such as revenue cycle management, denial management, and consultancy.

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.

Effects on Physicians reimbursements: Insurance Denials and uncertainty of health reforms

Insurance denials are one of the major factors that affect a physician’s revenue even though health reforms do address some issues faced by patients and physicians in dealing with insurance companies, the denial rate of claims has not significantly altered due to such reforms. These insurance denials are avoidable especially as they create problems for physicians and providers and delay or even eliminate the possibility of proper provider reimbursement. Dealing with insurance companies is tough enough for experienced physicians; it is even tougher for new physicians who have limited hands-on experience in such matters.

The reforms have played a significant role in reining in insurance companies and some of these policies may work but still remain to be fully tested. The survey conducted by The United States Department of Health and Human Services finds that the rate of denial is 19% but the denial rate increases with the age group of the patient. People who are older face more denials compared to young individuals and this is a worrying trend for a population which is continuously aging. The Government Accountability Office (GAO) has released a report on insurance denials which sheds some light on the nature of insurance denials- it states that in many cases the denied claim, if appealed, is often reversed. This survey also clarifies that the number of denials due to the inappropriateness of the service provided by the physician are less than those because of billing errors and eligibility issues.

The health reforms are going to  affect the insurance scenario in the sense that as now even people with pre-existing conditions can get insurance- this essentially means that physicians are more likely to see increased number of sick patients which in turn would increase the average physician-patient encounter time. The other aspects that will affect the insurance scenario in the country are that since there would be a large influx of consumers in the form of the previously uninsured 32 million Americans which would benefit the insurance companies to grow. However, initially insurance providers would see a drop in their revenue due to decreased profits and increasing number of claims.

Physicians and providers stand to gain from the health reforms in the long run and the way in which these new policies will affect payers even though some payers may decrease the Physician Reimbursement amount. Nevertheless, insurance denials are always going to be one of the major problems that providers will have to face in the future even after the implementation of reform policies.

The best way to deal with insurance denials is to ensure that denial management and payer interaction are performed by experienced professionals for better results. Such denial management and payer interaction can be performed in a professional and efficient manner by the largest consortium of medical billers and coders in the United States, medicalbillersandcoders.com Billers and coders in the consortium can not only assist in better Denial Management and payer interaction but also offer numerous other value added services such as revenue cycle management, research, and consultancy.

US Healthcare adapting to Reforms: Hospitals to Ease Physician Shortages

The health reforms have affected every aspect of the health care delivery system in the United States and smaller and solo practices in the country are finding it difficult to cope with the changes on almost every level of health care delivery. The changes in health IT sector, policies in government intervention, and changing reimbursement models are making it difficult for solo and small practices to cope with all these changes financially as well as functionally. Physicians as one of the options are turning towards hospitals and large group practices for better job prospects with reduced amount of responsibility.

The challenges faced by small and solo practices are not just limited to the core aspects of health care delivery. These challenges can range from functional impairments, workflow redesigns and other financial factors. The amount of work required to comply with the health reform guidelines is not just limited to implementation of EMRs and EHRs and ‘Meaningful Use’ objectives but also entails numerous other responsibilities in the form of maintenance of such EHR systems and changes in various departmental processes that are essential for boosting revenues. Increasingly physicians are struggling to find a holistic approach towards the practice and succeed due to the new reform guidelines that are complex and exhaustive in nature.

Hospitals are also taking steps in order to boost the revenue and streamline various processes by forming tie-ups with other group of physicians and hospitals. This not only encourages innovation but also cuts costs and saves time. This can also be a solution for reducing the shortages of physicians by giving an opportunity to those physicians who would have failed in Meaningful Use implementation or had decided to stop practicing due to the complex guidelines of the health reforms. Moreover, the implementation of successful Meaningful Use is carried by more physicians since they have the support of hospitals and larger clinics to comply with reform guidelines.

Due to the many reasons cited above, hospitals are starting to recruit physicians who are finding it very challenging to cope with the recent changes in the health industry. This can obviously help in relieving the pressures in big and medium sized hospitals and give an opportunity for better health outcomes. Such services backed up by departmental processes such as medical billing and coding, revenue cycle management, better accounts receivable handling, active interaction with payers offered by www.medicalbillersandcoders.com can assist any hospital in properly handing the financial side of the health care delivery.