Medical billing services, outsourcing medical billing services, medical billing audit, HIPAA-compliance, healthcare, medical billing company

What Medical Billing Audit can reveal about your Practice?

Medical billing services! Handling billing and coding operations, staying up-to-date with the operations, and managing financial tasks are a bit stress-full. In the end, we all want fruitful outcomes for physicians. A process can be done via several methods, so why not fueling our performance by assessing our operations.

It is a good practice for physicians who opt for in-house medical billing services to review their tasks and upgrade for better performance, even if it means going for outsourcing medical billing services.

Why Medical Billing Audit Outsourcing is Essential for Business?

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Medical billing services and physicians on a larger scale require straightening up their operations in light of the guidelines issued by CMS or other governing bodies. If they can’t subject to change or upgrade, it will affect their revenue, their reputation, and most-of-all the quality of healthcare services that every patient deserves.

Here are four reasons why billing practices should review their performance?

To Increase Revenue

Have you looked into reasons, why you haven’t grown your business? Maybe, you’re trying to expand your services but unable to do so, why is that.

Medical billing assessment can give hints about what is going wrong and what needs to upgrade in order to expand growth.

To Upgrade the Practice’s Policies

It is possible that you might not be getting returns as much you invest. Maybe it’s because the practice isn’t following HIPAA-compliance rules or payment rules in general. The reimbursement rate is only high when you are consistent with clean claims as per the rules.

The billing assessment can help to guide in highlighting liable policies.

To Upscale the Technology

We all strive for the quality healthcare system. In order to upscale our services, we should have tools and resources that handle the relevant tasks efficiently. What might be the latest technology a few years back, can already be outdated.

So, the technology assessment makes it easy to view things that are creating issues in simplifying operations.

To Streamline Workflow

Assessing workflow management can save time and cost. A company can only be as good as its staff. The workflow they follow has an impact on the overall performance of the company.

The assessment/medical billing audit can give insight into the process, and it can make or break your reputation plus revenue in the industry.

If you’re a medical billing practice or a healthcare facility, we are here for medical billing audit.

healthcare professionals, medical billing services, healthcare industry, COVID-19 pandemic, medical billing outsourcing, medical billing companies, medical billing outsourcing companies

P3Care Investigates HHS Report for Providers Relief Fund Concerns

We understand that this time is difficult and hospitals, healthcare professionals, medical billing services, insurance companies, clearinghouses are working on top of their abilities.  Of course, no one is undermining the efforts of the healthcare industry. However, the pandemic is not an excuse to not keep clean records of healthcare attributes.

The U.S. Department of Health and Human Services (HHS) has cleared the sense of the notion that the disparity in data transmission or data incompleteness is not negotiable.

Inconsistency in Data Requirements Leave Physicians Waiting for Outcomes

To follow through the CARES Act Provider Relief Fund money, physicians must abide by all the terms and conditions.

Important clauses for this relief fund are:

  • The fund is only to be used to avoid or respond to coronavirus affects.
  • The fund is only used as compensation to the lost revenue or the endured healthcare cost during the COVID-19 pandemic.

Physicians were quite unsure about how to act to these facts. Of course, medical billing outsourcing companies can’t proceed without their clients’ consent. Therefore, HHS took it upon itself to explain all the complications that restrict healthcare professionals to benefit from this program.

HHS Explains the CARES Act Provider Relief Fund Requirements

healthcare professionals, medical billing services, healthcare industry, COVID-19 pandemic, medical billing outsourcing, medical billing companies, medical billing outsourcing companies

A few weeks back, HHS issued a draft as in FAQs (Frequently Asked Questions) that answered all the physicians’ concerns. Moreover, medical billing services get a chance to look into attributes that were most wanted, especially the documentation of items that home care providers need to record in their records. For Instance,

  • Medical supplies to offer healthcare service for possible or actual COVID-19 positive patients
  • Medical equipment to offer healthcare service for possible or actual COVID-19 positive patients
  • The training/education of workforce offering services for COVID-19
  • Getting access to training, resources, equipment, recruitment, etc. to streamline the workflow

Although the expenses should be with respect to the COVID-19 treatment or response, HHS stated that it is highly unlikely that the COVID-19 expense goes back to the date before January 1, 2020.

What are the Lost Revenues that are Attributable to COVID-19?

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HHS also explains this phrase. Lost revenue will subject to any financial loss that is incurred due to coronavirus.  It also includes cases where medical billing companies couldn’t generate revenue for healthcare professionals due to fewer patients visits, canceled or delayed elective medical treatments and procedures, or surging uncompensated loss.

According to HHS, the dedicated fund can be used to cover that cost too that could be recovered otherwise, as long as it is subjected to coronavirus prevention, response, or planning. It implies that that the cost doesn’t have to be specific to coronavirus positive or possible patients, but it just has to be lost due to the pandemic.

These funds can also be used to maintain the quality of healthcare services and their timely delivery to the patients.  For instance, to pay for the payrolls, insurance plans, or EHR (Electronic Healthcare Records) fee.

This fund can be a ray of hope during the financial crisis period. HHS tried their best to give relief to patients. Now, it is up to medical billing services to strategize and compensate for the losses.

Medical billing services, Telehealth billing services, MIPS consulting, P3Care, Revenue cycle management

APTA Surveys Physical Therapists against Telehealth

Perhaps the most dramatically impacted area of healthcare as a result of the coronavirus pandemic is telehealth. Previously, the conditions were not in favor of virtual clinics because face-to-face visits were the norm. Now, however, the situation has changed. When other clinicians are making use of telemedicine, PTs and PTAs are, definitely, not far behind.

On March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) allowed PTs to conduct e-visits after which they can reach patients at homes keeping them away from the contagious virus. But it wasn’t easy, to say the least – It took a lot of effort.

It was not until April 30, 2020 – after rigorous advocacy by APTA – that CMS decided to include PTs and PTAs among providers eligible to bill for telehealth services. Such services include virtual visits contrary to real-time, face-to-face meetings.

In other words, COVID-19 persuades the government to make PTs and PTAs eligible for remote patient management, which results in a rapid increase in telehealthcare.

Increase in Video Consults via Live Sessions

Before the pandemic, 98% of physical therapists questioned did not do live video sessions with their patients. Furthermore, out of 2% who did, 69% of them saw only one patient per week on average. As a result of this awful virus, we saw 50% of PTs adopting live video sessions as an outlet to see their patients. In a matter of months, most of the physical therapy switched from real-time visits to remote visits.

Generally speaking, medical billing services, under the new world order, have to readjust keeping in view the regulatory and federal guidelines specifically for e-visits.

One of the PTs said, and I am paraphrasing it: Some of the aspects of video visits are a revelation – seeing positions of patients while they sit and watch TV or examining their postures of sleep. They would like to continue with live video sessions as part of their treatment even after the pandemic.

Uncertainty with Telehealth Billing Returns

Medical billing services, Telehealth billing services, MIPS consulting, P3Care, Revenue cycle management

The survey by APTA brought vital information to the limelight. Of those PTs who participated in this survey, 25% of them were sure their telehealth payments were consistent with in-person visits, while 53% were not sure of it. Similar, uncertainty was there when it came to patient satisfaction with telehealthcare.

As much as there is uncertainty to life, there is vagueness to practicing medicine online because we are all new to it. However, for consistent revenue cycle management, we must adhere to local and federal instructions for telehealth as we follow the HIPAA code of conduct in terms of PHI safety.

There is no denying the fact that telehealth has emerged as a blessing in disguise in these challenging times. When elective medical procedures were restricted, this facility helped many physicians to make up for the loss.

Yes! There were issues related to technology familiarization, but in most cases, there was relief that doctors were available for you. It was particularly beneficial for patients with chronic health conditions, who require regular monitoring.

Zoom to Meet and Treat

Medical billing services, Telehealth billing services, MIPS consulting, P3Care, Revenue cycle management

The survey showed Zoom as the most popular platform for video consults, according to 43% of the participating PTs. APTA’s June 2020 report covers the impact of COVID-19 on physical therapy. We deduce these results from it. The rest of the practitioners among the participants reported using more than a dozen other platforms for video care.

The graph below shows the usage of virtual platforms since the pandemic spread in the US.

Technology Is Both A Blessing and Burden

Technology, on one side, is the facilitator, but on the other, an obstacle. 31% of practitioners said their patients were not technologically ready for an e-visit, while 21% of the PTs said their facility lacked the technology to facilitate patients during the pandemic.

Another common barrier faced by PTs and PTAs was the lack of payments for telehealth services. Telehealth billing services by P3Care supports physical therapists to get them higher reimbursements, fewer accounts receivable, and responsive customer support. Besides, we apply tools and techniques to take our clients up the road of virtual visits resulting in better collections.

Below, you’ll see a graph of what obstacles our PTs face against technology, courtesy APTA’s June 2020 report.

Medical billing services, Telehealth billing services, MIPS consulting, P3Care, Revenue cycle management

Conclusion

PTs and PTAs are part of the frontline workers of the COVID-19 emergency response that have been crucial to the healthcare teams, providing care in private clinics, facilities, nursing homes, and hospitals nationwide. Moreover, it is due to their constant support that the patients in local community settings not affected by COVID-19 receive continuous care.

Mobility, strength, consistency, and patience are fundamental elements of physical therapy in any setting. PTs and PTAs help patients get well sooner with their expertise in musculoskeletal conditioning. Unquestionably, the role of PTs is vital to see us through the COVID-19 pandemic.

Note: At all times, the CDC recommends PPE for the safety of patients and therapists alike.

A Guide to MIPS 2019 Reporting for Physical Therapists is where you can find MIPS consulting essentials for the previous year leading to the year 2020.

CM

P3Care and Trump Administration Encourage Practices to Reopen

America should adopt smarter ways to counter COVID-19 as it reopens for patients and clinicians. In the meanwhile, CMS has come up with a guide for patients and beneficiaries as they decide to visit providers for in-person care.

As a result of the surge in COVID-19 patients, many providers were left with no option except to restrict care at their facility. They had to do that for the essential treatment of COVID-19 patients.

However, with a much-improved situation now, the government encourages private practices and clinics to resume their normal operations. They are to continue with their postponed non-emergency treatments and carry out in-person patient visits as we speak.

The patient guide ensures the safe reopening of healthcare facilities with patients receiving the much needed in-person care. National public health emergency took over, causing this delay in normal appointments, procedures, and treatments.

We can’t thank President Trump enough for his vision, the expansion of telehealth, to be specific, in a very short time. In this way, all this time when America was closed, patients were able to talk to their clinicians from the safety of their homes.

Ms. Seema Verma, Administrator of CMS, reinforces the vitality of in-person care and refers to it as a gold level of care. Such steps by the government are in favor of patients who have long been waiting at homes for procedures, vaccinations, operations, and evaluation of chronic conditions.

She further explained healthcare is the right of every American and our healthcare heroes are working day in and day out to deliver it safely. We should all feel confident when going for in-person care recommended by our providers.

On April 19, CMS issued the first part of recommendations to safely start in-person care activity in areas with a low occurrence or relatively low and constant number of COVID-19 cases. Hence, we move ahead with another set of recommendations.

CMS leaves no stone unturned when it comes to patient and clinician safety as healthcare systems, practices and clinics further enhance in-person care standards. Recommendations include a list of topics to ensure safety regulations are in place for patients and providers including facility measures; testing and sanitation levels; personal protective equipment and stock of supplies; and workforce presence.

The easy access to healthcare for everyone can be restricted to some extent. However, this decision can’t be prolonged due to financial discrepancies.

During the COVID-19 epidemic, healthcare professionals have lost a major amount of revenue as the resources were redirected towards the pandemic response. Now as the Trump administration is asking to bring normalcy in the economy under strict SOPs, we can expect a gradual balance between expenses and revenue.

As it was with part 1 of recommendations, decisions to reopen should be in line with federal, state, and local rules, CDC’s guidance, and association with the state and local public health authorities.

As the country continues to move on the path of reopening, patients have concerns about when to check-in with their providers for in-person visits.

CMS also acts as a guide with empathy for patients to make the right decisions as they prepare to meet their providers in person. Ultimately, it is in their best interest to follow the new rules.

Find guidelines for patients for in-person visits in English here: https://cms.gov/files/document/covid-what-patients-should-know-about-seeking-health-care.pdf and in Spanish here: https://www.cms.gov/files/document/covid-what-patients-should-know-about-seeking-health-care-spanish.pdf

To read one of the previous updates, go here – P3 investigates: Trump Administration plans to reopen nursing homes

To read about the work of the White House Coronavirus Task Force reaction to COVID-19, go to www.coronavirus.gov. For specific information about CMS, keep reading our blog updates.

Medical billing and coding, healthcare industry, medical billing companies, healthcare organization, revenue cycle management, healthcare professionals, HIPAA Compliant, medical billing outsourcing services, medical billing services, medical practice

How Accuracy of Medical Claims Could Save Your Revenue?

Medical billing and coding is an important step in the physician’s payment model. Depending on the compiled claims by the medical billing outsourcing services, insurance companies decide if the rendered services are valid and if physicians should be reimbursed. Therefore, the accuracy of the claims and medical billing services holds a crucial place in the healthcare industry.

Medical billing and coding, healthcare industry, medical billing companies, healthcare organization, revenue cycle management, healthcare professionals, HIPAA Compliant, medical billing outsourcing services, medical billing services, medical practice

Why do Experts Stress on Accuracy of Claims?

If physicians want to get reimbursed on time, the accuracy of the claims should be maintained. The wrong documentation or manipulation of data results in denied claims, even when the physician has provided the service to the patient.

Another issue is the under coding when physicians are not paid as much as the service cost because of coding errors.  Over coding can also dent the reputation of your healthcare organization. You can be charged with fraud and can bear financial and legal complications.

The survival of the medical practice can become difficult if medical billing companies don’t pay attention to the accuracy, resulting in revenue loss.

It’s also about the reputation of the medical billing companies, the high claim’s acceptance rate they have, the more revenue they generate, and the smoother revenue cycle management process becomes.

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Is Medical Billing and Coding Complex?

Medical billing services are a serious profession. The sensitivity of this field can be analyzed by its impact on healthcare professionals. There are several code sets and monitoring authorities, from which billers and coders can take guidance. Anyone, who is responsible for creating claims, must know about the exact diagnostic procedures, surgeries, documentation of symptoms, age, gender, pre-existing conditions, and all. Not just the claims must be accurate but also the HIPAA-compliance needs to be there to ensure the confidentiality of the information.

Staying up to date with the latest knowledge and creating claims accordingly is the skill and handling the bulk of claims at the same time is tricky. It is also a fact that leaving medical billing and coding responsibilities to in-house staff can cause financial problems.

Check and Recheck

Before filing medical claims with insurance companies, it is wise to check and recheck since there is no room for mistakes. A slight error could easily result in denial; and, denied claims use up time to get reimbursed, eventually, leading to delayed collections. Hence, a practice needs trained people to work on their claims for a breezy cashflow. One of the ways to achieve that is to look for billing companies with EHR knowledge.

So, What Option is Left.

We suggest outsourcing to medical billing services is the best option for a seamless revenue cycle. They have dedicated staff to handle all the accounting information and tasks, which certainly, can’t be managed in-house when you have patients to take care of.

P3 Healthcare Solutions is a professional medical billing service that has years of experience in creating claims and helping hundreds of physicians in maximizing their revenue cycle. It is our way to share their administrative burden.

Visit our website for further details – https://www.p3care.com/

Medical billing services, Medical billing service companies, Medical billing services near me, Revenue cycle management

P3 Defines the Role of Medical Billers and Coders

Any person who thinks there is a difference between medical billers and medical coders is right.

Because there is a difference. With defined roles, they bring the right charisma to a physician’s revenue cycle. Nevertheless, one depends on the other for the completion of the billing process.

Medical billing services hire both professionals to carry out an effective revenue cycle management process on behalf of healthcare providers. Theoretically speaking, both professions require the professionals to read, interpret, and comprehend Electronic Health Records (EHRs) and doctors’ notes. Hence, their education in science is a must.

We all know that medical billing is a complex process. But with medical coders and billers assigned to claims, medical billing becomes all the more manageable. Their capabilities provide all the help a healthcare provider needs to process medical billing claims.

For you, as a primary care physician or a specialty-specific clinician, an authentic team of health IT experts may, rightfully, carve the way to a successful practice.

Coding: Where Medical Billing Services Begin

Medical coding is a definitive structure of the medical bill. It becomes an integral part of medical billing service which reflects each and everything in a proper, organized, and coded form. At times such as this pandemic, the healthcare sky is lit with updates; new codes for COVID-19 have surfaced, so coders have a responsibility to stay in touch with CMS updates.

Moreover, they must remain proficient and knowledgeable in the ICD-10 coding system – the coding system that classifies diseases. The other one being the CPT set of codes identifies the treatment aspect of received cure.

The above systems help convert medical jargon into easier alphanumeric codes. For people inside and outside the medical industry, it may be hard to understand the names of diseases and certain procedures. Thus, the availability of these coding systems provides a comprehensive path to diseases and their solutions.

Since there are thousands of diseases, symptoms, and cures, it is not possible to write to them in complete form all the time. The only way possible is to design a coding system that classifies them.

Medical coders are required to manifest the knowledge of thousands of CPT and ICD-10 codes accordingly. Moreover, coders translate medical records for reimbursements later.

This gives us an overview of what coders are responsible for.

Medical Billing is the Social Part of Coding

After proofreading the claims, next comes the job of billing professionals to forward them to insurance companies.

A claim that is prepared by the coder has to go through a process; the person who carries it out through to the end is a medical biller. If it is a small practice, usually, there will be a small group of medical billers. However, to tend to a larger practice or hospital, there’s a whole team of billers and coders. Their times often concur with the time of the practice, but they can also work remotely to address claims as they come.

Without experienced billing personnel on your side, a health care facility, or a primary care physician’s revenue cycle would fail to function. Here, at P3, we have a whole team dedicated to medical billing outsourcing, so feel free to reach out at this number: 1-844-557-3227.

Purpose

Billers to devise the billing claim use information emanating in the form of codes by medical coders. That claim becomes the first-hand information for insurance companies to release payments. A well-written billing claim without errors has a higher first-time acceptance rate. Furthermore, collections occur fast, almost within 2 weeks.

If patients have outstanding bills, the medical billing experts are required to contact them as part of the following-up process. They will walk them through the process and inform them about any deductibles, copayments, or other insurance liabilities.

Besides, medical billing and coding teams coordinate with insurance companies to get providers on board if they are not enlisted with them. Sometimes the patients visit providers who are out of network, and not on their health plan. Then, the medical billing services have an additional role to play, to enlist such providers with insurance companies. To speed up things, doctors must provide any documentation that is urgently required to complete the registration process.

Filing appeals and conversing with patients is part of their job. There is little time between denial and resubmission; therefore, we must act fast, recompile, proofread, and resubmit.

Where Do They Work?

‘Medical billing services near me’ is one of the search terms often searched on Google. Why?

Because, one, physicians are in search of someone nearby; second, if they can find them nearby, they are physically reachable. However, the remote nature of work has popularized the job amongst outsourcing companies. Therein, we hear the term, medical billing outsourcing.

Most billers and coders are present on LinkedIn with incredible job portfolios. Often you’ll find abbreviations such as CPC – Certified Professional Coder – besides their names. Also, you’ll find abbreviations such as CCA – Certified Coding Associate – and CCS – Certified Coding Specialist – with their names.

Prerequisites

The prerequisites for this job are at least a high school diploma with a science background. However, an associate degree in medical billing helps convincingly in the long run.

You have four studying options:

  1. Bachelor’s degree in a health-related subject (4 years)
  2. Associate degree in medical billing & coding (2 years)
  3. Diploma (1 year)
  4. Certification (a couple of months)

All of these studying programs lead towards a bright future which is well-respected and well-paid.

Pro Tip – Choose schools that are recognized by AHIMA or AAPC.

For readers who like this article, please do comment. We love to read your feedback, and, also don’t forget to follow us on Instagram @p3healthcaresolutions.

Medical billing services, Healthcare IT experts

4 Approaches to Managing Old Homes to Minimize COVID-19 Community Spread

Medicare promotes and safeguards the health of senior citizens. A survey reports that by 2030, every 1 in 5 people will be 65 or above. As a result, exhaustion of the Medicare program is more than likely to happen.

However, with the recent COVID-19 spread in full-bloom, to protect the senior citizens and managing old homes is more important than ever before.

We see hospitals and practices, in general, are equipped with the latest certified EHR systems aiding a new-age healthcare system to evolve, sustain, and respond to improved outcomes – technology is now an essential part of the healthcare system. In such times, optimal use of tech is where it all begins and ends.

Furthermore, medical billing services have a responsibility to play in these critical times. They have to support healthcare providers who are fighting on the frontlines with coronavirus disease. As our healthcare heroes risk their lives, we, as healthcare IT experts, have a responsibility to fully support them in this time of crisis.

For the most part, growing old isn’t easy, but due to innovations in technology and new inventions, caregiving has become more manageable. As a senior citizen, you deserve all the care out there as it is your right to have that. We are here for you as a provider’s systemic support during the coronavirus pandemic. You mustn’t go on blaming yourself for running a cold, persistently coughing, or sneezing without a break because it is no one’s fault.

Let’s look at a few approaches we can adopt to minimize the COVID-19 community spread.

  1. Reunite seniors with their Professions   

We don’t realize our growing age, but others do not let it go unnoticed. The slow deterioration of health; the gray hair; the wrinkles on the face & neck give it away and have a story to tell the others. The fact of the matter is that the number of gray hairs tells us the number of years you have cared for others. Therefore, never feel the shame in being old. It is the exact opposite – you are the wisest of all!

As we reach the latter part of our lives, we grow fonder and closer to our memories, especially the most-cherished ones. We may not be able to perform even the basic tasks like going to the bathroom and back, but those memories are what hold us together during the darkest of times.

If you want the senior citizens to listen to you, you must respect their memories during the COVID-19 lockdown. A big part of their survival depends on the good times they had in the past. Make use of those memories as part of the place where they sit and spend most of their time. For example, put a movie on which they like from the past to take off the edge from this whole pandemic situation buildup.

Let them do what they do best. For instance, if someone is a carpenter, include semi-finished wooden shelves in their skills room. They can use tools under supervision to create the next masterpiece. This way they get to be happy and kill some time as well.

Similarly, a professor will be happy with books and students in a class.

On the whole, to keep coming up with ideas to engage them is a difficult but necessary process.

  1. Make them Feel Ageless

They are our seniors, and we have to give them respect more than anything else.

To never let them feel old should be one of our goals.

From where we see them, they are young and energetic souls and will forever remain like that. To stop the COVID-19 community spread, much needed along with the stay at home part is the motivation for them every hour of the day; and words of love and support to look past their problems could just be it.

In an old home, look for ways to make them feel young. It’s not a piece of advice but an opinion that we would do the same thing if we were in your place. When we feel happy, we feel young inherently; it helps in mental and emotional stability. (which we need at the time)

  1. The crippling old age demands a perfect meal during the coronavirus pandemic

A way toward happiness is to eat delicious meals. You must equip the facility with nutritionists who are ready to prescribe corona-friendly weekly diet plans to residents. Foods that add variety to the menu and also strengthen their immune systems.

Something delicious but allowed in their age brings color to their faces and puts an end to the routine doom & gloom. Hence, have a plan in place to prepare a variety of foods for them – Foods that do not interfere with their healing cycle, of course.

Since food is a natural motivator, to ask each of them of their favorite food item is a good start. Moving forward, set up diet charts for them with the help of nutritionists.

An example of food can be scrambled eggs; a name everyone understands. I am not a food specialist or an old home administrator, but I say these things out of my experience with elders at home and materials I read on the web.

  1. Ensure the flooring has no apparent obstacles

This is one of the factors we must take into consideration in a caregiving facility. It can be a real game-changer. The flooring should be plain and simple without any speedbumps. So, if you find some flooring that needs repair, it could help them from tripping over and falling. Since corona is in full effect, we don’t want hospitals to fill up with non-corona patients.

Stairs should not be part of an old home with seniors. If there are stairs, keep them locked at all times.

At an older age, we tend to fall without rhyme or reason. Hence, stairs present a big threat or an injury that is waiting to happen. Keep elders away from stairs and only let them use them as tools for exercise. A supervised trip to level one and back to the ground floor once a day can be a good workout for them.

Follow P3 Healthcare Solutions on Instagram for health IT insights into the world of providers here: https://www.instagram.com/p3healthcaresolutions/

A healthcare System without Surprise Medical Bills is a Progressive System

Health is an important asset to human beings. Patients, physicians, medical billing companies, insurance companies, clearinghouses, all are connected in one way or another to offer quality services. Physicians are then reimbursed for their services and that’s how the process flows.

Patients are particularly free from the burden of paying for healthcare expenses by themselves when they get a healthcare plan. They just have to pay their premiums, and the rest is the work of medical billing outsourcing companies.

In recent times, the payment system in the US healthcare system has especially been under scrutiny to facilitate patients and clinicians alike.

Healthcare Costs Have Gone Up

Due to inflation and in the name of empowering patients, costs have gone up severely. Deductibles and copayments have increased, and patients can’t do anything about it as they have to maintain their monthly healthcare package in check.

Increasing expenses for care services has left patients financially vulnerable. According to an estimate, patients paid around 35% of the medical bill charges in 2019. Looking into it, this percentage is quite high as compared to the previous years.

The reason behind this is that patients have to endure surprise medical bills, and medical billing services were not to blame for this. Stats show that two-thirds of the American adults, have savings less than $1000, and it is not enough to pay surprise bills sent by medical billing companies. Believe it or not, surprise medical bills are one of the causes of making families bankrupt.

All Stakeholders of Healthcare Industry will Suffer If Not Done Something to Resolve Surprise Medical Bills

A poll conducted by Kaiser Health Tracking in 2018 reflected that sixty-seven % of the Americans are somewhat worried about bearing unexpected healthcare costs for themselves or family members.

Another study showed that forty percent of the Americans who had insurance received surprise bills in 2019.

Forty-one of the Americans showed their concerns about how unexpected it was for them to see the bill going overboard.

The problem is huge. If patients are unable to pay for the rendered services, how will physicians survive? Medical billing services will not be able to get clear bills for physicians. The inability to pay bills and deductibles has increased seventeen percent from 2012 to 2016.

The US government has also noticed this issue, and there are multiple solutions into consideration.

What is the Solution?

Negative payment cycles can be reversed if taken proper actions against it.

One way to restrict the ever-increasing cost factor in the healthcare industry is to offer customized/personalized experience for patients.

The healthcare and billing process can be confusing for patients. A professional medical billing company on behalf of physicians should demonstrate each payment clearly to patients beforehand. From the appointment session to the final bill, every step should be clear to exclude the surprise element from bills.

The first strep of accurate billing services is to precisely estimate the cost of healthcare.

Medical billing outsourcing companies should break down each step for physicians to give them an idea of what patients can bear from their health plan and whatnot.

Listing payment options is also useful for patients when comes across with out-of-pocket expenses.

Providers who work in efforts to improve the quality of healthcare and reduce surprise billing can enjoy a significant improvement in revenue cycle management. One can’t expect a sudden change in the healthcare industry, but a seamless billing process without surprise bills is only possible via offering tailored payment models based on the patient’s financial situation.

Medical billing services, Professional healthcare, Healthcare professional, HIPAA, Healthcare services, Medical Billing Company

Telemedicine Emerges as Cure Outlet Amid the COVID-19 Outbreak

Got allergies? You can still see a healthcare professional if you are at home during the coronavirus outbreak.

U.S. health officials, clinics, hospitals, and insurance companies are insisting on people to try telemedicine for minor health problems such as ear infections, rashes, and earaches and skip the doctor’s office.

It is also a way to get screened for COVID-19 if you think you have the symptoms.

The Goal: Prevent it from spreading, especially to the elderly, the infants, and to those who are most vulnerable with existing health conditions.

Instead of waiting for the doctor for days, virtual care has long been a solution for the Americans; it is just that they have been slow at adopting it. Now is the time to embrace and make use of it in our best interest.

Let’s take a closer look at how Telemedicine functions.

What is Telemedicine?

Medical billing services, Professional healthcare, Healthcare professional, HIPAA, Healthcare services

Telemedicine is a means to connect with a healthcare professional via smartphone, tablet or computer. That is all you need to hop on this train. Sometimes, we use words like telehealth and virtual visits to describe it.

Ordinarily, it connects you with a provider like a doctor or a therapist remotely over a secure line. As a matter of fact, the patient makes use of an app to connect with them.

Sometimes telemedicine portals use a version that involves texts only for patients who may not speak or see each other.

Telemedicine often serves as a tool to diagnose and treat a new health problem, but it is also used to see a long-term diabetic or chronically ill patient. It is more than going for a prescription refill, although doctors can write prescriptions, if needed, after a virtual visit. That involves antibiotics, anti-allergies, or dietary supplements.

Where Can I Get Telemedicine?

Providers such as individual practices and hospitals are rich outlets of telemedicine. Providers are urging the patients to see them using telehealth channels during the outbreak. Search by calling your local hospital or simply put a query in Google to search for the best telehealth companies.

The federal government is committed to helping people with Medicare, i.e. citizens aged 65 and above as well as the younger slot who qualify due to disability through telemedicine. This trickles down to the state level where local governments are urged to expand telemedicine access to help people with Medicaid, i.e. people with low incomes.

Until now Medicare coverage of telemedicine was limited to rural areas where patients did not have care facilities like state-of-the-art hospitals and private clinics. Many Medicare Advantage plans also provide support for telemedicine. While the providers are busy treating the patients, telemedicine returns in the form of collections are good enough. Medical billing services play their part to full effect.

How Much Does It Cost?

Prices are variable. However, since the telemedicine initiative is being promoted, the prices are being waived off by many companies. It is to inspire them to use this outlet as their health companion.

It helps to check with your insurer or employer to see if it is part of your health plan. The plan may not offer specialty services like virtual therapy sessions or include only limited access.

For people without insurance, some telemedicine providers do give the option to pay out-of-pocket. The charges differ from provider to provider. Whichever company you choose, under the law of HIPAA, the texts of diagnosis and treatments are completely secure.

What Illnesses Can Be Sorted Out by Telehealth Services?

Some of the illnesses under telemedicine include sinus infections, seasonal flu, minor injuries, fevers, etc. Before you begin to doubt it, let me assure you that telemedicine saves you physical visits to the doctor’s office or pharmacy store.

Dermatologists can use it to treat moles and warts. Acne, pimples, blisters are additional examples for which they can offer their services. Moreover, therapists can be a source of calmness to patients suffering from anxiety, depression, and stress episodes during the pandemic.

Cyber consultation in case the patient has flu-like symptoms can be a relief. They have preprogrammed questions to gauge the health condition, and, immediately prescribe a remedy.

The Limits

With benefits come certain limitations.

A virtual doctor is unable to treat medical conditions in which the patient suffers from chest pains, fractures, or wounds in need of stitches. The virus test is also not available through this source.

Patients Need Time to Adapt

The association of gadgets such as your smartphone with healthcare has been there for a while but it is put to use with the spread of coronavirus nationwide. It will have lasting effects on the future of healthcare; patients who will get better will become its promoters.

If it doesn’t involve their regular doctor, they may be reluctant to try it all together. Additionally, awareness to make use of telemedicine in routine when the pandemic is over could send help where it is needed the most.

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CMS Issues Guidelines for the Nonessential Medical Procedures

COVID-19 has taken over the world. The coronavirus emergency has become so big that the regular medical procedures have taken a back seat until the situation gets any better.

CMS – The Centers for Medicare and Medicaid has announced that all the nonessential surgical, diagnostic, and dental procedures should be delayed during the novel corona outbreak.

The reason for it is that the number of corona affected patients are increasing and so is the demand for more doctors. As the physicians are participating in the fight against the pandemic, it is difficult for them to continue with the regular procedures. Moreover, they can also save on their personal safety equipment, tools, ventilators, and beds.

On the other hand, amidst the coronavirus lockdown, it would be difficult for medical billing services to compile claims when their resources can be used to document hundreds of cases of COVID-19.

CMS admits that this step will be helpful to treat those, who are more in need of quality healthcare. The coronavirus spread can only be limited when everybody takes charge of his safety and others around him. A conclusive step towards a corona-free nation would be that clinicians advise their patients to stay at home unless absolutely necessary to minimize their risk of virus exposure.

They should encourage patients to follow the government guidelines to slow down or contain the risks of COVID-19.

The Impact of Limiting Regular Medical Procedures

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The CMS-issued recommendations already come with an implementable plan for hospitals and medical practices for immediate COVID-19 response action.  The organization has also touched upon factors in which physicians may postpone nonessential surgeries.

The factors include:

  • Patient risk factor leading to the urgency of medical procedure
  • Availability of equipment/ beds/ staff

The recommendations will be compliant to assist emergency patients and save resources for corona effects. The decision to proceed with the dental, medical, and surgical procedures will be taken by the local clinician, patient, hospital, state, and local health departments.

All of these actions taken to assist medical billing services and clinicians are part of the White House Task Force efforts.

What the Bigger Picture Looks Like?

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Doctors and other healthcare staff are under great threat of having COVID-19. They are acting as front liners due to their nature of jobs. The recommendations will also be a step towards their safety. Ultimately, every healthcare organization has to implement these strategies so that, we don’t face handling the worsening situation with limited resources.

American Medical Association (AMA) also appreciates this step by CMS. In this way, healthcare organizations will be preparing for COVID-19 patients efficiently. Whereas, healthcare leaders will be strategizing to better support physicians and patients.

CMS offers much flexibility in its program for healthcare providers to consider the benefits of this suggestion. Medical billing companies can also manage their duties accordingly.