Traditionally Michigan has been amongst one of the economically stronger states in the US, but in the area of healthcare this strength is often not reflected courtesy of certain inadequacies like – lack of nursing home and chronic care measures, resulting in poor access to healthcare services to Michiganders. Also, Michigan has a population which is economically disparate and a large pool of this population is either not economically-sound to afford insurance (small-income self-employed groups) or not provided insurance coverage by their employers. This results in a sizeable part of the population falling out of the insurance net. Additionally contributing to the lack of access to healthcare in Michigan is that the state is faced with paucity of physicians.
To address these problems, the office of Michigan governor has proposed a two-pronged approach, one is self regulatory which recommends Michiganders to follow certain health-related best practices, like maintaining healthy diet, doing physical exercise; and the other is to develop a primary-care system with a patient centric medical home to provide patients with treatment which combines care coordination and appropriate preventive services for patients with safe and secure transfer of medical data through electronic means. Alas, this is aggravating the plight of physicians.
If the coordinated-care scenario, discussed above, is deconstructed, it leaves primary care physicians more to worry about than to rejoice. While well-intended, coordinated care is leading to nonclinical paperwork for physicians and adding to their woes is electronic data transfer, meant for claim submission via HIPPA 5010 to Medicaid and Medicare agents, which leads to rejected claims due to minor errors in data entries. This is affecting physicians financially and leaving them with reduced time for patient care.
As a result physicians in Michigan have been found to leave hospitals and return to their independent practice, further contributing to the ‘limited access to healthcare’ crisis in Michigan by withdrawing from organized healthcare net while failing to do away with their earlier administrative responsibilities given that the services provided under primary or physician healthcare, with or without a partnership with hospitals, come under insurance coverage requiring the same administrative work for claim submission and reimbursement.
To tide over the challenge of mounting administrative activities including paperwork leading to claim denials and affecting the operating revenue and profitability of physicians and hospitals and also be ready to meet the changing trends of a dynamic and highly regulated industry, physicians and hospitals in Michigan need to strengthen their Revenue Cycle Management with a platform to facilitate electronic medical billing based on revised human practices and appropriate software applications.
Medicalbillersandcoders.com can help you build a paperless and agile RCM process by performing an end-to-end study of your RCM process and environment and recommending an appropriate EMR software application.
Through its outsourced billing and coding services, Medicalbillersandcoders.com has helped several clinics in all cities of Michigan (Detroit, Grand Rapids, Warren, Sterling Heights and Flint as also the smaller countries and cities) to improve their finances and increase their focus on healthcare though a group of experienced billers and coders who have sound knowledge of insurance collections in a timely manner and good relationship with key insurance payers, like BCBS, United Health, Workers Comp and government payers across Michigan.