July 16, 2014
MedicalBillersandCoders.com has identified some basic healthcare concerns that will govern decision-making and policies in the year 2014. Some of the most prominent challenges that healthcare practitioners face today can be listed as follows.
1. Billing Errors: With the advent of technology and electronic billing, the risk of manual errors has been greatly minimized, but the probability of committing errors related to coding still exists. These errors lead to delays in payments, non-reimbursements and even strained relationships with patients or insurance companies. Unless we have dedicated organizations who take utmost care in managing and delivering data, we shall continue to be affected by errors that can easily be avoided.
2. Staying Up to Date with Coding: A major part of ensuring a smooth revenue cycle for any healthcare facility is its billing process. With the government implementing changes and updates in the codes frequently, we believe staying up to date with latest coding and terminologies is the key. For institutions that have not outsourced their billing process, training the staff continually and updating the software becomes a challenge as it takes its toll on the core areas of a hospital which is more medical in nature than administrative.
3. ICD 10: As the implementation of ICD 10 codes were to happen in October 2014, medical billers would have had to add about 57,000 new codes to the practice. These, along with another set of 85,000 procedural codes would transform this industry.
4. Collaborations: Many healthcare giants are collaborating to consolidate their billing and coding needs. This may lead to a monopoly like situation where small players will be uprooted or will remain outdated in their approach.
5. Adoption of EMR (Electronic Medical Services) debate: As codes and software become more and more complex, there is a parallel debate on whether dependence on paper billing or other traditional methods is now a thing of the past. Early adoption of EMR can iron out a lot of gaps that may eventually lead to delayed reimbursements, etc.
6. Population Increase: Every year the burden on medical facilities is only increasing. With inclusion of patients above the age of 65 in the insurance cover, there is a new age bracket of patients that doctors and hospitals need to attend to. These are new developments and thus remain areas for concerns.
7. Diseases: With advancements in economy and better living come greater problems like new diseases, allergies and health threats. It is thus important for all concerned in this industry to keep abreast with new disorders and diseases in order to update technology with the latest medical techniques and tests that may be required to deal with upcoming medical problems. One needs to account for these changes so as to not let the payment process suffer.
8. Revised CMS 1500 Form: CMS’ newest form that accounts for new codes under ICD 10 guidelines is something that needs to be understood fast.
9. CPT Code Changes: With the AMA announcing a plethora of coding changes; it has become virtually cumbersome to still rely on manual coding. Time has come to adopt technology which eases out pressures on medical professionals. Frequent changes in this regard need an expert to stay abreast with it.
10. Data Documentation: The on-going threat to lower reimbursements and non-payments contributes to the fact that data is not been given its due importance. Unless a healthcare facility realizes that documentation of every data is crucial to their core business, nothing can be expected in the smooth functioning of a revenue cycle.
MedicalBillersandCoders.com has their eye set on adopting the above methods to bring efficiency to your systems. We are working round the clock to ensure that a hospital doesn’t lose out on revenues due to non awareness of critical issues affecting this cycle.