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presentation

Seeking Possible Solution to Intensifying Medical Billing Documentation

February 01, 2012



“Beset with spiraling Medicare expenditure amidst a rather volatile economy, the Federal Government policy of linking physician reimbursement to quality outcomes will not only test physicians’ level of quality medical care, but also how they are going to document patient encounters. Therefore, physicians, required to furnish evidence-based healthcare documenting & reporting, will find hard to manage within the limited time and resources”.

Amidst healthcare reforms (both federal as well as provincial healthcare quality initiatives) –  linking physician reimbursements to quality outcomes, making Electronic Health Recording mandatory for availing incentives under ARRA, the possible compliance to Medicare Medical Billing norms, the documentation demand under Medicare’s Accountable Care Organization (ACO) model, and the last but not the least, the imminent ICD-10 and HIPAA 5010 transition – healthcare documenting is never going to be the same. While these healthcare reforms are objectively promulgated for ushering in clinical and operational efficiency, the level of transformation those physician offices need to cope up with can severely come in the way of the core-focus of medical services.

Beset with spiraling Medicare expenditure amidst a rather volatile economy, the Federal Government policy of linking physician reimbursement to quality outcomes will not only test physicians’ level of quality medical care, but also how they are going to document patient encounters. Therefore, physicians, required to furnish evidence-based reporting, will find hard to manage within the limited time and resources.

As Electronic Health Recording becomes mandatory, physicians may not be able to afford heavy capital investments associated with installing the requisite technology. But, as the EHR carries clinical and operational consequences – incentives for meeting and surpassing the benchmark as well as penalty for compliance – physicians will invariably have to outsource their EHR capability. Even then, amidst numerous service providers, their decision to decide upon competent provider will become crucial.

Further, Medicare, being revamped radically, physicians’ documentation for medical billing reimbursement is likely to be more detailed and exhaustive, resulting in complex medical billing procedures that can only be managed by competent medical billing houses. Invariably, physicians will have to allocate overheads for advisory from such medical billing houses. Although, the initial expenditure might seem high, yet, the associated returns will eventually outweigh the expenditure.

Above all, the imminent ICD-10 transition looming large, physicians’ medical coding is in for a major overhaul, prompting allocation of resources and time on an unprecedented scale. But, with internal competencies likely to fall short of the requisite ICD-10 benchmark, yet again, outsourcing could become a possible recourse, prompting judicious selection of competent service provider.

As physicians seek to safeguard clinical, operational, and revenue-generation interests, Medicalbillersandcoders.com tried, tested and proven credentials in medical billing management may well become indispensable. Its proven credentials in Revenue Cycle Management for clinical and operational excellence – complete with   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 – could proactively address the documentation challenges in the changing landscape.

 

Category : Best Billing and Coding Practices