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 them.

Evolving prospects

Medical billers and coders requirement is escalating almost exponentially due to an aging population and changes in medical technology. As the healthcare field shifts patient documentation to electronic data storage methods, health information filed is undergoing a radical change and positions related to medical billing and coding demand will as a consequence, provide lots of options in the market.

• Expand your outlook- Medical billing professionals at this point can widen their scope of work, coders who have been serving one clinic for 15-20 years with their experience can expand their outlook and include a group of clinics in their network and consult and train other younger medical billing entrants
• Accountable Care Organization model – is attracting the attention of hospitals, hence changes in hospital billing structure and increased patient volume will require increased coders to align this process.  The Bureau of Labor Statistics’ Occupational Outlook Handbook reported Medical billing and coding demand accounted for 40% of opportunities in hospitals and the rest in provider offices, nursing care, outpatient centers and home health service areas
• Income Potential- Medical billing and coding demand in big cities equals to more wages compared to smaller cities, and hospitals offer better compensation compared to clinics. According to statistics, the median income for medical billing and coding jobs ranges between $35,999 and $44,562, topping out around $74,000

Moreover the U. S. Bureau of Labor Statistics is predicting an 18% growth in job prospects between 2006 and 2016 and Pharmacies and insurance companies are also experiencing a growing medical billing and coding demand. Besides being restricted to only the doctor’s office the scope of medical billing has now grown to hospitals, pharmacies, nursing homes, mental healthcare facilities, rehabilitation centers, insurance companies, health maintenance organizations (HMOs), consulting firms, and health data organizations, or even from home.

Coders who are proficient with healthcare compliances like the Health Insurance Portability and Accountability Act (HIPAA) are already on the way to changing their work scope, Medicialbillersandcoders.com experts fulfill this need as key players in the healthcare workplace to deliver quality healthcare by capturing accurate and timely medical data. Our Coding professionals possess a thorough understanding of the health record’s content we have thousands of medical billers and our certified medical coders are trained to understand procedures to be coded better.

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 over the security of patients’ privacy and the information about the health of a patient. Hence advantages of using mobile technology come with its own risks and threats.

Some of the most common wireless threats to physicians include device risk content where the data on the device is susceptible to malicious executable files, unauthorized intrusion risk where unauthorized third parties may gain control and data integrity, confidentiality and authenticity risk where patients data could travel from the mobile device to the access point without being integrated and this can compromise the patients data to third parties. However, these threats can be reduced by protecting patient data when transferred between devices.

Usage of mobile devices by physicians in hospitals as well is advantageous to physicians as mobile access helps in drawing more value out of the big investments hospitals have made in electronic records. However, patient data needs to be protected and to further elaborate this – The National Institute of Standards and technology (NIST) has released a report regarding the security of information as far as storage devices are concerned.  Additionally a report by the United States Department of Health and Human Services titled “Reassessing Your Security Practices in a Health IT Environment: A Guide for Small Health Care Practices” states some of the methods in which HIPAA compliance can be maintained.

In the changing healthcare industry, usage of mobile technology to access Electronic Health Records is vastly advantageous and almost imperative, however physicians need to maintain patient privacy through administrative, technical and physical safeguards and observe HIPAA guidelines and physicians pressed for time can make this possible by outsourcing their services.

Medicalbillersandcoders.com well updated with HIPAA compliance and other issues related to the Health IT sector, maintain utmost confidentiality regarding client data. Equipped in handling all the administrative and technical details to preserve patient’s data security, MBC has guided thousands of practices across the 50 states in the US to exchange data securely and supported doctors to automate their practices making healthcare more electronically secure.

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 remains as mandatory as for general practitioners.”

There has hardly been anything that has got as much an attention as the CMS’ Meaningful Use criterion for medical practitioners – a program for eligible practitioners to be able to qualify for Medicare incentives upon meeting a certain set of core objectives set out in the Meaningful Use Clause under the ARRA. Although CMS has laid down guidelines for general practitioners, who serve the bulk of Medicare beneficiaries, yet their specialist colleagues – such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. – are not out of the CMS’ Meaningful Use ambit; after all they too are indispensable to CMS’ initiative towards an efficient healthcare environment. But, because their service-composition and documenting varies from general practitioners, specialists’ requisite compliance with core objectives set out in the Meaningful Use Clause under the ARRA gets a little different.

Recognizing the diverse nature of specialists, CMS has allowed for certain exceptions and exemptions from complying with certain objectives that does not owe allegiance to these specialist practices. Therefore, of the 20 mandatory objectives to be met out a possible list of 25, specialist practitioners can still seek exemptions on the ground of being unique fields of medicine. Consequently, their mandatory objective-list ultimately becomes less than 20; while CPOE, eRx, Vital Signs, Smoking Status, Electronic Copy of Health Information, and Clinical Summaries are usually allowed exemptions from Meaningful Use objectives, the following exclusions may still be claimed under substantiated evidence: Drug Formulary Checks, Clinical Lab Test Results, Patients Reminders, Patient Electronic Access, Medication Reconciliation, Summary Care Record, Immunization Registries Data Submission, and Syndromic Surveillance Data Submission.

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 remains as mandatory as for general practitioners. Thus, everything points towards sourcing and implementing EHR software’s that best serve unique needs of diverse practices while also being compliant with the CMS mandate on Certified EHR Technology for achieving Meaningful Use criterion bench-mark.

Despite the market being replete with numerous EHR software – a prior advisory on judicious selection is always advisable as any hasty selection can have multiple repercussions: adverse impact on clinical documenting, practice management, and revenue generation. Given the prevailing scenario, Medicalbillersandcoders.com proven credentials in advising and implementing certified EHR software platforms –  Medisoft , Misys Tiger, Eclinicalworks, Advanced MD, Office Ally, Sage Medical Manager, GE centricity, Lytec, Altapoint, Dentrix being some its leading names in an exhaustive portfolio innovative and futuristic models – for diverse clients comprising Allergy, Anesthesiology, Cardiology, Dermatology, ENT, Endocrinology, Family Med, GI, Geriatrics, Internal Medicine, Long-Term Care, Multi-Specialty, Neurology, Neurosurgery, OB/Gynecology, Occupational Medicine, Ophthalmology, Optometry, Orthopedics, Pediatrics, Plastic Surgery, Podiatry, Psychiatry, Psychology, Pulmonology, Rheumatology, Surgery, SurgicalCenter, Urgent Care, Urology, and the rest.

About Medicalbillersandcoders.com (www.medicalbillersandcoders.com)

Medicalbillersandcoders.com has been a leading source for comprehensive medical billing revenue cycle management. A talent-pool of qualified and competent medical billing professionals with diverse skills specific to unique needs of multiple medical disciplines has been instrumental in our being a leading consortium for medical billing management.

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 1^st 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 Association of American Physicians and Surgeons reports that various physicians are declining to take on new Medicare patients and many are thinking about cancelling enrollment from the program.

Medicare hassles:

Since the past 10 years physicians and Congress have been grappling with similar situations; however the difference which is pushing doctors to consider opting out is the severity of the cut and the escalating costs of a permanent solution, and few can continue to operate in an environment where revenues are cut by 27% while costs continue to rise at a rate of 3% or higher. An internal medicine physician in New London whose approximately 80% patients are covered by Medicare, with this cut is likely to lose about one-third of his revenues, possibly forcing him to restructure his entire practice.

Another issue that has created problems for Medicare beneficiaries and their medical providers for years is the sluggishness of the claims process and the payment process. Medicare doctors in three western states – California, Hawaii and Nevada, are in a situation where Medicare’s payment backlog has created a multimillion dollar problem.  Various doctors have not been paid since February, a backlog of almost 10 months,  forcing some doctors to have to drop some or all of their Medicare patients while others are on the verge of declaring bankruptcy or have already done so.

Physicians’ current & upcoming scenario:

President of the New London County Medical Society said that the prolonged uncertainty about Medicare reimbursement rates has motivated some doctors to take an early retirement. A survey by the Medicare Payment Advisory Commission (MedPAC) indicates that by 2025 there will not be enough primary care physicians. Additionally, this cut comes at a time when physicians face potential penalties associated with  HIPAA 5010 , electronic prescribing, ICD-10, PQRS and electronic health records which are difficult to adhere to in a time of dramatically falling revenue.

However, even though physicians are pushed to consider other options, in the next 20 years senior citizens requiring Medicare will rise, and doctors who can sustain the current pressures and adapt to the reforms have a vast potential for growth. The physicians need to face this challenge of payment cuts by making their system more efficient; reduce their extra administrative burdens and revamp their revenue cycle giving them a competitive edge. Medicalbillersandcoders.com can optimize physicians’ billing process and reimbursement cycle, which will help doctors maintain their revenues as they tackle Medicare issues.

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Dealing with overpayments in your practice

“Simple it might seem, yet given the time and the resources that such monitoring and reporting eventually consumes, physician practices can find it hard to take up such intensive scrutiny amidst the overriding challenge of keeping their medical service quality benchmarked to the perennially raising medical standards. All such apprehensions point towards outsourcing medical billing management that comes with the value-addition of surveillance-check on Overpayments”.

Strange it might seem, frequency of overpayments from insurance carriers, particularly Medicare, seem to grow as the volume of health insurance claims swells with each passing day. Irrespective of the reason, whether stemming out of up-coding or lapse on the part of the payer, it is never recommended that you keep the overpayment without informing your medical insurer. As Medicare has made it mandatory for physicians to report any incident of overpayment within 60 days from the actual day of receiving such payment, failure to comply by scheduled time-frame can constitute fraud and abuse inviting penalties, such as cancellation of practice-license, monetary penalty, or imprisonment depending upon the severity of the intentional fraud and abuse. More than the material punishment, it is the credibility that you may be risking while going for unscrupulous overpayments.

Having convinced of the efficacy of reporting overpayment, now it is time to know how to report, whom to report, and how to be immune to such overpayments:

Upon finding out overpayment, the physician concerned should write a refund note to the Medicare carrier along with a brief explanation of the reason for the refund; certain extraordinary cases may need to be reported to federal and/or state criminal authorities such as the Department of Justice or the Office of Inspector General (OIG).

Further, there needs to be consistency in reporting overpayments: reporting selective or randomly may not be sufficient for building goodwill with your payer as it still opens up chance for audit exposure
Appoint your staff to specifically look into the genuineness of payment posting, and monitoring of the actual realization against the claim realization.

Simple it might seem, yet given the time and the resources that such monitoring and reporting eventually consumes, physician practices can find it hard to take up such intensive scrutiny amidst the overriding challenge of keeping their medical service quality benchmarked to the perennially raising medical standards. All such apprehensions point towards outsourcing medical billing management that comes with the value-addition of surveillance-check on Overpayments. Therefore, it becomes crucial that your prospective medical biller’s scope of Revenue Cycle Management – along with the usual patient scheduling and reminders, patient enrollment (demographics and charges), insurance enrollment (for physicians and offices),

Insurance verification, insurance authorizations, coding and audits, billing and reconciling of accounts (payment posting), account analysis and denial management (EOB analysis), AR management (insurance and patient), financial management reporting – is inclusive enough to identify and report such odd incidents of overpayments.

Medicalbillersandcoders.com being a leading provider of such inclusive medical billing revenue cycle management, holds key to physicians’ endeavors towards honest and credible practice management.

U.S. Health Spending Projected To Grow at 5.8 Percent Annually: Pros and Cons

The recent extrapolation by the economists in the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) – which has projected all healthcare spending in the United States to be at an annual average rate of 5.8 percent for the period 2010 through 2020, and at 19.8 percent of GDP by 2020 – should be cause for celebration as well as challenge for all stakeholders: physicians, patients, insurance carriers, and professional medical billing companies.

Looking at healthcare market of $4.64 trillion by 2020, nearly half of which will be funded by the Federal Government for its popular Medicare and Medicaid programs, it is only natural that there will an unprecedented growth in medical practitioners vying for their share of the apple pie. Consequently, the medical service benchmark will get pushed up by a few notches as the patients will have options to choose from. Ultimately, with the Affordable Care Act’s Accountable Care Organization scheme coming into picture, an enormous opportunity will actually get translated into quality-driven physician services.

Going by the expansion of health insurance coverage through Medicaid and subsidized private health insurance under the Affordable Care Act, as well as Medicare reforms – which will induct more baby boomers into Federal health insurance – nearly 30 million more will come under the ambit of health insurance by 2020. Consequently, there will be a considerable reduction in the out-of-pocket spending on medical services by a majority of the underprivileged class.

Although insurance carriers can think of substantial increase in premium inflow, the prevalence of government-funded Medicare and Medicaid (nearly half of the total health insurance composition), and Federal Government’s extra vigil on controlling undesirable increase in premium, and incidental charges, will only drive them to be even more stringent on medical reimbursements.

Medical Billing Companies , which otherwise would have stood to gain in terms of additional market share, will be required to be even more competent in the wake of the ensuing ICD-10 and the HIPAA compliant 5010 standard for coding and reporting respectively – both of which demand a higher degree of competence as compared to the previous ICD-9 and HIPAA 4010 regimen.

The sum total of all these consequences will eventually reflect on physicians/hospitals’ ability to effectively and efficiently conduct medical billing, which is crucial to their sustenance and growth. But, judging by the historical experience of failed experiments with in-house medical billing practices – either in-house staff reporting it to be detrimental to their core function of supportive medical care, or underperforming despite heavy investment on training and system-implementation – it is anybody’s guess that physicians/hospitals will eventually be forced to avail competent medical billing services.

In such a scenario, Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – the largest consortium of medical billing professionals, who are adept at accurate charge-capture, intricate procedure coding, electronic filing of claims, patient billing, multi-tiered appeal process, denial elimination initiatives, compliance standards, and ride on an paralleled set of pre-qualifiers: certified by the American Association of Professional Coders (AAPC).

These proficient medical billers and coders are trained to use advanced medical billing softwares such as Lytec, Medic, Misys, Medisoft, NextGen, IDX, etc., and latest coding softwares such as EncoderPro, FLashcode and CodeLink. Their expertise in applying standard CPT, HCPCS procedure and supply codes, and ICD diagnostic codes has earned them an impressive track-record of maximizing client reimbursement of medical bills with leading private insurance carriers such as United health, Wellpoint, Aetna, Humana, HCSC, Blue Cross Group, and Government sponsored Medicare and Medicaid. These Medical Billing and coding specialists will be an ideal ally in complementing their clients’ cost-minimization and revenue-maximization endeavor through a proactive medical billing management.

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Impact of Federal Debt Ceiling on Medicare Payments to Physicians

Debt ceiling on Federal Debt is a perennial topic for debate in the US healthcare scenario. Debt ceiling or Debt limit is the brink to which U.S. Federal Government can raise debts to fund its budgetary allocation. Although there have been instances in the past that allowed for raising debts well over the statutory limit, yet the present scenario is such that it has put a question mark over the Federal Government’s ability to borrow. Consequently, despite the talk of an additional $2.2 trillion borrowing through governmental securities, the fear of imminent debt ceiling effects across the spectrum of healthcare industry looms large.

With the national debt having approached its statutory limit of $14.29 trillion, there is an imminent set of repercussion waiting to engulf the Federal Government’s economic sectors. As the eventual debt ceiling is going to trigger off default or delay in payments to Federal Government commitments, there is a growing degree of anxiety among interest-groups: creditors, beneficiaries, vendors; military staff, social security and Medicare, and unemployed beneficiaries.

Among the many interest-groups that are likely to be impacted by the Debt ceiling, Healthcare sector – which accounts for a majority of share in the Federal Budget – is going to feel the heat more. Consequently, its stakeholders – physicians/hospitals, patients, insurance carriers, and medical billing professionals will all be forced to rethink their operational efficiency to stave off the negative impact of Debt ceiling.

Federal Government, already faced with the impending Sustainable Growth Rate (SGR) problem, will be pushed to float unprecedented radical reforms to its popular Medicare and Medicaid programs, such as

• Increase in the Medicare eligibility age and a jump in co-pays and deductibles
• Lowering benefits to low-income individuals under Medicaid
• Cuts to Medigap insurance, which would limit supplemental insurance plans for the elderly, and the implementation of a policy requiring high-earning seniors to pay higher premiums for their plans
• Reduction in spending by $1.2 trillion across a wide array of federal programs, including a 2 percent cut to Medicare provider payments starting in 2013.
• A possible threat of 29.5 percent cut to Medicare payments if the Congress doesn’t alter the Sustainable Growth Rate, in which case payments to doctors would drop so low that many would be forced to stop seeing Medicare patients.

In such a scenario, physicians – whose patient composition happens to be a majority (nearly half of their total patient composition) of Medicare and Medicaid beneficiaries – will be forced to operate at less than break-even point, which is hard to sustain.

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Faced with such imminent consequences, physicians/hospitals – who are already grappling with a highly competitive healthcare market; stringent compliant environment: ICD 9CM to ICD 10 compliant coding and HIPAA compliant reporting; and failed in-house medical billing experimentation, where in either in-house staff reporting it to be detrimental to their core function of supportive medical care, or underperforming despite heavy investment on training and system-implementation – physicians/hospitals will inevitably have to look up to qualified and competent medical billing management experts, who ensure operational efficiency and revenue maximization.

Medicalbillersandcoders.com (www.medicalbillersandcoders.com), the largest consortium of medical billing professionals, can prove to be an ideal ally in complementing its clients’ cost-minimization and revenue-maximization endeavor through a proactive medical billing management.

Our medical billing experts – who are adept at accurate charge-capture, intricate procedure coding, electronic filing of claims, patient billing, multi-tiered appeal process, denial elimination initiatives, and compliance standards – have been preferred choice of a majority of physicians/hospitals groups across the U.S. Proficient in using advanced medical billing and coding softwares and an impressive track-record of efficient reimbursement with the leading private insurance carriers such as United health, Wellpoint, Aetna, Humana, HCSC, Blue Cross Group, and Government sponsored Medicare and Medicaid as well – our medical billing professionals carry an extra edge in the industry.