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Rural Hospitals Surviving Healthcare Reforms with a Billing Specialist

October 04, 2013



In many ways, healthcare reforms have opened doors of opportunities for rural hospitals but the changes in healthcare system have also imposed certain challenges. Rural hospitals are not just facing pressure due to rise in cost of care but reduction in reimbursements has also increased their trouble.

Challenges affecting rural hospitals:

  • Payment from government is declining as rural hospitals are small in size, having modest financial reserves. Majority of patients coming to these hospitals are Medicare patients, typically older and sicker compared to their urban counterparts
  • Amidst financial challenges, reforms have forced rural hospitals to comply with various regulatory requirements such as ICD-10 and HIPAA
  • Hospitals are finding it difficult to provide quality care through aging equipment and there is no money to implement EHR technology, which makes them lose out on incentives
  • Rural hospitals don’t get trained staff, including billers and coders as not many show interest in moving to a rural area. Lack of financial reserves and delayed reimbursements make it difficult to retain them for a long time
  • Lack of skilled staff results in coding and billing errors, which leads to delayed or no payment
  • Due to lack of finance, rural hospitals are at times unable to buy expensive IT and train the staff on how to use new technology  

Why is outsourcing- a cost-effective solution?

Considering the financial, operational and regulatory challenges posed by healthcare reforms, the trend of outsourcing billing and coding services to a billing partner has become a popular trend among rural hospitals.

Since a team of skilled billers and coders focus on error-free coding and billing, filing claims, following up with insurance companies, documentation and other administrative functions, rural hospitals don’t have to worry about hiring or retaining staff for such tasks. Effective coding and billing results in reduced claim denials, leading to timely reimbursements.

Timely payments strengthen the financial reserves of rural hospitals, which can be used for buying better equipment for quality care. As the outsourced team handles major tasks, hospitals get ample time to concentrate on patient care.

By outsourcing billing services, rural hospitals don’t need to invest in latest health IT (computer software or hardware) as the assigned billing team will be updated and trained to use the latest billing software at their end. Billing partner will work as per the latest reforms and help the hospital with HIPAA, ICD-10 and other compliance.

The cost incurred in hiring staff, buying software, conducting training sessions and managing other administrative functions at the hospital would be any day higher than hiring a billing partner.  Outsourced hospital billing and coding services offered by Medicalbillersandcoders.com, the largest consortium of billers and coders in the US, have helped medical practices improve their finances. The team at MBC is licensed and trained in accurate claim development, timely follow-up, unique, error-free procedure coding, documentation and electronic filing. While we fulfil your reform requirements, you can concentrate on provision of quality patient care.

 

Category : Revenue Cycle Management