The Value of Accurate Documentation in Medical Bill Reimbursement

Medical documentation has myriad applications in today’s health care administration – being reference-source for future encounters; enabling coordinated care, both within and across the clinical network; contributing to macro health care planning and reforms; ensuring clinical data privacy and security as per HIPAA norms; and ensuring flawless medical billing. Notwithstanding providers’ effort to document as best as they can, “accuracy” continues to be a matter of great concern. While inaccuracies in medical documentation can lead to lapse in medical care quality and breach of trust, it is the reimbursement that will be most affected.

Every reimbursement starts with medical billing, which is calculating the cost of administering medical services. Clinical documentation – which contains physicians’ narration of entire course of medical management – is the source on which billers rely upon in assigning monetary value to medical services. Because most of the physician documentation is supposed to be true, medical billing is as good as your clinical documentation. But, physicians, with all their good intention and focus, may not always be expected to document without omission or error. And any omission or error may either correspondingly reduce reimbursement or expose your bills to chances of denial or delay.

One way to do away with omission or error is to encourage doctors to check back on every chart before they move on to the next patient. But doctors are seemingly busy, and may not wish to keep the next patient waiting or compromise on clinical priorities. In such cases, internal staff may be assigned with the job of elaborating the doctor’s notes into comprehensive charge sheets or case summary. Training and orienting the so deputed staff is crucial before they take over the charge and start feeding medical billers with charge notes.

Clinical documentation has undergone remarkable changes recently – paper-based charts have given way to automated documentation. Medical practitioners are lot happier with pace and ease with which modern-day systems can generate voluminous reports that can easily be exchange across the health care network system. But, automated documentation is also inherent with investment, implementation, and training issues. Moreover, patient security and privacy may be at a higher risk from hacking concerns. All these issues may prompt the intervention of competent medical billing service providers who know how to upgrade providers’ internal clinical documentation in sync with medical billing and coding.

Medicalbillersandcoders.com – known for its catalytic role in clinical and operational management of a majority of medical practices across the 50 states – is prepared for the next challenge: changing face of clinical documentation in ICD-10 and HIPAA 5010. With the entire provider-fraternity transiting to a more robust, comprehensive, and technology-driven clinical documentation environment, it hopes to own up the responsibility of transformation. It is well-served by its core group, comprising clinical documentation specialist, expert medical billers and coders, and strategic partnership with best-known vendors of automated documentation systems. The fact that it has already executed documentation upgrading as part of its comprehensive RCM services is a testimony to its credential and competence.

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.

Small Medical Practices Register Meteoric Rise in EHR Adoption

It seems solo and small medical practices have decided to take the plunge in a big way – recent statistics reveal that small practices have been able to half-bridge the gap with their larger cousins, whose EHR penetration stands at an impressive 80% since the EHR became mandatory under “Meaningful Use Clause” in 2011.

Remarkably, the growth of around 40% has come about all of sudden – not so long ago, small medical practices had a single-digit adoption rate. What is even more interesting is that larger practices could add only 5% to their growth during this momentous rise by smaller medical practices. Within small practices, practices with less than two physicians are relatively ahead of practices with 6 to 10 physicians. Penetration of this scale could not have come about without valid reasons.

Many believe the government's incentive program and funding of the regional extension centers – which are helping to train smaller practices – to have helped boost small practitioners’ confidence. Credit should also to go EHR vendors, who seem to have shifted their focus to smaller segments. These two factors may have helped small practitioners’ overcome cost, training, and implementation inhibitions.

There has also been considerable improvisation in EHR technology – technology is becoming more portable, less expensive, customized, easier to operate and maintain. Small practices now have choices as against standardized versions initially. This may have considerably influenced their decision in favor of EHR adoption.

Significantly, hosting has become unbelievable easy – small practices can now rely on cloud-based EHRs, which essentially help doing away with all those difficulties associated with Onsite hosting. Moreover, small practices have begun forming pools as a means to optimize the investment on EHR hosting – a remote hosting facility is entrusted with the task of hosting the entire pool’s customized EHRs. The advantage of this form of hosting is that small practices are saved from investing individually on hosting infrastructure facility. This too may have hastened the decision on EHR implementation.

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Above all, small practices seem to have been convinced of EHRs ability to dramatically improve clinical and operational functions. News of EHR’s catalytic effect on large practices’ revenues must have been a great motivator.

Despite all these positives, small practices’ EHR implementation has not been all that easy – there have been challenges in terms of deciding on proper vendors, training internal staff, resource mobilization, and integrating with external clinical and operational network. While they deserve to be applauded for their commendable progress, the remaining portion may well face similar roadblocks. Medical billing service providers, being the vital cog in the EHR adoption, will have a huge role to play in helping the rest of the small practitioners to make right decisions on vendor, training internal staff, resource mobilization, and integrating with external clinical and operational network.

Medicalbillersandcoders.com – which is a leading consortium for mediating the entire range of medical billing services – has already begun its catalytic effect on small practices’ EHR implementation. It is distinguished by extensive knowledge of medical billing domain, strategic partnership with EHR manufacturers and vendors, and payers. While small practices in few states may already have felt its catalytic advantage, Medicalbillersandcoders.com – with resource mobilization to rest of the 50 states – hopes to bring about complete EHR compliance.

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.

It Pays To Be a Medical Billing and Coding Specialist

Choice of a profession is determined by its stability against job market fluctuation, potential growth and monetary rewards. Medical billing and coding profession seem to be one those few professions that possess all these attributes. While professionals in other spheres are fighting lay-offs and salary cuts, medical billers and coders’ present and future looks highly secure. And it pays to be a medical billing and coding profession!

The primary reason behind this optimism is that care providers’ reliance on medical billers and coders will increase further. As the recent reform foretell major overhaul in coding and billing practices, providers may see it worthwhile to entrust an activity that is not their specialty. This shift in strategy could further increase the demand for qualified and competent medical billers and coders. It is worth remembering the U.S. Bureau of Labor Statistics (BLS) reports, which forecast a 20% growth in demand for medical and billing professionals between 2008 and 2018.

Second, the payback time for a medical billing and coding specialist is faster – it takes less than a year to complete a formal training, or about a year-and-a-half for an associate degree.  Therefore, you can expect to be industry-ready or certified professional within your budget. Moreover, with certainty of being employed in a secure and stable profession, you can easily recoup your investment in few months.

Third, training and education is unbelievably convenient – online medical billing and coding degree and diploma programs have virtually removed barriers of time and place. All you need to do is to select a credible source of training and education based your specialization. With so much convenience around, you should save considerable amount of time and money that would otherwise be spent conventional mode of training and education.

Fourth, medical billing and coding profession is not physically exhausting – most of your work is conducted through a computer, and it usually involves helping out your physicians and patient to avail the best possible medical reimbursements. Therefore, medical billers and coders are better off when compared with other healthcare personnel who usually work long hours and are required to move patients, stand or walk for long periods of time, clean up after patients and so on.

More importantly, profession in medical and billing offers flexibility to schedule your work hours based on your convenience. As providers are more inclined to outsource medical billing and coding from external consultants, there is an upsurge in home-based billers and coders, who seem more than pleased with the prospect of operating from the comfort of their homes, having a perfect balance between their personal and professional lives.

Medicalbillersandcoders.com – which has successfully orchestrated training and placement of a majority of medical billers and coders across 50 states – hopes to play a bigger catalytic role. Its core team of expert billers and coders, affinity with leading knowledge sources, and partnership with prospective employers will essentially be responsible for providing aspirants with a jump start to their career in medical and coding.

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.

Life as Medical Billers & Coders in Today’s Economy

The world’s largest economy has had to weather one of the worst recessions in the recent times. Not too long ago U.S. GDP hit the rock-bottom (at -8.9 in the middle of 2009). While it has slowly been coming out of the depths, the growth is not enough to bring down unemployment rate, which is hovering around 7.9% as of October, 2012. While most of the service sectors seem to have been affected uniformly, health care sector has remained an exception. And, medical billers and coders, being integral to health care industry, too have benefited from this. While, they have not been totally immune to lay-offs or salary cuts, at least percentage wise they are the least affected, with only 3-4% of the certified billers and coders being unable to find jobs.

The reason why medical billers & coders are least affected is health care is something indispensible – whether a positive GDP or negative, health care spending continues as usual, and providers’ reliance on billers and coders remains unaffected. The 3-4% unemployment is largely because of those billers losing jobs on account of being tied with lone-standing or small practices who may have decided to wind up operations. Otherwise, qualified and experienced professionals continue their lucrative association with clinics, hospitals, and group practices.

Being in a protective industry has surely helped them to be immune to the impact of the current economic scenario. But what is truly remarkable is the kind of flexibility and adaptation that these professionals exhibit in coping with adverse conditions.

What primarily stands out is their commitment to remain as competent as ever. Employers are increasingly growing quality conscious, and medical billers and coders are required to be as seamless as possible. Billers and coders are proving their mettle by undergoing refresher courses that keep them abreast with latest developments.

Networking with peers too is proving to be ingenious way to getting employed or reemployed. As per reliable statistics, over 38% of aspirants and professionals are known have followed networking as a means of finding employment opportunities.

Some professionals devised work-hour adjustment to adapt to these testing times. It is believed that currently there are two categories of professionals – one working an average of 31 to 40 hours per week, the other devoting an average of 41 to 71 hours per week. The former accounts for nearly 38% of the total medical billers and coders, and the latter constitutes 58% of the total medical billers and coders. Together, they have found a way out to remain active without being unemployed or unpaid.

There have also been instances of medical billers exhibiting extraordinary capacity for excellence, which have been suitable rewarded with health insurance & dental insurance through employer, sick leave from employer, and prompt benefits & incentives.

Therefore, it is apt to say that medical billers and coders have not been comforting under health care security, but responding creatively to evolving economic conditions. As a result, they have been able to remain least affected in terms of being unemployed or unpaid. It seems brighter days are ahead of them. In fact, The Bureau of Labor Statistics (BLS) reports that medical billing and coding will grow by 20% between 2008 and 2018, which is enough incentive for billers and coders to remain focused and optimistic.

Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – being a leading platform for provider-biller interface – is committed to help billers and coders maneuver through these testing times. Over the years, we have helped a majority of professionals connect with their true calling across 50 states in the US.  And, as we enter into a time of great transition, we are even more focused on facilitating right employee-employer connection, enriching professional experience, and more importantly promoting service excellence.

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.

Forecasting the Future of Medical Billing and Coding Post ICD-10

United States is on the verge of a major billing and coding reform – the introduction of ICD-10 in particular marks the beginning of the most robust, effective and efficient system of billing and coding ever to have been followed. While providers and payers will benefit from progressive changes, medical billers and coders will have the onus of keeping their expertise renewed from time to time. One of the best ways to be ready for future challenges is through preparedness based on forecast for a certain milestone period. 2020 happens to be that immediate milestone period.

Medical billing and coding will have undergone considerably sophistication by 2020. Amongst a number changes to impact billers and coders, following happen to be on top of the agenda:

• Progressive coding specificity
• Billing automation
• Career requirements

ICD-10 currently has 70,000 odd codes. And, given the progressive nature of ICD-10 coding system, it may have added a few more by 2020. All this extension means that coders will have to be conversant of codes as and when they added. Therefore, coders need to have access to such information from reliable sources.

Billing automation is another area that billers and coders need to watch out for. It is expected that the industry will have reached maximum automated billing and coding by 2020; paper medium will more or less have lost its edge. Therefore, professionals should continually seek upgrading their knowledge on billing and coding software. More importantly, they would be required to mediate EHR practices between providers and payers. Their employability will primarily decided by their technical competence.

While career opportunities will have risen considerable by 2O10, the skill-level too will have grown equally demanding. Among other professional traits, billers and coders ability to promote patients’ privacy and safety through confidential clinical documentation will have received utmost prominence. Therefore, it is crucial that aspiring professionals keep on conforming to evolving privacy and safety rules under HIPAA 5010. These fundamental requirements should not seem difficult given the prospects of rewarding career – The U.S. Bureau of Labor Statistics expects the growth to be around 16% till 2020, with an entry level salary of $35,010.

Billers and coders will continue to have a bright and promising future well beyond 2020. Even though technology will take-over manual operations, billers and coders’ personal touch will still be indispensable to efficient and effective medical billing management. This is precisely the reason to believe that they will have a secure future despite the accompanying challenges. Therefore, professionals should continue to be optimistic of the future.

As medical billers and coders look forward to a future of hope, Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – the largest platform for career aspiration in medical billing and coding – is committed to help them navigate to successful career paths. While our core team of expert billers and coders helps improve your competence, our extensive network with employers facilitates compatible placement.

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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.