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presentation

Impact of Hospitalist Billing Workload on the Quality and Efficiency of Care

February 13, 2015



Hospitalists face challenges in delivering quality care because they are always under pressure to maximize productivity. Due to increased workload, they have to work for longer hours and make quick clinical decisions. All these factors impact their work - life balance and also take a toll on their patients. According to recent findings, patients being treated by hospitalists (responsible for more than 15 patients at a time) experienced a high cost of care and longer length of stay in an inpatient setting.

  • According to a 2013 issue of JAMA Internal Medicine, many hospitalists blame increased workload for delayed admission and discharges, inability to answer patient treatment questions and unnecessary testing and treatment

The workload impacts the quality of patient care adversely. It has been observed that a patient’s length of stay in the hospital increases proportionally to the physician’s workload. This is more common when the hospital has an occupancy rate of less than 75%.

Challenges Faced by Hospitalists

The hospitalists are facing financial pressures due to various reasons including the implementation of Affordable Care Act (ACA), rise in the healthcare costs and tightening of the governmental budgets. They are constantly under pressure to boost productivity for compensating the declining revenue. They have to work harder in order to meet the operational demands of their practices and the policy changes such as reduced number of primary care physicians (PCP) in the hospital, specialty co-management and limited resident work hours.

How can Hospitalists Handle Billing Workload?

Billing challenges have increased for hospitalists as they are attending more patients due to the ACA. Considering their workload, it has become important for them to streamline their finances and get paid for all the rendered services.

According to the industry experts, hospitalists perform more than what is reflected in the documentation; however, they cannot bill for everything they do. They usually avoid excessive billing practices to avoid Medicare audits. These medical professionals also need to undergo a coding audit once a year to tackle under-coding and over-coding issues.

Hospitalists need to focus on documentation because if it is not at par, the hospital can experience decrease in reimbursements, loss of revenue, Medicare audits for non-compliance of healthcare reforms and reduced quality and efficiency of patient care.

Can Outsourcing help Ensure Timely Revenue?

Hospitalist workload impacts the medical billing procedure because providers are left with less or absolutely no time to focus on documentation. To ensure a steady flow of income, many providers choose to outsource hospitalist billing services. A dedicated team of coding and billing experts manage the AR for hospitalists, capturing denials and reporting the EoB (explanation of benefits) information in an accurate manner.

Outsourcing hospitalist billing services to a reliable vendor such as MedicalBillersandCoders.com assures timely claims submissions and regular AR follow-ups with insurance companies. Experienced and certified coders ensure error-free coding of all services performed by the hospitalists. MBC also offers effective denial management and streamlines claims appeals. From error-free coding and timely claims submission to denial management and compliance to healthcare reforms, every single aspect of hospitalist medical billing is handled efficiently.

 

Category : Practice Administration