September 02, 2013
The US health care system has undergone major reforms in the last few years. This includes adoption of new healthcare IT reforms such as EHR (Electronic Health Records) and EMR (Electronic Medical Records). It has also changed the way physicians are reimbursed. The cuts imposed on Medicare leaves doctors with reduced revenue resulting in negative financial repercussions for physicians, clinics, hospitals and patients alike.
One of the major problems that health providers face is the overhead maintenance tasks which account for about 40% of the revenue earned. The transformation from ICD-9 codes to ICD-10 codes is going to impact the finances and the cash flow of hospitals, clinics, and physicians temporarily because of the involved complexity and increased error chances. Moreover, HIPAA guidelines will also require to be given high importance; as information would be transmitted to various entities using the internet.
Healthcare providers need to ensure that the third party vendors are fully conversant with HIPAA privacy laws, and their staff follows all the HIPAA compliance procedures. This would ensure that HIPAA guidelines are not compromised even by mistake and they do not have to bear the financial brunt of breaking such regulations.
Increased claim denials faced by physicians and health care professionals
Medical claim denials have increased because technology is able to detect the slightest of errors in claims which might happen due to registration inaccuracies, incorrect diagnosis code; insufficient authorization coupled or may be coupled with common causes such as non-eligibility for insurance and so on. Much labor and time is wasted on maintaining these record overheads of rejected claims.
To provide effective claim filing, we need to have pre-filled templates, automatic drop codes to speed up the billing process and increase productivity. Correct medical coding can greatly help reduce the number of rejected claims and avoid unnecessary government intervention. Successful Revenue cycle management can be done much more effectively with a dedicated and professional team of medical billers and coders rather than hiring an in-house assistant.
How outsourcing can help increase profitability?
In an outsourced facility, billing experts routinely streamline all payer contracts and update them as per industry standards. This is done to improve pay backs and reduce denials. Translating medical documentation into industry-standard medical codes need to be done very meticulously to avoid any errors. This drastically reduces the burden of correct billing leading to a decrease in denials and improved paybacks. Getting partial / full-time support for billing requirements can help healthcare providers in cutting costs and also frees up the medical staff to focus on core issues of patient care and research.
Medicalbillersandcoders.com is the largest consortium of medical billers across all the states of the USA. It offers an exhaustive medical billing process which is always updated with current industry trends and works in line with new innovative payment models. Our billing experts have more than a decade of industry knowledge and are regularly updated with new codes and various regulations. MBC offers end to end medical billing services right from patient verification, denial management with follow ups. The services are aimed to reduce your operating and maintenance costs, hence in turn increase revenue.
Revenue Cycle Management