Healthcare Systems Adopt Trend of Outsourcing in the New Era of Value-Based Care

Accountable Care Organisation In the time when both, federal and provincial healthcare quality initiatives have come up with healthcare reforms, thus making EHR mandatory in order to avail the incentives under ARRA, the compliance with Medicare Medical Billing norms, demand of documentation under Medicare’s Accountable Care Organisation (ACO)...

Navigating Through a Multiple Payer Environment – Providers’ Perspective

Healthcare delivery in the United States of America has come a long way from cash-based to insurance-backed. Currently, over 85% of the nation’s residents have health care plans either through employers’ private pools, private companies, the veterans’ health administration, the children’s health insurance program and Medicare/Medicaid/TRICARE. While insurance payers (whether Federal or private) essentially cover health risks of the insured,...

The Financial Importance of Timely Medical Claim Submission

The importance of timely claims submission is not lost on physicians or their staff and is an integral part of the revenue cycle management (RCM). The dynamic nature of the health industry and the reforms has further exacerbated the already volatile situation when it comes to claim submission, denials, and re-submissions. There are numerous factors that affect the efficiency of the claim submission process and these may range from type-o...

Predicting the scope of medical billing consultants after 2014 and beyond

Although it has been quite a while since the Federal Government announced a series of far-reaching healthcare reforms, we are yet to experience their full impact across the healthcare continuum. And, with the Senate bill deferring a major chunk of the reforms further, it is expected that we may have to wait as late as 2014 to witness their full impact. Amongst a string of reforms that will take effect from 2014 are the ones emanating...

Revenue Management & Being Vigilant amidst the impending Medicare backlash

“Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their medical billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix.” Dispelling all the speculation of a permanent...

Medical Reimbursement issues push Physicians to flee hospitals triggering a reverse trend

For over a decade, US healthcare has seen hospitals integrating with primary healthcare physicians across all the states of the US, challenging the traditional notion of primary care as a separate set of services from hospital healthcare, to provide all types of healthcare services under one roof and ensure mutual benefits that help all the sides involved in a treatment cycle and healthcare operations – access to physicians to a larger...

Job outlook for medical billers & coders looking optimistic in Idaho, Florida & other US states

Various factors playing a role in altering the salary of a medical biller and coder including work experience, geographic location and type of employer, the job outlook for medical billers and coders in Idaho is very optimistic according to the United States Bureau of Labor Statistics (BLS), mainly due to the growing healthcare trend in this state. Moreover, BLS reports that with already 1000 individuals working as professional billers...

Medical Billing professional’s career prospects brighten

Growth in Employment of medical record and health information technicians is expected to accelerate much faster than the average field according to the United States Bureau of Labor. The Bureau of Labor Statistics reported health information technicians are one of the 10 fastest-growing allied health occupations, being a challenging interesting career where you are compensated according to your level of skills and how effectively you use...

Increased usage of Mobile Devices by Physicians while accessing medical records

Smartphones and other mobile devices have made it easier for physicians to perform some of their duties from any remote location and have also pushed many physicians to test the plausibility of these technologies being used in the healthcare industry. CompTIA, an information technology association, survey reported that 56% of physicians are using smartphones, and 25% are using tablets for work. However, there have also been some concerns...

Meaningful Use’ Compliant EHR Technology Implementation – specialists’ perspective

“While specialist practitioners, such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. can claim exemptions and exclusion of certain objectives set out in the Meaningful Use Clause by CMS, they are not treated preferentially as far as documenting clinical processes using approved and compliant EHR software is concerned:  their responsibility for reporting clinical data using Certified EHR Technology and EHR modules...

Doctors contemplate opting out due to continued Medicare hassles

Physician participating in the Medicare program are scheduled to face a 27.4% cut in their payments, effective 1st January, 2012, and with providers anyway complaining about current reimbursement rates, the cut is likely to considerably impact both patients as well as doctors adversely. As a result of the cut the Medicare physician conversion factor will decrease to $24.67, approximately $15 less than it was in 2001. In this scenario, the...