How Streamlined Medical Billing Helps Deal with Pay-for-Performance Challenges

Due to variations in health plans, physician performance and rise in healthcare costs, a significant number of practices in the US are implementing pay-for-performance incentive program. P4P started in the private sector but due to growing popularity it crossed over to the public sector as well.

Browse All: Medical Billing Services

As a tool to improve quality of care, this program has the potential to benefit providers; however, there are certain challenges related to P4P that can cause trouble for practices.

• This medical billing companies model has increased pressure on the workforce, leading to healthcare attrition. Since the focus has shifted on provision of value and derivation of customer satisfaction, staff at medical practices is finding it difficult to understand and implement their KRAs and duties
• Providers will have to bring variation in their practice to become eligible for this program. Medical safety practice will have to be promoted to reduce errors and chronically-ill patients will have to be given best care to reap benefits of P4P
• Hospitals will have to ensure that there are no complaints in terms of patient stays and emergency room visits. Only when the care co-ordination between office, home and hospital for chronic disease patients is of good quality, a practice or hospital will become eligible for P4P
• Providers will have to spend money on buying the latest health IT for treatment of Medicare patients who are chronically-ill as this is also a criteria for getting rewards under P4P
• Time and money will have to spent to make sure that the patients coming to your clinic or hospital are well-informed and powered

All the above mentioned tasks will have to be performed by providers if they want to reap the benefits of pay-for-performance program. In case you are planning to stay out of P4P you will end up losing out on market share as well as patients.

There is no doubt that pay-for-performance has several advantages but in order to become eligible for P4P rewards, practices need to streamline medical billing and get paid on time. Fulfilling the requirements for P4P can become daunting if your practice is facing revenue loss and claim denial issues. Only when the cash flow is smooth, providers can focus on enhancing quality of care and other requirements to get paid under P4P.

Considering the lack of time, money and resources, an unorganized billing department can reduce your chances of implementing pay-for-performance in your practice. Therefore, seeking help from a billing company can work wonders for you in terms of minimizing claim denials and maximizing revenue collection.

Medicalbillersandcoders.com is helping physicians across 50 states in the US with effective AR management and billing services to help them reap benefits of P4P program. Our team of well-trained coders and billers make use of the latest technology to ensure your practice gets paid on time for all the services offered. We can also assist you in training your employee for P4P and help you improve your in-house practices.

---

Published By - Medical Billers and Coders
Published Date - Feb-07-2014 Back