Revenue Management & Being Vigilant amidst the impending Medicare backlash

“Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their medical billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix.”

Dispelling all the speculation of a permanent solution to the impending Sustainable Growth Rate (SGR) fix, the Federal Government has deferred Medicare cuts till 2013, and with that it is pretty sure that the issue will meander for another year or so. Despite its possible impact on the Federal Budget, the Federal Government seems to be in no mood to stir hornet’s nest as it could possibly have demoralized physicians’ morale and motivation, resulting in deterioration of the quality of medical services – which remains the uttermost concern – across the nation’s healthcare industry.

Strangely, the Sustainable Growth Rate (SGR), which was promulgated to limit the Medicare expenditure within the permissible limit, has contributed to an alarming escalation of Medicare expenditure, which now stands cumulatively at 27.4%. The Federal Government, in a desperate attempt to keep the figure from swelling further, is diverting $11.6 billion from the Patient Protection and Affordable Care Act, including $5 billion from the prevention fund, and $2.5 billion from Medicaid funds earmarked for Louisiana. Although physicians can heave a temporary sigh of relief for having escaped the backlash of Medicare cuts, they would always carry the apprehension of the impending possibility.

Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their medical billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix. When you consider the ominous task of being vigilant with medical billing practices along with the imminent healthcare reforms – mandatory EHR implementation, Accountable Care Organization (ACO) model, ICD-10 and HIPAA 5010 compliant coding & reporting amongst others – it is sure going to tell on the physicians’ ability to keep their quality of medical services unblemished.

Therefore, amidst all these realignments, outsourcing the medical billing Revenue Cycle Management (RCM) from credible and competent vendors seems to be more viable. Apart from easing the possible workload on physicians, the outsourced model of medical billing Revenue Cycle Management (RCM) can prove financially vindicated as it can offer the advantages of voluminous operations from being source to many medical practices, clinics, and multi-specialty hospitals.

But, like in case of decision involving trusting the credentials of a vendor, physicians need to be doubly sure of their service providers’ integrity so as to avoid falling prey to unscrupulous intentions.

Medicalbillersandcoders.com – the largest consortium of medical billing services with over a decade of proven credibility and competence – has become a premier source of medical billing and operational management solutions for a majority of medical practices across the length and breadth of the U.S. Compliant with the best practices in the industry, its medical billing solutions – being ICD and HIPAA compliant, processed on the latest automated EHR platform – traverse the comprehensive Revenue Cycle Management – comprising 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, AR Management, and Financial Management Reporting – is built for clinical, operational and revenue augmentation.

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