As the United States was ignoring the health reform during the 1990's Clinton administration, various health practices faced complex issues regarding rules and regulations to secure payment for their work. The tradition fee-for-service practice started diminishing and was replaced by various reasons why the physician payment was denied. Providers felt that managed care plans and major payers are making it difficult for physicians to collect their bills for the services rendered.
Through that decade, the revenue of the physician depended upon the combination of older billing technology and a huge billing staff that were trained to handle simpler times and reimbursements rules. Operating in the 21st century, difficult contractual arrangements, the increasing number of denials and the need to follow up made health groups to hire more staff which not only increased the cost, but also the reimbursement came under a downward pressure.
More than a decade passed and there are more rules and regulations coming in, making the resources and durable technology to protect the physicians from underpayment and denials which in turn increase the business cost. In an attempt to fight the reimbursement challenges and eliminate operational inefficiencies, radiology groups are hiring new tools and ideas to lower overhead and increase payments.
To stay further of the curve in billing and practice management, it is important to predict and understand the upcoming trends:
Increasing focus on outsourcing:
The main concern of every radiologist today is to get maximum earned dollar for a lower billing cost. This is not an easy task as the responsibility shifts from institutional payers to patients, whose dollars are more difficult to collect. Hence many practitioners prefer to turn the radiology billing and coding process to experts as contrary to the in-house team.
It actually costs less to outsource the billing, than to create and maintain an in-house team.
Though many physicians feel hesitant to switch to outsourcing, there are many benefits that can make a practice run more efficiently and successfully.
An outsourced medical company can:
Reduce radiology billing errors
Qualified and expert professional
Improves Scheduling and AR Days
Improve Patient collection
Inorder to keep profits and reduces submissions; insurance carriers are driving the market to high deductible plans, which have a significant impact on the radiology billing practice. Medical practices can no longer be successful by just focusing on insurance collections and neglecting the most important payer to collect from-the patient. A recent article published on the website of MGMA revealed that 30 to 32 percent of practice revenue comes from patients responsibilities.
There are many opportunities, tools, and processes that can help you to increase patient revenue. For example, patient portals are an increasing tool that many practices use to make it easier for patients to pay their medical bills. A custom-made, secure webpage that is accessible via a practices website allows a good communication between patients and billing entities. Getting paid is a very cumbersome task. Why not increase the number of methods your clients can use to pay you?
Making the best use of reimbursement through coding
Inaccurate coding and incomplete dictation are one of the main reasons practices lose significant revenue. This becomes more difficult when physicians are into pressure to acquire reimbursements with few resources inorder to cut the primary cost.
Billing software, assisted with a computer assisted technology can ensure optimum and accuracy for payments of radiology work. This system can minimize denials and increase optimized payments. Automated coding assistance technology makes it easier to assign codes correctly, which means low errors, unsettled claims, and requests to resubmit claims with supporting documentation.
Today, physician continue to face the revenue cycle and practice management challenges which are growing more and more complex with each day passing. Understanding hoe to hold on to enhanced technology is important for optimizing income, minimizing cost and provide organized data to support informed decisions.
Published By - Medical Billers and Coders
Published Date - Oct-24-2016