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Hospitalists as Primary Care Providers

March 14, 2012



In all the states of the US, healthcare is becoming an integrated affair with hospitals combining traditional healthcare services like surgical treatments with primary health care activities responsible for elementary requirements of a treatment cycle from blood tests to coordination of various activities within a treatment episode to ensure availability of all components of healthcare services under one roof, when seen in the larger context, and advantages like proper coordination between various components/phases of a care cycle and day-to-day patient care within the scope of a treatment episode.

Primary healthcare providers integrating with hospitals are, in a loose sense, family physicians, traditionally located outside the big organized healthcare space, relocating themselves to the sphere of hospital-provided healthcare system where they are called hospitalists. Albeit, the difference is hospitalists have to be more acquainted with sophisticated healthcare procedures to function in the environment of a big healthcare operator.

This practice of hospitals providing physician services (or integrating with hospitalists) is over a decade old in US healthcare which owes its survival to the fact that these services (or hospitalists) bring into conventional hospital treatment a combination of old-world healthcare values like individualized attention to patients and patient safety and new-age methods like proper coordination, documentation, etc., which have collectively been found to lead to improvement in quality of treatment and reduced costs.

However, primary care mostly deals with elderly patients suffering from ailments that require not a touch-and-go treatment but protracted care either through extended stays in hospitals or through recurrent readmissions. Because of their age bracket and the nature of their ailments mostly related to heart brain, lung, lever, etc., these patients account for majority of medical expenses billable to Medicare.

This being the nature of aliments primary healthcare mostly deals with, its involvement is not restricted to any one part of treatment but is spread like a grid across the treatment cycle, forming its basics starting from, if viewed from a financial viewpoint, registration to reimbursement.  And this leaves healthcare providers to handle financial administration activities that warrant a strong Revenue Cycle Management system, a process that covers the entire range of financial needs/activities resulting from initiation to termination of a treatment episode.

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Medical Billers and Coders, through its RCM consulting services, scrutinizes the areas of deficiencies in your Revenue Cycle Management, like outdated processes, software inadequacies, under-optimized   workforce, unidentified training needs, and helps detect the sources of revenue leakage and plugs them by streamlining your processes. As a result, a coherent RCM process helps healthcare organizations to prevent registration errors, lack of pre-verification of insurance coverage and facilitates an effective collection policy for insurance deductibles and co-pays, and an in-depth analysis of Account Receivables reports on a payer- patient-service basis. Additionally, it also prevents audits by detecting overpayment by Medicare and helping return it on time.

Medicalbillersandcoders.com brings these RCM benefits to its clients through a team of specialists with expertise and experience of dealing with healthcare providers for years combined with sound knowledge of changing trends and regulations operating in the US healthcare industry, resulting in saved cost and time for healthcare operators.

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Category : Practice Administration