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presentation

Countering the phenomenon of Physician Shortage: Medical Reimbursements

March 15, 2012



“Consequently, physician reimbursements would largely depend on their ability to seamlessly process medical claims with either Medicare or private insurance carriers. But, with the reimbursement environment promising to be more vigilant and stringent than ever, physicians would find their medical billing competencies invariably short of the requisite persistence.”

Physician shortage has been one of the major issues that have been plaguing the U.S. healthcare industry.  Significantly, twenty two states and 17 medical specialties have already felt the dearth of physicians. While the aging physician community and the lack of reserve pool of physicians may well have been the primary reason, it is also true that the aging patient base and an unprecedented population growth have contributed to the growing chasm. And when you consider the influx of an estimated 40 to 50 million people who were previously uninsured and the baby boomer generation now becoming eligible for Medicare, the issue is only going to be worse.

But, healthcare being one of the priority sectors and health of millions of Americans at stake, Federal Government is looking at policy changes that would make healthcare practices attractive to professionals. As Family practice, internal medicine, and geriatric specialists form the priority disciplines, a lot of stimulus is being given to physicians showing inclination to these specialties. Physicians, who used to take such disciplines as a societal cause, are now being made eligible for incentives. Apart from this priority-based stimulus, the Federal Government is also looking at correcting the regional imbalance, where in physicians from higher density regions are being wooed to regions that are acutely short on physicians.

Quite parallel to policy measures, the qualitative measures like mandatory EHR compliance – seen as augmenter of fast and efficient clinical and operational management – would pave the way for accelerating medical care. The penalty or incentive factor associated with EHR non-compliance or compliance is seen as qualitative measure for enhancing the scope of clinical reach to an ever-growing patient base. Then, you have the Accountable Care Organization (ACO) model, which would eventual ensure streamlined healthcare dispensation for a population that has grown disproportionately to the physician numbers.

While these qualitative measures by the Federal Government would invariably increase practice opportunities and revenue prospects for physicians across the U.S., there is also going to be unprecedented incidence of medical insurance reimbursements as most of the medical related expenditure is invariably met by health insurance schemes – either State sponsored Medicare or Medicaid, or private health insurance schemes sponsored by private insurance players. Consequently, physician reimbursements would largely depend on their ability to seamlessly process medical claims with either Medicare or private insurance carriers. But, with the reimbursement environment promising to be more vigilant and stringent than ever, physicians would find their medical billing competencies invariably short of the requisite persistence.

And, when physicians face up to such challenging medical billing  environment,  outsourced medical billing services would eventually become indispensable. Medicalbillersandcoders.com, whose medical billing Revenue Cycle Management is capable of ensuring both qualitative and qualitative dispensation, should prove to an ideal recourse. Its comprehensive medical billing 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 designed for augmenting revenue generation while also keeping medical efficiency enhanced perpetually.

 

Category : Revenue Cycle Management