Average Single Specialty practices cater to 42-49 percentage of Medicare Populace!

That means nearly half of your total patient population comprises of Medicare beneficiaries.  And, you could have remained indifferent as long as Medicare’s reimbursements continued to be as normal as private health insurance reimbursements.

While physicians’ have remained immune to its impending backlash thus far, they may not be so lucky henceforth; the Federal Government, unable to contain the exploding Medicare expenditure, has finally pressed the panic-button which physicians had been feared of –

Medicare reimbursements cut and their effects:

Approximately 4-5% cuts expected each year through 2012, – can result in a substantial erosion of practice revenues

Practice will find it hard to compete, sustain, and grow – on marginal revenues from private insurance reimbursements

Extreme possibility – the cumulative effect of such Medicare cuts may even bring practices on the brink of sell-out or closure

Ways to off-set the adverse impact of the imminent Medicare cuts:

Maximize your Medicare reimbursements – error-free billing, coding, and submission

Being eligible for Medicare bonuses and incentives – adopt ACO model of medical care dispensation and compliant EHR practice

Focusing on getting as many reimbursements as you can from – other sources (private health insurance reimbursements and fees)

Get credentialing services for your practices

Outsourcing your billing to dedicated specialists could be the key!

Specialization as their lone concern is to maximize their clients’ revenues from reimbursements

Voluminous operations – helps in reducing the cost of medical billing services

Market-orientation –  ensures that clients’ medical billing practices are compliant with the evolving industry standards

Tackling Medicare as well as other reimbursements with MBC …

Medicalbillersandcoders.com – by virtue of being the leading consortium of medical billers and coders across the U.S – is uniquely poised to play the defining role in this regard. Combining its unique legacy with a comprehensive process of medical billing RCM–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 – Medicalbillersandcoders.com additionally offering value added services like consultancy and credentialing promises to guide physician practices through these testing times.

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.

When was the last time your clinic checked the fees schedule? Streamlining your Medical Billing

Optimizing Fee Schedules for Physicians: An Overview 

The fee schedule for any physician practice is an important pecuniary factor that affects not just your revenue but also the way in which healthcare is delivered to the patients. Many practices fail to update their fee schedules on a regular basis which can affect the profitability and the revenues in the long run. The relation between Accounts Receivables, Collections, and fee schedules is undeniable and therefore it becomes important to set fee schedules that are optimized in order to secure profits and avoid long term losses. 

Here are some factors that affect the way in which fee schedules are set and their effects on the overall revenue of the physician and the clinic: 

• Collections – The collections process is one of the most important aspects in the financial health of a clinic and any uncollected fees or revenue which is written off affects the efficiency of the fee schedules set by a clinic. Collections are not just limited to those received by payers but also apply to co-pays which are collected by patients when they visit the clinic. This co-pay may seem to be a small amount but has immense importance in the long run and affects the efficiency of the working of fee schedules for providers.

• Setting the Correct Fee Schedule – Setting the correct fee schedule can be a complicated task that requires patience and dedicated effort in order to guarantee optimization of financial benefits for the clinic in the long run. Fee schedules should be such that they reflect the complete value of the services that are provided and ensure that the providers are paid a meaningful amount of remuneration in order to avoid losses.

• Discounts and Sliding Fee Schedules – There are many cases where the patient may not be able to pay a part of the amount and needs a discount. In such cases a sliding fee schedule can be set up if the patient falls under the poverty line and these can be set up so that they are set at an amount lower than the actual fee schedule and increase over a period of time. This procedure can give you the accurate amount of fees collected by such patients and assist in correct evaluation of revenues and profits.

• Time and Costs – The actual costs of the service provided and the time that you dedicate for a certain procedure are also important factors that influence the financial efficiency of your fee schedule. If you believe that the time and costs of the procedure is high compared to the remuneration that you are being provided by the payer then there is certainly a scope for negotiations in order to ensure increase in the fees and optimization of revenue as well as optimum utilization of time.

• Medicare Fee Schedules – The Medicare Fee Schedules are calculated by the formula [(Work RVU x Work GPCI) + (PE RVU x PE GPCI) + (MP RVU x MP GPCI)] x CF, where GPCI is the Geographic Practice Cost Indices, work RVUs are the relative levels of time and intensity that are associated with a Medicare service and account for 50% of the total payment amount associated with that particular service, PE RVUs are the Practice Expense RVUs that are associated with the costs of maintaining an office such as renting of equipment, buying furniture etc, MP RVUs are the Malpractice RVUs, and CF is the conversion factor. The CF is updated every year and stands at $24.6712 for the year 2012 and is calculated based on factors such as medical inflation, the probable expansion in the domestic economy, projected growth in the number of recipients in Fee-For- Service Medicare, and changes in regulations and laws.

One-stop Solution 

The complexity and the various laws and regulations that govern the fee schedules make it a difficult task to check the appropriateness of fee schedules on a regular basis. The only method of ensuring that your fee schedule is efficient and accurate is outsourcing this task to professionals who are aware of the latest changes in not just fee schedules but also the other factors that influence it. Medical billers and coders who are experienced in not just revenue cycle management but also efficient in handling practice management solutions and other aspects of billing and coding can ensure that fee schedules are checked regularly and any lacunae and errors removed so as to optimize the revenues of providers in the long run. 

Medical billers and coders at Medicalbillersandcoders.com are capable of not just checking fee schedules but are also the largest consortium of medical billers and coders in the United States that provide various other important services such as research, effective interaction with payers, accounts receivable analysis, practice management solutions, and efficient revenue cycle management services that aim to streamline such various functions for smooth and competent fee schedules for your practice. 

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.

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