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healthcare providers, medical practitioners, HIPAA Privacy and Security, HIPAA Security Guidelines, Telehealth Communication, healthcare workers, telehealth services, HIPAA regulatory requirements, HIPAA Compliant, MIPS reporting, QPP MIPS, MIPS 2020, QPP 2020, HIPAA medical billing, telehealth medicine

COVID-19: HIPAA Security and Privacy Guidelines Relaxed for Providers

The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services has announced relaxation in HIPAA rules for covered entities and business associates who participate in good faith in the COVID-19 testing site operation.

It doesn’t stop there, but HIPAA penalties won’t apply to covered healthcare providers for practicing telehealth medicine using third-party applications such as Skype or Facebook Messenger. OCR exercises its power to stall some of the HIPAA provisions, momentarily, in connection with the good faith provision of telehealth during the state of a national health emergency.

Provided we stand in the middle of an epidemic and our country is under attack, rightly so, such steps seem to be the only way out. Governor, Andrew Cuomo, of New York State, is a constant media personality during this crisis briefing us on developing stories every day of the week. He is a true patriot who is committed to taking his stand until the enemy backtracks to where it came from.

The fact of the matter is that OCR holds the right to exercise enforcement discretion, and they did so on April 9 in an immediate press release. It goes to show their determination to eradicate the novel coronavirus from the US, and, also speaks of their active role in the recovery process.

Director OCR, Roger Severino, narrates and I am paraphrasing it; It is time to empower medical practitioners to serve patients across the United States during this public health emergency period. We are concerned about the health of the vulnerable the most, including older Americans and persons with disabilities.

Why the Relaxation in HIPAA Rules?

First, the HIPAA rules were relaxed to provide immediate assistance to healthcare providers, including some large pharmaceuticals and their business associates that would like to participate in community-wide testing site operation. It is officially called the Community Based-Testing Site (CBTS) operation; moreover, it includes mobile, drive-through, and walk-up sites where they would conduct COVID-19 specimen collection or testing in abundance.

Second, telehealth products had to follow the HIPAA Privacy and Security Guidelines before COVID-19 was here. Now that this virus has spread all over the country, to stop it, the exception of extreme circumstances comes into play and brings flexibility to HIPAA rules.

What Products Are Safe for Telehealth Communication?

healthcare providers, medical practitioners, HIPAA Privacy and Security, HIPAA Security Guidelines, Telehealth Communication, healthcare workers, telehealth services, HIPAA regulatory requirements, HIPAA Compliant, MIPS reporting, QPP MIPS, MIPS 2020, QPP 2020, HIPAA medical billing, telehealth medicineProviders don’t have to worry about which products to use as long as they are not public-facing software applications. Products like Facebook Messenger, Skype, Apple FaceTime, Google Hangouts, or Zoom are good to go for care audio & video chats.

While the use of the above applications is allowed, some applications come under the public-facing criterion, apps including TikTok, Twitch, and Facebook Live.

Therefore, before dispensing care, use applications in the allowed category instead of those that aren’t.

As the nation is in dire need of healthcare workers, OCR exercises enforcement discretion for care to reach the farthest areas of the country in connection with the good faith provision of telehealth services. It means providers won’t face penalties in case of noncompliance with HIPAA regulatory requirements.

HIPAA Compliant Technology Vendors

Since malpractices in desperate times have their odd way to creep in, it is best to choose technology vendors who are HIPAA compliant and are willing to enter into a business associate agreement (BAA) with the provider. As a result, any audio or video communication that occurs through such vendors will not result in an intrusion or put PHI at risk.

The following list of vendors provide a haven for secure telehealth services; moreover, they are HIPAA compliant and willing to enter into a BAA with covered entities.

  • Skype for Business / Microsoft Teams
  • Updox
  • VSee
  • Zoom for Healthcare
  • me
  • Google G Suite Hangouts Meet
  • Cisco Webex Meetings/Webex Teams
  • Amazon Chime
  • GoToMeeting
  • Spruce Health Care Messenger

Now, that is the list of software for safe and complaint-friendly audio and video communication.

A word by OCR

OCR doesn’t endorse, recommend, or certify the above applications but simply suggests their use for guidance. It has not reviewed the BAAs that they have come up with. There may be other vendors out there who are HIPAA compliant and willing to enter into a BAA with a covered entity. The names above do not suggest any kind of endorsement or affiliation with the above-mentioned products.

P3 as a business associate comes under the obligation of HIPAA too; moreover, we are trying to help the healthcare heroes on the front line as best as we can by the use of HIPAA compliant communication channels. HIPAA medical billing is one of our principal services along with QPP MIPS reporting. As providers make their way out of the pandemic, we will support them on each twist or turn of their journey.

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HIPAA , HIPAA security analysis, HIPAA security, HIPAA Requirements, HIPAA medical billing, HIPAA medical billing company, Health IT, COVID-19 , Coronavirus, Healthcare IT companies, Healthcare Under HIPAA, Healthcare providers Healthcare solutions, HER, EHR

4 Health IT Recommendations for Remote Healthcare Under HIPAA

Working from home is a new reality. The novel coronavirus has left us at home while it continues to affect the human race. It doesn’t differentiate between humans based on their race, wealth, color, sex, or religion; moreover, it treats the young and grownups alike. That is how ruthless it is.

In such overwhelming times, when healthcare workers face the challenge of a growing number of COVID-19 patients on one side, they are required to follow the rules of HIPAA remote care on the other. They are under obligation to meet HIPAA security and privacy requirements no matter how big or small their practice is. In fact, it is not something new to them in the best interest of Protected Health Information (PHI).

Therefore, we will know in today’s article that how physician practices, with the help of health IT, can address the HIPAA security risk analysis issue head-on, especially when it comes to remote care.

Under HIPAA, it is obligatory for hospitals and practices in the US to protect sensitive patient data from violators or from going public. The new norm of diagnosis and treatment coupled with the support of health IT ensure remote healthcare to fall in line with the rules of HIPAA.

Telemedicine moves forward with a bubble of protection to safeguard patient information. Let’s see some recommendations for technologists supervising remote care communication:

  1. Set Clear Instructions for Remote Use of Healthcare Devices

One thing that we should remember is that healthcare providers are not IT experts. While they know the importance to protect the confidentiality of patient data, they don’t always know how to achieve that stage. Besides, they are too busy with their patients to worry about the laws that govern remote healthcare access.

Here comes the role of the technologists of practices who have the responsibility to provide clear instructions on how to use devices or software securely.

When developing the guidelines, come up with step-by-step execution of the process that simply describes what to do. Too many options or vague advice lead to confusion instead of clarity. HIPAA security risk analysis of remote healthcare ensembles with the list of recommended tools and how providers may use them to provide care.

  1. Know HIPAA Requirements Before Suggesting Tools

For a technologist, to know the requirements of HIPAA are one of the essentials they cannot ignore. Since many healthcare practices now turn to new teleworking technologies facilitating video chats, data share, and follow-ups, it comes on you to explain to them which tools are allowed under the Health and Information Portability and Accountability Act (HIPAA).

Providers can only choose a selected bunch of tools that adhere to the HIPAA privacy and security guidelines to communicate. They are not at liberty to use just any tool that they find on the internet and download it for free. Hence, it is of utmost importance that the health IT experts handling your practice’s remote communication are aware of the provisions of HIPAA. Moreover, they must show the will to enter into an official contract as a business associate.

Zoom is an example of a tool that is allowed for healthcare professionals to see their patients. However, there is a specific version that is permissible under HIPAA. Licensed Specialized Zoom for Healthcare solution is the version that fulfills the requirements of HIPAA. Hence, business associates can carry out PHI transmission through Zoom’s specified version.

Also, the above version integrates with electronic health record (EHR) systems seamlessly.

  1. Supply Compliance-friendly Devices for Safety & Management

 When remote care is at play, the idea is to create a safe passage for patient-provider interaction. The healthcare IT teams have to supply healthcare workers with compliance-friendly correspondence devices because that is far less burdensome than manifesting security in each of the employee-owned devices. So even when they go home, they may use only a secure line of communication.

Preconfigured gadgets guarantee adherence to policies that govern PHI safety.

Additionally, for IT teams it is much easier to manage a system that they are familiar with; it is the same mobile device management system they work on at the office.

  1. Use of VPNs to Secure Online Connectivity

Virtual Private Networks (VPNs) are software applications that offer encryption of any data that travels through them. Health IT teams have a job to do; they must remember to equip devices in use of practitioners with enough security controls to counter unauthorized access.

Two networks need to be secured: providers’ home network and the Internet between the home and the practice.

Management of device configuration solves most of the problems, but it still leaves room for intruders to jump whenever they want.

Hence, suggested is the use of VPNs to ensure safe online connectivity. Any communication that happens between the office and home is secure. A VPN develops a secure encrypted tunnel across the communication channel from the practitioner’s device to the receiver’s end.

It further provides content filtering, firewall safety, and end-to-end encryption to home users just as it would for workers within a hospital or clinic.

With the above four recommendations, we conclude this article in the hope that it is sufficient information regarding telemedicine’s safety standards for health IT. If you want to hire services of professionals who can offer HIPAA security risk analysis to remote medical practices, please get in touch with P3 Healthcare Solutions. We are also a HIPAA medical billing company that takes extreme caution when it comes to protected health information.

Remember to follow us on Instagram too.

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Medical billing services, Healthcare IT experts

4 Approaches to Manage 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/

Medical billing services, medical billing companies

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

Medical billing services, medical billing companies

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?

Medical billing services, medical billing companies

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.

Medical Billing Outsourcing, Medical Billing Services, Revenue Cycle Management, RCM

Apply These 5 Secret Techniques to Improve Revenue Cycle Management

Practices receive payments for rendered services after weeks, and sometimes it takes months for them to get paid. It is not a deal between patients and doctors, but there is a third player involved – payer (the one who pays). The word P3 stands for Patients, Providers, and Payers, the three main players and ‘Care’ join them in a meaningful way turning it into P3Care.

The healthcare system in the US is complex. Consequently, medical claims have to pass through insurance companies to convert into hard cash, in other words, collections.

Before getting paid in full, the provider spends effort in sending the remaining bills to the patients. It is critical to the life of practices to stay profitable and meet their monthly expenses. Medical billing services such as P3Care amplify the RCM process for doctors across the country.

  1. Bring medical billing services on board

Due to the disconnect between payments and physicians, going for medical billing outsourcing makes sense. A medical billing company becomes responsible for all their finances and the whole RCM process. Most physicians complain of the slow payment process from patients with High Deductible Health Plans (HDHPs).

To keep it simple and to the point, health IT firms like P3Care work on behalf of providers to get them what they deserve promptly. We believe an efficient billing company is central to the financial freedom of clinicians, for them to have a strong association with their patients, which is the most vital element in healthcare.

  1. Effective financial policymaking

For a patient, to get well is everything. However, before they get well, it is important to understand the cost of care. A financial policy means your practice receives payment before treating the patient. Except for a clinical emergency, if they are unable to pay, reschedule their appointments to another day. Lobbies and waiting areas should have this policy stated on their walls for public awareness. And, if you have a website or social media channels for that practice, pin it to the top of the page. Get the patients to sign it, so their acknowledgment comes in writing.

  1. Spread the word categorically

When someone calls for an appointment, inform them of your financial policy, i.e., collect payments before checking the patient. The automated message that goes out to different patients should include the recorded statement of your financial policy when new patients call in or sending out appointment reminders.

Keep the policy in the loop of communication whether it is at the front desk in the form of a hard copy, through email, or the messenger so there are no surprises.

  1. Calculate upfront costs before checking in

Some tools help practices calculate out-of-pocket costs for the care delivered. They collect data from payer contracts, physician and facility charges, and patient’s health information to calculate upfront costs accurately. We recommend the use of such tools for the sake of financial security. Build self-check-in kiosks in one corner of the waiting area to speed up the care process. They also have an option to accept payments.

Not only do such tools add to the patient experience because of their quick check-ins, but their application speeds up the payment process.

  1. Train front desk staff in insurance programs

When front desk staff is trained in applying for Medicaid and other patient assistance programs, it is an additional skill they can use to motivate the patients. Train staff in scenario-based scripts in which they are face-to-face with a real-time situation before it happens for copayments, cost-sharing charts, and outstanding balances.

Regardless of what the US healthcare seems like, the cost of care is inevitable. Whether we can afford it or not, physicians have the right to earn what they just delivered. P3 healthcare providers to be paid faster and to have a running revenue cycle management process. For that, we prepare claims according to ICD-10 and CPT coding guidelines by CMS and AMA, respectively as early as the patient leaves the doctor’s office.

medical billing services, medical billing and coding, medical billing companies, healthcare services provider

How to Verify Healthcare Insurance: Step By Step Guide for Medical Billing Services!

There is no doubt in it that physicians need revenue for their survival, and medical billing services work day and night to help them meet their expenses efficiently. They focus on developing a strategy for an efficient billing solution to maximize revenue.

Besides the other medical billing and coding procedures, verifying the eligibility of health insurance before the patient’s treatment maps out a financial situation for physicians. It is an important revenue increasing practice for healthcare organizations as well as patients; because patients are also aware of their financial responsibilities beforehand.

Given below is a guide on how medical billing companies can verify insurance eligibility in 10 easy steps.

Let’s check out!

  1. Obtain Important Information from the Healthcare Provider

The process starts when the patient visits a medical practice. It is where the front-desk staff accurately records the patient’s information. The information includes,

  • Name of the patients
  • Date of birth
  • Social security number
  • Contact number
  • Information of insurance provider
  • Insurance ID & group number

Medical billing services need to access this information if healthcare providers don’t provide them with the accurate patient’s bio; it would be difficult for them to verify eligibility.

  1. Ask for the Original Health Insurance Card from the Patients

Request the patient to provide the photo ID and make copies of the original health insurance card for the future.

  1. Contact the Respective Insurance Company

Make a call to the relevant insurance company or via electronic means, check if the insurance that patient claims, is valid.

  1. Research If the Insurance Benefits Remain Valid on the Date of Treatment

Verifying the date of patient’s health insurance safes from unnecessary stress in the future. This information has to be checked with the insurance company.

  1. Check for the Insurance Benefits

By contacting the insurance company, medical billing services also need to verify about the benefits that a patient can avail and the copayment that he has to pay by himself.

If there are charges that insurance doesn’t cover, make sure to inform the patient before the treatment, so that, he recognizes his financial responsibility before time.

  1. Check If Your Healthcare Provider is included in the Patient’s Insurance Network

If the healthcare provider is not included in the patient’s insurance network, the insurance company may not reimburse completely to the doctor.

  1. Know About the Deductibles

A deductible is an amount that the patient pays before the insurance company pays for the services. There is a different amount for different insurance plans. Medical billing companies need to ensure if the patient has paid the respective dues or not.

  1. Verify Copayments

Collect copayment from the patient, give them a slip, and provide them with treatment details. In this way, patients can verify their insurance benefits by themselves.

  1. Be Efficient with Customer Support Services

Generally, healthcare providers don’t have time to deal with patients regarding payment matters. So the front desk staff should assist patients’ queries efficiently.

  1. Verify If the Patient Has a Secondary Insurance

Often patients have secondary insurance and a certain amount of charges is covered in that plan. It is advisable to verify secondary insurance information, the same way as the above-mentioned.

Successful medical billing companies ensure practices that best suit the healthcare service provider and elevate his revenue cycle. Insurance verification serves the same purpose. If the insurance verification process is completed beforehand the treatment, patients know about their financial responsibilities, and the rate of accounts receivable (AR) is reduced.

What do you think? Give us your views at https://www.linkedin.com/company/p3-healthcare-solutions/ and stay updated with the latest billing knowledge.

Forget In-House Medical Billing, Hire Medical Billing Company!

Hiring a medical billing company is a great decision. After all, physicians hand over all of the precious data to another company, and their reimbursements are based upon the performance of the medical billing service.

Particularly, this decision is very hard for small medical practices. They don’t have extravagant budgets to spend on medical billing. Efficient revenue cycle management remains their main objective. Moreover, their operations revolve around doing more with less.

Doing medical billing and taking care of patients simultaneously don’t do good for physicians. They often fall short in their efforts and don’t get reimbursements on time, making their survival even more difficult in the complex U.S healthcare system.

However, consulting a professional medical billing company as P3 Healthcare Solutions helps in saving lots of bucks while managing medical claims with accuracy and precision.

https://www.linkedin.com/company/p3-healthcare-solutions

Why Medical Practices Hire Medical Billing Companies?

If you’re confused while making the right decision for your practice, have a look into the following advantages. It may make up your mind in favor of hiring a medical billing service provider.

The Medical Billing Process Becomes Streamlined

A medical billing service makes sure that physicians get notified of all the accounts receivable (AR) and the received payments from both ends, that are, from patients and insurance companies.

Medical practices don’t have to dedicate resources, who spend hours keeping track of payment posting for each patient. Hence, when they hire a medical billing company, they get a complete report at the end of a specified time and can plan revenue strategies for the future.

Medical Billing Company has an Integrated Practice Management System

With the advancement in the healthcare sector and the focus on value-driven medical services, the medical billing system has also become advanced. Now, insurance companies don’t receive papers, but they receive claims electronically via practice management software. In addition to the introduction of electronic healthcare records (EHRs) in the healthcare system, data collection has become secure but complex.

The integration of practice management with electronic healthcare records is important. Otherwise, you won’t be able to create and submit medical claims in an organized manner.

Now, do you think that it is possible for medical organizations to have a fully integrated system? No. It requires separate dedicated staff to handle all of the systems, which means more cost expenditure. However, medical billing services have experienced team of medical billers and coders on hand with an integrated practice management system.

Accurate Medical Claim Submission

The Healthcare industry undergoes several changes each year. The changes may be regulatory or by the federal or state government. Nevertheless, keeping up with the industry norms and changes is indeed a tiresome task, which only a medical billing service can do efficiently.

Professional services have time and resources to make sure that medical claims are created with up-to-date knowledge and in accordance with the rules and regulations. Thus, by hiring medical billing services, physicians’ time is saved.

Increased Return over Investment (ROI)

Medical billing services submit medical claims according to the guidelines of the insurance companies. They have the time, resources, and expertise to process medical claims professionally. They don’t only submit claims but keep track of the claims with the denial management system and follow-up services.

Healthcare organizations that want to improve their medical billing reporting method should definitely hire medical billing services. After all, physician’s work is to take care of the patients rather than scratching their heads over medical codes and bills.

Thus, the best option left for physicians is to consult a medical billing company and improve their revenue cycle management.

How Can MIPS Consulting Services Help Increase Your CPS?

MIPS has been an amazing initiative in the healthcare industry. This quality payment program instantly got attention from clinicians in terms of providing value-based services to patients. Therefore, the physicians’ participation rate has been outstanding since the very first year. This trend has also put pressure on the MIPS consulting services to use improved methods to better report clinical data.

Another reason for high participation is the fortification from the penalty that is imposed on non-participation or poor performance. This has to do a lot in changing physicians’ thinking to strive for being the top-scorer, especially, when there is so much to gain as incentives and bonuses.

Reporting MIPS quality measures with data completeness constraint requires accuracy and dedication from MIPS consulting services. The thing to consider is that healthcare organizations already have data and then consult MIPS qualified registries to report data.

Then, how can MIPS consulting services improve performance based on the present data? This question demands thorough analysis and this article gives insight into four MIPS score-increasing tactics.

  • Document Data for a Large Set of Quality Measures & Look for High Performers

This is the simplest way to ensure that the data you have is best for reporting MIPS quality measures. When healthcare organizations consult MIPS consulting services, most of them already know about the best-suited quality measures. However, there are some that at the start of the MIPS reporting period, run hundreds of tests to determine the most scoring MIPS quality measures.

The advantage of running this strategy besides the obvious one is to check if you can get extra points from the available data while submitting it to CMS. Moreover, the search for high-priority measures becomes easy for MIPS consulting services via this method.

Some professionally qualified registries or even healthcare organizations tend to chase a larger set of performance measures throughout the year. This way, they get the flexibility to report for the best performing measures at the end of the year.

  • Switch to Electronic Methods for Reporting

The end-to-end electronic reporting method is the best way to earn bonus points, and thus requires data submission through Certified Electronic Health Record Technology (CEHRT) to CMS. It automates the data submission process with efficient data extraction and measures calculation.

This method helps MIPS consulting agencies to earn additional points per measure or even increase 10% of the total MIPS score.

  • MIPS Consulting Services Should Report Free Text DataMIPS Consulting and quality measures

Qualified services should invest additional efforts in collecting free-text data. It surely involves the extra time and a bit of investment but can result in improving the MIPS scorecard.

Going through patients’ reviews and medical codes can help taking out important points. A dedicated team is required to abstract data for this purpose. Otherwise, outsourcing companies can also do this favor for MIPS consulting services.

  • Review the MIPS Score for Individual & Group Performance

Getting incentives and eligibility for the bonus pool gear up physicians’ performance and it is only possible when MIPS data is optimized. Before data submission, reporting services should check performance rates both as individuals and even as a group.

It is possible that clinicians get more points while submitting data as a group for treating a similar set of patients. It also helps to add low-performing physicians in the group that may be excluded from the MIPS race as individual healthcare providers.

Thus, physicians can earn a high score when MIPS consulting services uses a few simple tricks. Indeed, these tricks require efforts and but continuous monitoring of score throughout the year, provide opportunities to increase revenue cycle.

As a MIPS consulting service, would you try these tactics or have any other ideas for high MIPS score, share with us at https://www.linkedin.com/company/p3-healthcare-solutions

Looking Back At EHR Meaningful Use From A New Perspective

ARRA – The American Reinvestment & Recovery Act was legalized on February 17th, 2009. It aimed to revolutionize many economic and social sectors including healthcare. Health Information Technology for Economic and Clinical Health (HITECH) Act was also one of its considerations. This act was in great support of the meaningful use of the electronic healthcare records (EHRs), an initiative by the Centers for Medicare and Medicaid (CMS) and the Office of National Coordinator for Health IT (ONC).

Its emphasis on the implementation of EHR technology throughout the USA. Moreover, it is also in accordance with the MIPS quality measure Promoting Interoperability (PI) in which physicians use innovative methods to improve the quality of care services. It requires the use of certified EHR technology to provide a secure exchange of healthcare information.

Plays an Important Role in MIPS Data Submission

The meaningful use of EHR technology also helps physicians to efficiently submit MIPS data to CMS. On the other hand, physicians using this technology can also report measures regarding value-based services to the Secretary of Health & Human Services (HHS) and get incentives.

The Need for Meaningful Use (MU) Act

This act is helpful in generating five possible outcomes for the betterment of the healthcare industry.

  • Improvement in public health
  • Improved coordination in healthcare sectors
  • Increased engagement of physicians and patients
  • Protect patient’s private data from unauthorized use
  • Improved services, safety, and efficiency of the healthcare system

What benefits physicians have for meaningfully using EHR technology?

Meaningful use of EHR

The incentive payment ranges from $44,000 for 5 years to $63,750 for 6 years (Starting from 2011).   Eligible physicians (EPs) and eligible hospitals (EHs) demonstrating adaptation and efficient use of EHR, get valuable rewards. To encourage physicians to go for EHR meaningful use and reduce the burden for healthcare providers, it is classified into three stages.

Stage 1 of Meaningful Use

The requirements of this stage are divided into the 15 core set and 10 menu set objectives. There is an option of choosing 5 out of 10 menu set objectives with the compulsion of at least one population/public health measure.

Stage 2 of Meaningful Use

CMS and ONC have also set standards for the second stage of meaningful use (MU). It released the final rule for incentive programs of Medicare, Medicaid and EHR technology in August 2012.

For this stage, eligible physicians are required to meet for the exclusion to 17 core objectives and 3 out of 6 menu set objectives.

Whereas, it was a must for eligible hospitals and Critical Access Hospitals (CAHs) to qualify for an exclusion to 16 core objectives and 3 out of 6 menu objectives.

Stage 3 of Meaningful Use

In the modified version of stage 2 meaningful use for 2015-2017, clinicians attest to any combination of 2 measures out of 3, while EHs and CAHs attest for any combination of 3 measures out of 4. For stage 3, submitting data for meaningful use was obligatory in 2018.

ONC along with HHS (Department of Human Health & Services) released a final rule in the context of meaningful use and gave certification to the 2015 edition of electronic healthcare records (EHRs). This initiative allowed diverse types of healthcare organizations to get access to healthcare IT.

Thus, medical practices that adopted EHR technology in previous years are now in benefit and can target more incentives, as they have completely understood this method. To get incentives and adopt healthcare IT, physicians should invest their efforts in this system respectively.

HITECH provides high opportunities for healthcare providers to improve their medical practice. The phased approach of three stages allows room for improvement in the public health sector. Moreover, it sets the base of the healthcare system with fewer discrepancies and controls chronic diseases.

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3 Types Of Payment Models, Physicians Probably Don’t Know!

Value-based healthcare services have not only changed the patients’ healthcare standards but also the physicians’ payment model. Value-based reimbursement models encourage clinicians to adopt methods that make healthcare easy and efficient. Programs like MIPS & MACRA and more depict a value-based care system and allow physicians to achieve rewards and bonuses. The purpose is value-based reimbursement models are too.

  • Straighten up physicians’ revenue cycle management
  • Make patients empower the healthcare system where they choose their desired service

We have heard many of the benefits and the need for value-based healthcare models, but the proper information about the available models is not very common. Let’s review that.

What are the Available Value-Based Care Models?

There are a few types of value-based payment models with a variety of risks attached and the benefits.

1. Accountable Care Organizations (ACO)

It is a system of hospitals, clinicians, and other healthcare providers to provide organized and high-quality services to Medicare beneficiaries. It was started to help patients receive up-to-the-mark services at the most appropriate time. It means that in case of emergencies or other scenarios, patients don’t have to wait to get to the relevant doctor.

This organization ensures that patient only bears expenses for those services that are absolutely necessary to treat an illness. Redundant medical services are reduced by eliminating medical errors that occur while diagnosis or treatment.

Healthcare providers volunteer in this program to get shared savings if the ACO fulfills the standardized healthcare criteria with reduced expenditure.

Risk Factor Involved in ACO

It is not like ACO volunteers always end up adding a bonus to their revenue cycle, but the financial risk is also involved. When able to meet the requirement, physicians have a jackpot, but on the other side, they also have to bear shared losses if any.

For shared loss, healthcare providers have to pay Medicare as compensation for not delivering value-based care to patients.

This value-based reimbursement model is not just about value-based medical procedures but also supports volume-based services. However, the evaluation is based on quality, safety, and experience.

2. Bundled Payment for Rendered Services

This payment model pays physicians not for each service but as a whole series of services. Clinicians receive collective reimbursement for treating a medical condition, including all the charges for physicians and the types of rendered procedures.

For Instance,

If a patient undergoes a surgical procedure, CMS (The Centers for Medicare and Medicaid Services) sets a collective payment for surgeons, an anesthesiologist. It then pays a total amount rather than paying separately to each clinician.

Risks Attached with Bundled Payment Model

A certain level of risk is also involved with this type of payment model same as the ACO. Physicians get to full their pockets when they collectively reduce the incurred cost. Otherwise, they get will have to bear the loss.

Thus, this practice requires standardized procedures so that, all stakeholders get the rightful reimbursements.

3. Patient-Centered Medical Homes (PCMH)

It represents the healthcare payment model in which a primary care physician coordinates the patients’ healthcare. This payment model manages and handles all the needs of the patient in a centralized setting.

It’s certification highlights that the physicians are capable of providing healthcare in a patient-centered setting with team-based methods. Moreover, it also ensures consistent care quality for patients.

Patients are allowed to develop a one-to-one relationship with their physicians, and it governs the medical and environmental factors.

This payment system has shown great potential in reducing the unnecessary cost expenditure. According to a Maryland – based PCMH, via the efficient practice of this reimbursement model, they were able to save up to $98 million and enhance their quality standards by 10%.

Alternative payment methods other than the fee-per-service are not very popular practices. However, physicians are unable to meet their financial requirements. Thus, they are devising ways to incorporate new technologies into their system to speed up the workflow.

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News

An Overview: New York State Battles COVID-19 Complacently

To call it a battle seems right.

Ever wondered what it’s like to have a non-human combatant in front of you. Well, it feels just like how the world feels at the moment. Emotionally, we are all in this together, the sooner we accept it, the better. Coronavirus is not a friend but an enemy to billions of people on this planet regardless of their color, race, or wealth

It is not even a living organism; it doesn’t have tanks or artillery to fight off humans but still manages to injure and attack us. However, Andrew M. Cuomo, Governor of the New York State, is hopeful that they will come out of it stronger, healthier, and smarter than ever before.

Under the current circumstance, when New Yorkers are looking in the eye of COVID-19, to say that it brings the best out of them will not be wrong. Healthcare heroes are activated to full effect across the country, and New York has them too. They have maintained a steady caring environment for patients who are recovering, and the incoming surge of patients.

It reminds me of healthcare saying by Thomas Frist M.D., “Take care of the patient and everything else will follow”

Sounds about right?

Quality care could be a ray of hope and lesson the number of patients coming into the hospitals. At the time, it feels idealistic when it is not. The fact is that we must take this slow; one day at a time, ensure care equipment such as ventilators is all there for them.

You never know, the results could just surprise us, in a good way. That’s what care can do and what the patient so rightly deserves.

Healthcare providers, hospitals, population health experts, doctors, nurses, volunteers, and staff are all playing their part diligently; we can’t ask for more. Sadly, the number of deaths keeps on climbing up for New York. Governor Cuomo admitted that the rate of deaths will increase in the upcoming days. However, the good thing is that the number of people coming to hospitals will decrease.

We will see a rise in the number of deaths each day in New York. Why? According to Governor Cuomo, the people that are already in hospitals, on ventilators for weeks now; they have less chance of surviving.

Coronavirus has so far consumed the lives of many of our fellow humans. I have to say I didn’t expect something like this to hit the world in 2020. Although the world remains calm, courtesy to the leaders who are doing their jobs well. Otherwise, with a virus like this one shaping up into a pandemic, chaos was inevitable.

Here, P3Care would like to appreciate Governor Cuomo for this war against an unseen enemy. Yesterday, he said and I am paraphrasing it, why do the poorest among us have to suffer the most? Whether it is hurricane Katrina or some other disaster, poor people suffer the most. The person at the rooftop wasn’t a rich white man. We have to find out the reason for that. We really do.

Also, he was of the view, and I am paraphrasing that this virus is our true enemy; it attacked the weakest and the vulnerable. It is our duty as a society to protect our weak and vulnerable.

A Brief History of the Virus in New York State and the United States

According to a recent article in the New York Times, several studies prove that this virus came to the US through Europe and not an Asian country. Research puts the time of this virus to mid-February when it began to circulate in the state of New York.

In New York alone, there are 159,937 confirmed cases so far; 13,000 have recovered; and a staggering number of 7,067 deaths. God bless the departed souls.

There are 469,121 confirmed cases; 26,448 who have recovered; and 16,676 deaths across the United States so far.