Managing HIPAA Issues at your medical practices

With the application of HIPAA, (Health Insurance Portability Accountability Act), health care organisations need to be cautious with whom to share the patient information. HIPAA calls for protection of the individual’s health information, at the same time; this privacy rule also permits limited disclosure of health related information to related entity of a person who needs patient care, thus, bringing on added responsibility for the staff.

Challenges faced: Introduction of HIPAA has proved to be a challenge for medical billing over the recent years with providers required to send claims electronically in compliance with the act, in order to receive their payment. Medical billing and insurance companies have both been affected because of the regulations imposed by HIPAA requiring additional waivers and increased documentation related to HIPAA. Moreover billing software used along with business processes – practice management service vendor, billing system and clearing house – also need to be re-looked so as to become compliant with the HIPAA.

Benefits to medical practice due to HIPAA: Efficiency and cost savings are some of the many advantages of using HIPAA standard transactions:

• Electronic claims: the HIPAA rules require the Medicare claims to be submitted electronically. Most of the providers are able to electronically claim directly to their insurers
• Patient satisfaction: an efficient HIPAA compliant billing system ensures patient information privacy hence improving patient satisfaction and in turn patient count for the physician

Electronic claims have proved to be a giant leap for the health care industry. Huge gains have been estimated by the analysts by implementing the transactions as per required by HIPAA.

Current move to HIPAA 5010: According to CMS Physician offices are seeing reductions to their revenues after the move to HIPAA Version 5010. Industry experts feel problems due to this transition has affected physicians, billing clearinghouses, and public and private insurance payers as well. There has also been a lack of uniformity with certain practices billing using the older HIPAA 4010 standards, with some health plans adjudicating those claims while some clearinghouses are automatically converting 4010 transactions into the 5010 format for payment.

Streamlining your billing system: Getting a separate billing system for your medical practice can be prove to be beneficial as being specialists in their field they can easily perform assessments of your practice, using the latest HIPAA regulations and standards, also improving the revenue cycle- leaving enough time for the health care staff to do their job and physicians to solely concentrate on patient care.

Medicalbillersandcoders.com billing for more than a decade now play an indispensable role in confirming to HIPAA while billing for health care organisations. They make sure that individually identifiable information on health is protected and there is no violation of the act. MBC serving various specialities in healthcare is constantly updated with all billing reforms along with HIPAA norms while billing, helping health care professionals to concentrate on their core job of patient care, rather than worry about proper implication of HIPAA and other reforms.

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.

Medical Billing Partner: A Strategic Avenue for Achieving Revenue Integrity?

Healthcare providers in the current environment are aware of the fact that every step counts, leaving no room for errors as far as securing the revenues and reimbursements are concerned for their services. However, as the procedure of patient billing information has been traditionally managed by different departments in isolation, showing little integration the deficiencies of one department might impact the other department adversely, and even damage the revenue cycle of the healthcare provider, hence providers are now in need of a strategic avenue to procure the right revenue for their clinic.

Processes like medical billing, collections and denials managements are some of the prime activities handled by the health care providers, which play a significant part in ensuring revenue optimisation. However payment accuracy, resolving cases of denials and managing the underpayments are specifically critical in order to maintain the healthy bottom line. Additionally healthcare reforms like – Electronic Health Recording (EMR) mandatory for securing incentives under ARRA, transition to HIPAA and ICD-9 to ICD- 10, though improving quality of care are also slowing down the Revenue cycle. All in all physicians have very little option but to re –organize their clinics entire billing process.

Medical billing partners being specialists in their field provide a practical and optimum choice for improving the revenue cycle, streamlining medical billing functions, ensuring optimal reimbursements, operational efficiency and compliance, thus helping the physicians and health care providers to achieve revenue integrity. Billing partners regularly check for any coding errors adding any modifiers if necessary thus negating any chance of discrepancy in the billing process. Problems like denials and underpayment can also be dealt with on the same platform, as billers assist in helping streamline changes to the clinic due to health care reforms providing experts who are well versed with ICD-10, HIPAA & knowledge about the EMR software suitable for your clinic.

RCM of a health care provider being quite complex, involves various processes and people, ranging from scheduling the patient to billing for the services and collection. MBC through it medical billing services has been helping physicians who are at a constant risk of losing considerable amount of revenue where lack of communication between various departments and inefficiency are common features. Medicalbillersandcoders.com has been involved in revenue maximization for healthcare organizations by billing and coding for over a decade now for physicians across the 50 US States and across varied specialties.

Our team is constantly training and updating themselves about industry requisites also providing consultancy right from the best EHR– to data analytics. At MBC our medical billing and coding experts are constantly striving to update themselves to achieve the right revenue for your organization.

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.

Improved Hospital Billing and Operational Benefits with EHR Adoption

The past decade has seen every major industry being computerized, including the medical industry and hospitals – which have moved on from hand written prescriptions to Electronic health record (EHR). According to various studies EHR implementation provides several benefits including improvement in the process of clinical care and overall patient experience. Along with it, EHR also has a potential to create opportunities in health care organisations as it can help with the cumbersome administrative processes. EHR adoption can create a better work flow and quality in mainly three fields – namely coding, chart analysis and records management.

EHR implementation has surprised many physicians to learn that tedious procedures like processing claims have become an electronic and highly automated process that doesn’t even require increase in personnel resources. The latest version of EHR software have, in fact, focused specifically on billing processes, that includes robust eligibility checking for preventing errors, updates with Medicare as well as with other payer reimbursement rates.

Usage of EHR can also cut down on inefficient and time-consuming paper works. Patient information flowing through the practice, like tests, diagnosis, prescriptions and procedures can be accessed with just a click. The other information for a patient like demographic data, appointments, scheduling, billing and other pertinent information can also be accessed from anywhere, be it home or office. This means that the information exchange between the various levels of heath care like labs, hospitals and imaging centre has become effortless and efficient, thus saving labour and a considerable reduction in hassle over billing. The patient is produced with an electronic bill which integrates all the levels into one paper slip.

MBC serving healthcare for over a decade across all states and specialities has also been assisting in EHR implementation providing vast term benefits to physician practices. Some key services MBC provides towards implementing EHR includes – choosing the right EHR for the hospital, mapping the process flow, figuring out the areas of the hospital which require support and helping the physician to set standards which can be achieved easily by using meaningful sources – thus helping physicians with the implementation of EHR, and also earning incentives and revenues.

As usage of EHR has positively revolutionised billing and operational system of a hospital, making it more organised and simpler, MBC in keeping with industry trends too have been providing consultancy and assistance EHR along with medical billing and coding services. With the help of our experts specialised in hospital billing services and vast knowledge acquired regarding the right EHR as per the organizational set up, Hospitals and Physicians can rest assured about their revenue management as they solely concentrate on providing health care to their patients.

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.

New Staffing Roles with New Reforms at Physician Clinics – Getting A Billing Service to Fill in The Gaps!

With the introduction of the Affordable Care Act, medical practices on one hand need to gear up for an influx of patients, while on the other hand according to a recent survey physician shortage has been intensifying. This shortage along with increasing demand for physicians and healthcare reforms has led to an expansion in the scope of work of the administrative staff, nurse practitioners and physician assistants. According to the latest job reports as per health care jobs network, although the most sought after job remains that of a physician, there is an increasing trend of employing more NPs, PAs and health IT professionals.

Recent healthcare reforms like HIPAA, EMR and ICD 10 certification essentially introduced to improve the efficiency of health care organisations, have brought with them new responsibilities for staff like increased reports, increased documentation, increased denials and follow ups. Consequently, providers are in continuous need of more professional staff to handle documentation and reports, rather than concentrate on their core activity which is providing patient health care services. At the end of the day, with insurance payers also increasingly denying claims there is a considerable loss of revenue for the practices.

Amidst the changes billing service partners can efficiently undertake responsibilities like -

• Billing, documentation, reimbursements, dealing with insurance payers, RCM management etc., hence allowing the in house staff to handle effectively administrative functions of the clinic. This division of labour increases efficiency of staff improves quality of patient care and also increases revenue

• Medical billing partners solely concentrating on medical billing functions can accurately take care of all the billing and documents at every stage, with regular quality checks, analysis and the usage of correct modifiers thus avoiding any coding errors, misunderstanding or inefficiency also reducing the number of denials the first time itself

A Medical billing partner can provide undivided attention needed for the finances of a clinic, against the in-house management of revenues. Hence, hiring a medical billing and coding service is practically forming a new finance department for a practice which concentrates completely on all the procedures like billing, documentations, handling denial and underpayments, insurance claims.

MBC’s medical billing services expertise in the field of billing and coding, besides being in line with all the latest updates and strategies followed in the market. Our expert team of medical billers and coders are certified and well trained in all the upcoming healthcare reform trends and work together to assist physicians to help deliver exceptional services, while taking care of their billing activities involving insurance payers and government entities. MBC’s has been providing billing services to physicians across all US 50 states for over a decade now and have proven results showing their accomplishments.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Service according to their preferences of specialty, city, software and services performed.

Managing Payer Denials, Cuts & Delays at Your Practice with a Medical Billing Service

An increasing cause of worry for almost every doctor in USA is payer denials and delays which invariably result in potential loss of revenue for the physicians. With the introduction of reimbursement cuts in medical bills, physicians and medical practitioners now face various payment challenges and a more uncertain future. Considering the increasing expenses acquired with the recent health reforms, it is important for physicians to receive payments on time, so as to cover their expenses and also be able to efficiently provide necessary services to their patients.

Conversely, as health insurers tighten eligibility requirement, filing claims have become more complicated and the chance of claims being denied have increased substantially, consequently claims are filed with high possibility of being denied, with increased providers struggling to balance patient care and billing. Industry standards state that high performing practices depicted denial rates are below 5%; while other practices denial rates were between 10%-20%, reducing denials by 5% can increase a practice’s revenue tremendously.

The current economic climate in healthcare is that of ambiguity and uncertainty. The economic cuts proposed under the Medicare system by Congress is leading to economic crunches have forced such doctors to carry on their medical practice at the cost of their personal assets. On an average, one third of the patients who come to a clinic are on Medicare, in addition private insurers who follow Medicare rates prove to be plummeting further. This situation makes it very difficult for an independent practice to survive and may even result in closing down of clinics along with causing shortage of medical resources.

Additionally various documentation issues like -  incorrect patient details, inaccurate coding, incomplete claims, lack of communication, submitting claims to wrong insurer or not following up due to lack of AR process can lead to claim delays and denials. In the face of these numerous challenges large numbers of physicians to increase their bottom line are turning towards the facility of medical billing service. Being specialists in their field medical billing companies provide a safe and secure way to overcome all these issue and guarantee timely payments.

Hence outsourcing the denial process successfully creates a unique and safe platform for doctors as well as medical institutes to manage their billing cycles, and also allows practitioners to concentrate on their responsibility of providing healthcare. Industry experts believe that up to 40% of the costs of payments to hospital and physicians can be saved by using medical billing companies.

Medicalbillersandcoders.com serving healthcare community for more than a decade now across all 50 US states provides the advantages of medical billing services by offering a dedicated and specialised team of experts who excel in the denial management, along with coding specialists who ensure correct coding of claims in compliance with HIPAA norms. MBC’s specific billing model uses planned billing software and methods which are fast and accurate so as to deploy claims within a short span of time with minimum possibility of errors.

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.