How to make a right Medical Billing Team for your Practice? CureMD 07:17

Staff is the backbone of any business, particularly service-based business like a medical practice. It is necessary that there is an adequate number of staff with proper skills required by the medical practice.

Like the clinical staff, the medical billing staff should also be trained in their duties to bring efficiency in their performance that effect directly on the medical billing services.

Your practice should have right number of medical billing staff

There are several ways to determine the right number of staff for the billing department. This may depend on the number of patient visits, volume of claims to be processed, and number of accounts that each biller has.

However, the best practice is to have an established standard to determine the accurate number of employees you will need to run your medical billing department. The standard may vary between specialties, depending on their workflow and patient visits.

According to the benchmark set by American Academy of Ophthalmic Executives (AAOE) for ophthalmology practices, cost of billing staff should be approximately 5% of your income.

Make sure your billing staff has the right skills

While advertising the position of medical biller, be very particular about SOP of the billing services and specific requirements of your specialty along with the general responsibilities.

Billing is a complex department. In order to deal effectively with insurance payers and patients, the medical biller need to be self-motivated, has an eye for details and creative enough to find problems to issues.

It is ideal to hire billers who have experience or knowledge of medical terminology and medical coding system. However, in-house training provided to the billers can be more beneficial. Well-trained billers will understand the specific workings of your practice, the patientflow and mechanism to deal with the issues faced with payers.

Make Patient-Practice Communication part of your Medical Billing Process CureMD 09:29

Communication is the key to a strong relationship. In a patient-practice relationship, effective communication of financial responsibilities of patients can result in increased payments.

Patient payment is crucial part of the medical billing procedure. Taking care of your patients means that you are taking care of your business, ensuring that the patients’ cooperation in paying bills.

Let’s find out how communication improves your medical billing practices.

Listen to your patient

Listen to understand is the first rule of effective communication. While taking down information from patients, listen to them carefully. Train your staff in standards of clear and comprehensive communication of financial details and responsibilities of patients. This includes practice’s payment policy.

This way, patients are left with no ambiguity regarding their payment plans and responsibilities towards the practice.

Make the message simple

Patients are not financial analysts. While drafting medical billing policy of your practice, keep in mind that it should be in a language which is comprehensible by the patients. Refrain from using too many billing and insurance jargons. Keep it simple and concise.

However, patients should be informed about necessary insurance plans and procedures, like deductibles, co-insurance in a simple language.

Be transparent in your dealings

A medical billing process of a practice should be fair and transparent. When a new patient makes an appointment, communicate to them about your insurance eligibility policies. Discuss with them what is included and what isn’t in their health insurance plan and whether your practice can assist them in this regard.

Do not make promises that you cannot deliver in future. It is better that the patients are communicated about their responsibilities, and procedures and services allowed in their insurance plan.

Medical billing process is a complicated segment of practice. To make things relatively simple, practitioners should try to develop a strong relationship with theirpatients for timely patient collections. 

How does outsourcing medical billing expedite claims? CureMD 06:04

The time between when a claim is sent out from your office to the time you receive a reimbursement for that claim varies from practice to practice. You might have noticed competitors managing the process swiftly and efficiently, and getting their money faster in the process. There are two ways by which you can do the same; a huge billing department with as big a payroll or via outsourcing your billing service to professional billing companies.

By outsourcing, you can still maximize reimbursements without the added cost of allotting lavish budgets to your billing department. The article will give you an overview of the claim submission process after which you will have a better understanding of the benefits of outsourcing.

   

With in-house billing, once you code and document a patient’s visit, the claims are sent to the insurance carrier or Medicare for reimbursement. The process can take approximately 3 to 6 weeks.  

However, with outsourcing, the process will be shortened to just a couple of weeks. Additionally, your patient information is just as well protected, if not more.

Here’s how the process will work

First is the transmission of claims (either electronic or paper) for coding to the outsourcing company. The billing company will enter and recheck your claims for errors before transmitting batch orders.

The batch orders are sent either to a clearinghouse or directly to the insurance carrier. The clearinghouses convert the data into a standard format before sending it to the carrier for processing. 

The clearinghouse helps identify any medical coding errors and results in the amount of claims delayed due to errors falling to almost nil.

When the carrier gets the claim, it issues a receipt of conformation for claim tracking. Receiving a reimbursement via electronic claim filling usually takes around two weeks after which you receive a reimbursement check and an Explanation of Benefits (EOB).

Furthermore, you can always find out the status of any claim from the outsourcing company. And without worrying about your practice’s billing, you can focus more on your patients as the billing process is in the hands of competent and experienced professionals. 

Why should a small practice outsource medical billing and coding? CureMD 09:42

With the amount of regulation in the healthcare industry, a few errors are all that separate your practice from a huge compensation price. This makes a lot more sense in the context of billing documentation and medical coding; a few errors in either could cost the disruption of quality care to your patients in addition to making your wallet significantly lighter.

By outsourcing, you will save the expense of employing personnel with diverse skill sets. In most cases, especially for smaller practices, it is not practical and feasible to employ separate IT specialists and separate billing specialists.

Consequently, with thousands of new ICD codes coming up, coupled with the HIPAA audits beginning this year, you will require competent, experienced and able personnel to do your medical billing for you. Here’s how they’ll help your practice prosper and flourish:

Facilitating compliance with strict coding regulations is one of the foremost and key benefits of outsourcing. Taking time on billing is important, as you don’t want insurance companies to deny payments because of small errors in your bill. With so many deadlines, guidelines and instructions, even the biggest of practices fall prey to such mistakes. Your practice is much smaller, and thus, such mistakes will have more impact on your revenue stream with the subsequent audits and potential fines. 

   

The specialized personnel to whom you've outsourced this service have a strong grasp of the service, and the expertise required to get the job done with the maximum success rate in the minimum time. Moreover, they possess the extra time, which a small practice like yours seldom has, to recheck the reports they've compiled and to identify any changes in regulation and compliance that you could easily overlook. 

The overall revenue for your practice will also rise as they have the resources and the experience to effectively claim reimbursements, ensure receivables are collected faster and to minimize denials. With the revenue cycle of your business flourishing, your practice will enjoy accelerated growth.

Your patients will also be more satisfied with lesser errors, and more importantly with the added time that you are now able to dedicate to them.

Consequently, you save a significant amount of money and markedly more time to focus on your practice.

Levels of Patient Engagement through EHR CureMD 12:40

Changes in the healthcare industry encourage patients to be proactive about their wellness and health regime, helping them to change the culture from treatment to prevention. Proper implementation and use of ElectronicHealth Records (EHRs) facilitates the proposed change by engaging patients in wellness programs through the Patient Portal. However, the level of patient engagement may differ, depending on the use of EHR systems.

The first level of patient engagement requires practitioners to implement an integrated EHR system at their practice – facilitating their patients to interact with physician and practice staff for medical advice, scheduling visits and bill payments.

An uninterrupted communication through Patient Portal will allow the patient to stay connected with the practice, so that they are informed of their test results, change in medical dosage, appointment schedule etc.

At this level, a contributing patient emerges. This patient, after connecting with the information exchange tool, contributes towards the health record sharing. Such patients would like to stay updated about their health condition by accessing the information available on their Patient Portal. Similarly, they contribute to the medical information by adding information relevant to changes to their health, such as medications, allergies, immunizations etc.

By this level, access to and sharing of health information gives rise to a more responsible patient, the conferring patient. Based on their medical history and health information, they actively seek out advice, ask questions and engage with their physicians for creating health plan that would help them to lead a healthy lifestyle.

At this point, providers should adopt different models of practice to provide health advice to proactive patients with convenience. Telehealth is a cost and time effective means of providing healthcare to patients, who seek preventive medical advice to increase quality of their health.

Meaningful Use of EHRs is not only beneficial for medical practices, but it also helps patients to stay informed and engage in medical decisions to prevent health hazards.

Practice Management: Physicians’ call for improved business CureMD 12:57

It has been getting difficult for small practices to keep their business up and running because of increase in costs and decline in collections that result in financial loss. According to a survey by QuantiaMD and CareCloud, physicians were asked to highlight reasons behind decrease in profitability at their practices. Of the 5,012 physicians, 65% reported decline in reimbursements, 57% cited rise in costs, 48% responded Affordable Care Act, and 44% said changes in method of billing and coding.

These challenges pose threats to a business of any size, but small practices can be the most affected. One way to combat these threats is to implement a practice management system at your practice to minimize the threats.

Improve rate of claim decline

A Practice Management system can help physicians to improve the claim rate of practice. This issue has become even more important with the 2% cuts made for Medicare payments. Although physicians cannot do anything about reduction in Medicare payments, but they can increase their reimbursement amount by submitting accurate and clean claims.

In this regard, practice management system comes in handy as they allow non-clinical and billing staff of the practice to verify insurance details of the patients to ascertain their eligibility and use accurate codes to create claims that have lower chances of being declined.

Minimize the costs

A reliable Practice Management system can help cut down costs of running a practice. The electronic system of billing and making claims would help physicians in reducing the money spent on resources, such as stationery, while also saving time on making claims. According to estimates by MGMA, submitting a paper-based claim to insurance companies can cost $6.63, while the same claim if submitted electronically will cost physicians $2.90 only.

A Practice Management system can also help in reducing the cost of human resources. By hiring and training the less number of staff in using the electronic system, practices can cut down on costs of extra staff as workload will be reduced.

Changes made in Coding

ICD-10 deadline may have been delayed for another year, but without any doubt the system is going to be implemented. Therefore, it is recommended to buy a Practice Management system that qualifies for ICD-10 coding. This will not only reduce cost of buying or upgrading the system once the new coding system is implemented, but also helps to train the staff in advance in the new coding system.  To minimize the error in coding, a Cloud-based Practice Management system is highly recommended, as it allows the system to upgrade automatically, thus saving the cost of buying a new one.

EHR system is usually talk of the town in minimizing cost and improving efficiency of the practice workflow. However, practice management is equally important for small practices to reduce the cost and improve their business.

Mastering Meaningful Use - It's still not too late! CureMD 08:55

Eligible providers, have you missed the July 1st Meaningful Use deadline?

As a Medicare provider, if you have not meaningfully started using a CCHIT certified EHR by July 1st; you will be facing a 1% reduction on Medicare part B payment in 2015.

However, it is still not too late. You can avoid further penalty in 2016 and still receive the government incentive payment if you follow a timeline in the next few months.

Tune into our webinar to learn how CureMD’s experienced Meaningful Use consultants can help you gear up for October 1st MU deadline, so you can get back to what matters most - helping your patients.

Key points:

• Increase financial stability by avoiding payment penalties
• Ensure successful documentation of Meaningful Use
• Improve the overall effectiveness of patient care
• CMS Audits for MU – What you need to know?

We will help you with everything from start to finish.