It Is Worth Paying for Medical Billing Services Than Be Affected with Suspended Reimbursements

Affordable Care Act, along with a few other pro-beneficiary health care policies, may have helped rationalize cost of health care as well as cost of health care insurance across the broad spectrum – Medicare, Medicaid, and a variety of private insurance plans offered across the U.S. Beneficiaries could even benefit from lesser co-payment obligations and deductibles. However, it may not be said with any certainty that their woes with delay and denial would come to end. If the recent reactions are any indicators, medical practitioners may well see denials and A/R days going up more than they used to be earlier – there have already been instances wherein physicians’ reimbursements have been held up for as long as 60 days and even more. Just, imagine the kind of negative impact it could have had on their clinical and operational efficiency!

With health insurance premiums reaching lowest levels, payors have resorted to various contingency strategies – abandoning their services altogether, restructuring their portfolios, and of course withholding reimbursements till they are pursued aggressively by the medical practitioners concerned. While payors are within their right to safeguard their financial and business interests, medical practitioners could do better with Medical Billing Practices that are better tuned to expedite A/Rs before they become impossible to be follow-up and may even have to be written off as bad debts.

When it is obvious that such A/R delays will become more common in the coming days, medical practitioners would be left with no alternative but to spruce up their A/R management beyond the routine Medical Coding and Billing exercises. As soon as your bills cross the permissible time, your A/R management team should take over the process of finding out the reason for delay, following up with possible remedial measures, and expediting the process of realization. Operating under multi-payer reimbursement environment, you may have entered into contracts with Medicare, Medicaid, and a host of private health insurance agencies. Therefore, you A/R management team need necessarily have to be versatile enough to deal with multiple payors.

While your A/R Management team is doing what it is entrusted with, coding and billing efforts need to be equally supportive with accurate charge-capture, intricate procedure coding, electronic filing of claims, patient billing, multi-tiered appeal process, denial elimination initiatives, and compliance standards. Although every medical practitioner aspires to be equipped with as comprehensive a medical billing as possible, he may be limited by time and financial factors. Hence, you may be required outsource your entire process of medical billing from patient enrollment, scheduling insurance verification, insurance authorizations, scheduling and re-scheduling, coding, billing and reconciling of accounts, collections, AR collections, to denial management & appeals. One big advantage from outsourcing is that billing companies can be expected to deliver services at a price that is within your budgetary constraints. Moreover, they are invariably versatile enough to deal with complex medical billing issues. 

As you begin to preempt the possibility of undue delay of A/Rs with external billing mediation, Medicalbillersandcoders.com may just be the platform for complete, flexible, affordable, and more importantly tailor-made to the critical situation when your claims are likely to run the risk of being held up far in excess of admissible period of time.  Our credibility is essentially built around chosen billing affiliates (across the 50 states in the U.S.), who are versatile enough to monitor, follow-up, and expedite claim realization when you seem be giving up on your aging or withheld Account Receivables.

How Crucial are Cardiology Billing Specialists during Reporting and Following-Up Cardiology Medical Bills?

In the last few years, cardiology has had to manage with negligible fee increase while having to cope up with numerous coding and billing changes. While cardiologists may have seen an increase of 1 to 2 percent increase in Medicare’s fees, they have had put up with reduction in medical reimbursements beyond permissible limits. To a large extent, these practice-related medical reimbursements reductions could have been triggered by a series of relentless medical billing and coding changes that have seemingly been more challenging than ever before.

It all began around 2009 when codes for implanted devices were replaced with an entire set of new codes. Notable among such revolutionary codes were the ones that would be applied specifically to internet (remote) device checks, codes for devices with leads in 3 chambers, ICM device follow-up codes, and codes for per procedural checks. While this coding overhaul may have helped streamline Cardiology Billing, cardiologists’ medical billing has not been fully able to decipher them to their best advantage.

Quite parallel to these intermittent cardiology coding revisions, 30 and 90 day global periods too have been active for follow-up for certain devices. What is more, the new codes are specific to either an interrogation evaluation or a reprogramming evaluation without being inquisitive of the happening of reprogramming. It is quite possible that cardiology practices may have found cardiology coding and billing rather difficult.

Interestingly, wearable cardiac telemetry devices too have been assigned specific codes, and it is impossible to assign unlisted codes that previously could be applied with slight modification. Moreover, these wearable cardiac telemetry devices are equally susceptible to complication of global periods as in the case of certain other cardiac devices. Yet again, cardiologists’ medical billing and coding may have found this coding-specificity an unusual thing.

Not least of them all, bundling multiple procedures under a single has limited cardiologists’ ability to breakdown a larger service into smaller components. As a result, insurance payors can now insist on bundling an echo with both a Doppler and color flow and a stress flow into a single and comprehensive CPT code. While this may have reduced multiple coding and billing, it certainly has limited cardiologists’ ability to maximize revenues from breaking down larger services into smaller components.

While Cardiology Medical Billing has already been affected by these monumental changes, cardiologists may still face harder challenges during reporting and insurance follow-up under the ensuing ICD-10 billing and coding regime. With the possibility of coding specificity, bundling, and billing and coding restrictions getting magnified even more, cardiologists may well have look beyond conservative cardiology medical billing practices. Hence, cardiology medical coding and billing, integrated with enhanced coding compliance, electronic processes, and competent billing practices could help measure up to challenges in insurance reporting and follow-up.

Medicalbillersandcoders.com has verifiable success as a leading and progressive medical billing consortium, more so for cardiology billing. Our cardiology medical billing mediation has been backed with deployment of experienced, techno-savvy, and competent medical billing specialists. As a result cardiologists across the 50 states in the U.S. can look forward to engaging medical specialists who have evolved with cardiology medical billing challenges.

How to Prevent Shrinking Bottom-Line with Streamlined Cardiology Billing Process?

Cardiologists are reported to have been writing off a considerable chunk of medical bills that could otherwise have been realized if they had a more responsible cardiology medical billing in place. If the industry sources are to be believed, over 20 percent of claims are left unrealized. What is even more worrying is that Account Receivables too are languishing in the basket for more than 60 days! As a result, cardiologists bottom-line has constantly been sinking, making it hard to sustain effective and efficient cardiology services. While cardiology billing requirements may have more demanding, they are not something that cannot be overcome with streamlined Cardiology Billing Process. And, when we mean streamlined billing process, there ought to be an ideal integration of cardiology medical billing specialists, technologies, processes and RCM solutions aimed at bringing down revenues losses to negligible percentage.

• Educating Cardiology Billers
  
  Significant advances have been made in cardiology billing system in the recent, and it is possible that your cardiology medical billing staff may not be knowledgeable of current billing system. Hence, educating cardiology medical billing specialists with latest billing system is the primary step in streamlining cardiology billing process.
  
• Adapting to technologic advancements
  
  Second, you have the privileges of technologic advancements in cardiology coding and billing. It is remarkable how these technologic advancements have redefined cardiology billing – automation of routine tasks, and reminders when follow-ups are required; time management in resolving complex billing cases and denials; enabling collection improvement and reduction in A/R. Therefore, coding and billing software built on ASP model may possible accomplish such critical tasks.


• Improving processes
  Third, processes to ensure:
  
  
  • Claims are submitted the same day of charge entry is entered; applying payments fast: electronically for carriers with automatic reconciliation and, for others, using procedures optimized for each payer.
  • Filing secondary claims—with electronic EOB attached—on the same day payments are applied from the primary payer.
  • Queuing up denials and other payer responses to be followed up automatically by A/R team
  • Electronic monitoring of  patient and procedure data, eligibility, specifics of coverage, submitted claims, electronic adjudication of  claims, negotiation of electronic remittance, and automated posting to line items on the original claim submission
• Devising Revenue Cycle Management
  
  Last, Revenue Cycle Management integrated with complete revenue cycle process could go a long way in ensuring increased collections, minimize A/R days, and more importantly control and enhance clinical and operational efficiency.

This entire act of streamlining cardiology medical billing may require considerable time and resources. And cardiologists, who are already hit by revenue erosions, may be low in morale. That is why it is advisable to leverage with external billing companies that can transform or streamline your entire cardiology billing within your budgetary constraints. 

Medicalbillersandcoders.com has a credible history of sourcing and deploying medical billing resources within the budgetary constraints of diverse health care disciplines across the 50 states in the U.S. And, at time when streamlining cardiology medical billing is high on the minds of every cardiologist, we promise to leverage and streamline their cardiology coding, billing, and follow-up with our broad  resource-base, who are trained and acquainted with the most modern cardiology billing practices, systems, and processes.

Are Orthopedics Justified in Embracing HIPAA Compliant Orthopedic Billing to Boost Their Reimbursement

Reimbursements have generally been tight recently for orthopedics – Medicare cuts, shrinking fee schedules, increased technology intervention in medical billing, and a multi-payer environment that is more vigilant than ever have really made it tough for orthopedics to realize their reimbursements to the maximum. But amidst these monumental challenges, HIPAA compliant clinical and operational management may still offer avenues to keep reimbursements level above average. Thus, orthopedics across the U.S. are beginning to embrace technology-driven HIPAA compliant Orthopedic Billing to offset the impact of a series of restrictive impositions on medical billing.

The significant about HIPAA compliance is that it can not only endorse orthopedics as being responsive to patient privacy and security but also entitle them to incentives for showing up as responsible partners in effective and efficient health care delivery. Moreover, payors perceive HIPAA compliance to be yardstick for measuring orthopedics’ integrity for medical billing. Therefore, HIPAA compliant Orthopedic Medical Billing may just be the factor that can create a sense of trust among your payors. But HIPAA compliance needs to planned and executed in a way that best suits individual practitioners or hospitals; HIPAA compliance cannot be generalized even though you happen to be in the same discipline as orthopedics. The factors that will need to be taken care of while migrating to HIPAA compliant orthopedic medical billing are:

• Ensuring Protected Health Information (PHI) : HIPAA compliance requires you to protect health information, which may include anything that can be used to identify an individual and any information shared with other health care providers or clearinghouses in any media (digital, verbal, recorded voice, faxed, printed, or written).
  
  
• Adhering to Principles of HIPAA : While HIPAA may allow smooth flow of PHI for healthcare operations subject to patient’s consent, it is deemed violation of HIPAA compliance if you disseminate PHI for purposes other than treatment, payment, care quality assessment, competence review training, accreditation, insurance rating, auditing, and legal procedures
  
  
• Following HIPAA Implementation Process : HIPAA implementation need necessarily include both pre-emptive and retroactive controls and have process, technology, and personnel aspects.
  
• Sourcing right Technology for HIPAA Compliance : HIPAA compliance needs to be served with the right technology that can assure physical data center security, network security, and data security
  
  
• Being enabled role based access control (RBAC) : Because health care data under HIPAA compliance may accessed by multiple stakeholders across the clinical delivery system, it is important that data is made available based on Role Based Access Control (RBAC) to control the extent of data that may be shared with each of such stakeholders.

Because of interplay of these multiple factors in HIPAA compliant orthopedic clinical and medical billing operations, providers may have look beyond internal competence and outsource technology enabled HIPAA-compliant clinical and medical billing implementation. Medicalbillersandcoders.com offers to ease complexities during as critical an implementation as HIPAA compliant orthopedic medical billing. Our affiliation with experienced, competent, and credible orthopedic medical billing resources should provide the right choice of expertise to have your medical billing infused with HIPAA compliance standards.

Relevance of Outsourced Medical Billing as Hospitals’ Rely More on Technology to Elevate Patient Satisfaction

Patient satisfaction has always been the yardstick for operational success, and hospitals have tried out novel ways to keep patient experience enriched. While physicians’ skills have primarily been pivotal, technology too has helped considerably. And, technology has begun to be so significant that hospitals seem to have accepted them to indispensable in enhancing overall patient satisfaction, comply with evolving industry regulations, and being competitively ahead. As growing number of hospitals across the U.S. are beginning to embrace technology to elevate patient satisfaction, they are realizing the need to integrate clinical activities with medical billing activities to arrive at mutually beneficial equation – patient satisfaction that promotes practice revenues. Therefore, they may have to leverage with outsourced hospital medical billing that are integrated with clinical and operational features.

When confronted with the question of finding technology that is clinically and operationally dependable, integrated Electronic Health Record (EHR) systems come to be recognized as the most reliable technology platforms. EHR systems integrated with Practice Management Systems (PMS), Clinical Decision Support Systems, and Patient Communication Network Systems can create both clinical and practice efficiencies, and promote opportunities for enhanced patient access to data and patient engagement. The combined impact of these features may significantly improve patient satisfaction as:

• Patients perceive them to be part of improved care system: Experience has shown that patients value doctors who are progressively tech-savvy. It is interesting to note that around 75 percent of U.S. population associate technology-inclusion with better care.
  
• It would enable convenient access to scheduling and communication through patient portals; patients would appreciate the ease and convenience of online tools that allow them to schedule appointments, request for appointments, ask questions, and more.
  
• There would be swift prescriptions with eRx; patients will benefit from the efficiencies created by e-prescribing capabilities within the EHR. With e-prescribing, a prescription is sent to the pharmacy as soon as the provider prescribes it, which means patients can avail their medications faster. E-prescribing also eliminates the need for patients carry and present paper prescription.
  
• EHR solutions offer the capability to automate email appointment reminders, which will help patients remember their appointments and show up on time.
  
  There would be enhanced clinical efficiency; clinical decision support tools and clinical protocol compliance tracking tools within EHR systems can help providers enhance the care they deliver to patients.
  
• Last, but most significant, robust EHR system can make medical billing and coding accurate and compliant with coding and billing conventions, thereby enabling hospitals show up as Meaningful Compliant with HIPAA practices and maximize reimbursements from Medicare, Medicaid, and commercial health insurance payors.

For a considerable segment of hospitals that are yet to migrate to full-pledged technology-defined clinical care delivery, it might seem a daunting task. Thus, they may have been drive to outsource medical billing services integrated with EHR platforms. Medicalbillersandcoders.com offers them the right window for sourcing resources (medical billers and coders) that are skillful, tech-savvy, and versatile enough to balance hospitals’ primary concern of patient satisfaction and operational success.