Posts

Medical billing services, medical billing companies, outsourcing medical billing, revenue cycle management, US healthcare industry, healthcare providers, accurate medical billing, healthcare services

4 Powerful Ways to Improve Medical Billing Services

Medical billing services are a vital player in the US healthcare industry. Without them, physicians would have to face dire consequences in the revenue cycle. However, when the focus is upon refining the quality of care, the healthcare providers demand the same quality criteria for medical billing companies as well.

Outsourcing medical billing is a way for dedicated billers to take control, but it also supports the whole revenue cycle management process. When we talk about taking the healthcare industry ahead, medical billing companies must equally go through the process of screening according to set standards. It will benefit physicians and patients alike.

Two physicians from Johns Hopkins University researched in this sector and concluded the following arguments.

Let’s find out!

Medical Billing Services Should Be Transparent

Medical claims should clearly state the codes to get an estimate of the total bill without difficulty. Not only physicians but also the patients can read the claims. They must have the facility to check if the rendered services are accurate and billed correctly.

Firstly, it empowers patients and then the doctors, making them independent financially. Secondly, it checks costs as they turn out to be accurate for patients, useful to both doctors and patients. Ultimately, it leads to increased transparency in the billing procedure.

Opt for Price Transparency 

Another suggestion by physicians is to make prices public for patients. Although some medical practices in the US offer this facility to patients, it is still not the norm everywhere. The vast majority haven’t made them public yet.

Allowing patients to view prices of diagnostic and surgical procedures is to offer them price transparency. Moreover, patients would know their out-of-pocket expenses beforehand, and physicians would know their bills.

To know more about quality medical billing services, this might be a good read:

What Steps Can be Helpful for Tracking and Maintaining Quality for Medical Billing Services?

Involve Patients in the Billing Process

In order to improve medical billing services, it was suggested to encourage patients to speak with the concerned person in case of any ambiguity in the bill.

With this facility, bills would often be correct, on time, and accuracy would increase while preventing errors resulting in reduced denials. Moreover, patients would get more involved in the billing process, and their input can be utilized to compile cleaner claims.

Don’t Burden Patients Unnecessarily

Looking into the payment system, patients have to pay higher than the insurance plan devises for them. This approach is actually unfair in terms of the transparent flow of money. Furthermore, medical billing services should consider complications that may occur while the patients receive care.

The idea is to offer value-driven healthcare services to the patient alongside an optimized healthcare expense.

The financial aspect is crucial for the healthcare industry. The focus has to be only on the quality of services, but also on optimization and transparency of prices. It is observed in a survey that a large population of patients thinks of delaying healthcare services due to concerns in medical bills.

Thus, CMS and other governing bodies have to empower patients in the billing process for better outcomes. Let’s do that right away.

medical billing services, medical billing companies, medical billing company, outsourcing medical billing services, healthcare professional, healthcare services, healthcare industry, qualified medical billing, healthcare providers, medical billing service providers, credentialing services, expert medical billing

Medical Credentialing is a Process – A Physician’s Guide

Medical Credentialing strengthens the reputation of any healthcare professional! It is a process to verify that clinicians have undergone strict scrutiny and practice to acquire the skill of medicine to provide quality healthcare services to patients.

It is also helpful for medical billing services as they can get reimbursements on time without any complications.  The purpose of this process is not just to verify a physician’s degree but to ensure that patients only get services from professionals, whose qualification, license, training, and abilities are acceptable to practice.

Why Healthcare Industry Including the Medical Billing Companies Promotes Credentialing?

Quality of care has taken a central position in the healthcare industry; every stakeholder is adopting the latest methods and technologies to achieve this goal. Where technology incorporation is inevitable, the expertise of the medical staff is equally important in order to treat patients skillfully. It also increases the revenue of medical practice. Therefore, we cannot undermine the competence of the medical staff.

Moreover, now, hospitals have a penchant for credentialing through qualified medical billing services. Nowadays, every healthcare facility including ambulatory care centers, long-term care institutions, and even urgent care clinics don’t hesitate from credentialing.

Looking into the qualifications of the healthcare professionals creates a sense of trust between patients and healthcare providers, and medical practitioners and medical billing service providers. We have seen many cases in the past when false degree holders were caught treating patents. There is no place for such negligence in today’s world, especially after the pandemic.

This article will take you to the journey of how professional credentialing services are performed. No doubt, the criteria, and function of credentialing have gone complex over time. The provider’s scope of expertise, payers’ requirements and accrediting bodies have to blame for this.

However, an expert medical billing company can solve any issue coming its way.

Here is the detailed process of credentialing.

How Credentialing Functions?

Every medical practice should hire a dedicated team or outsourcing medical billing services to ensure that the system runs effectively and the healthcare staff is qualified to perform its duties in a safe environment.

After verifying the individuals’ credentials, the practice license also comes under scrutiny for maximum performance.

  • Verify the practitioners’ clinical degree, training, and performance
  • Verify if a healthcare professional meets the criteria for working in the hospital
  • Establish ground rules for denying verification of professionals after the pre-application process
  • Establish a process to allow the rejected healthcare worker to re-apply after the initial denial
  • Have a process for rapid credentialing of emergency staff and short-term employment staff
  • Limit those healthcare workers who do not follow guidelines or their standard of healthcare is unsatisfactory

Temporary Access to Professionals outside the Practice

In cases when an outside medical or surgical specialist has to offer advice or perform surgery, there should be laws to accommodate them by the medical billing services. In the time of emergency or natural disasters, respective rules should allow practitioners outside the practice to perform their duties.

A proper code of conduct should be in place for healthcare workers who corporate for credentialing plus for those who don’t.

Sometimes, physicians from outside America have to perform a complicated operation because of their different training. In such cases, shadowing or proctoring is required by the host medical practice, and bylaws should be there to smoothen the process.

Healthcare professionals working in any capacity should also understand that practicing medicine is sensitive and privilege and cannot be taken for granted.  Therefore, there is nothing better than accompany your degree with a credentialing process.

If you want to boost your revenue and reputation, contact P3Care for professional credentialing help!

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, was a constant media personality during this crisis briefing us on developing stories every day. He was relentless in front of an unseen enemy.

The fact is, 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. Also, it 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. Second, it is officially called the Community Based-Testing Site (CBTS) operation. In short, it involves mobile, drive-through, and walk-up sites where they would conduct COVID-19 specimen collection or testing in abundance.

Before COVID, telehealth products had to follow the HIPAA Privacy and Security Guidelines. 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 those guidelines.

In a time, when doctors are overburdened with the surge of patients, the administrative burden can only add to their worries. Therefore, CMS and OCR on their behalf have given breakthrough in strict conditions.

However, it doesn’t mean that HIPAA has been totally swept under the carpet. The importance of HIPAA cannot be undermined, and risking data is not compensable.  It’s just that the strictest rules are made flexible for guanine reasons.

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 you can use the above applications, some applications such as TikTok, Twitch, and Facebook Live come under the public-facing criterion. It means they are not permissible.

Therefore, before dispensing care, use applications in the allowed category.

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 non-compliance 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. In addition, they should be 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. In reality, 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 affiliation with the above-mentioned products.

P3 as a business associate comes under the obligation of HIPAA too. We are, in fact, trying to help our healthcare heroes as best as we can by the use of HIPAA rules. One of our services, security risk analysis, uses HIPAA to conduct a risk assessment of practices. In addition to that, HIPAA medical billing, our principal service, follows the provisions of HIPAA accordingly. As providers make their way out of the pandemic, we are here to support them on every twist.

Please hit the follow button on Instagram for more insights: @p3healthcaresolutions

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.

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/

Medical billing services, medical billing companies, CMS, healthcare services, healthcare professionals, medical billing and coding

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.

US healthcare system, Medicare and Medicaid programs, medical claims, Medical billing services, medical billing outsourcing, medical billing company, RCM process, healthcare IT, Provider medical billing services

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 doesn’t have to be patients or doctors all the time; when it is time to get paid, there is a third stakeholder – the payer – that comes into play.

The US healthcare system is made up of complexities. A system in which people with disabilities and above the age of 65 are covered by Medicare and Medicaid programs, clinicians ought to make their financial cycles a priority. When it is the first thing on your to-do lists, medical claims approve at a much faster rate without having to worry about denials.

Before getting paid in full, providers have to spend time sending the remaining bills to the patients. It is critical to the life of practices to stay profitable and meet their monthly expenses. A much practical way to achieve those goals is to hire Medical billing services such as P3 and amplify the revenue cycle management process.

We bring five secret recipes for your practice to run as seamlessly as the wind itself useful even in times of COVID-19. As America realigns with the after-effects of the pandemic, make use of the following techniques:

  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, getting 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. Provider medical billing services help you get paid faster and execute a result-oriented 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.

How accuracy of medical claims could save your revenue?

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

How to Verify Healthcare Insurance via Medical Billing Services?

Undeniably, physicians need a stable revenue cycle. To achieve this complex goal, medical billing services work day and night to reimburse claims for them. It is their job and a way to give back. Eventually, efforts like these sum up to reflect better reimbursements and stability for a practice. If your practice’s focus is on developing a strategy for effective billing, the rest is easy.

Besides, it is crucial to verify the insurance eligibility of providers.

Medical billers have to find an answer to this question: Whether the patient’s health plan covers the treatment and the provider or not? Also, if the provider is out-of-network, it gives billing companies a chance to enroll them with the insurance company.

On the other hand, patients also have a responsibility to fulfill; they must keep their health plan updated. We are here to spread this sort of awareness, so they receive the healthcare they deserve.

The article discusses such a topic so the providers can get the most out of insurance companies maximizing their revenue. The RCM process is the backbone of practices!

Let’s not wait anymore and delve into how medical billing companies can verify insurance eligibility in 10 easy steps.

  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 patient information. Such information includes:

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

Medical billing services have to find this information if healthcare providers don’t provide it, because, without it, it would be difficult to verify their insurance eligibility. Moreover, P3 Healthcare Solutions has a staff of billers and coders to expedite the process of verification.

  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 patient’s health plan saves providers from unnecessary stress. In short, it is the additional job of medical billing services to verify and confirm a patient’s eligibility.

  1. Check for Insurance Benefits

By contacting the insurance company, medical billing services verify the benefits that a patient can avail and the copayment that they have to pay.

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

  1. Ensure You Are 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 Deductibles

A deductible is an amount that the patient pays before the insurance company pays for them. There is a different amount for each insurance plan that a patient has to pay. In fact, medical billing companies need to ensure if the patient has paid the respective dues or not.

  1. Verify Copayments

Collect copayments from the patient, give them a slip, and share with them the treatment details. In this way, patients get to know their insurance benefits too.

  1. Be Efficient with Customer Support Services

Ordinarily, healthcare providers are busy people. It is not advisable for them to treat and charge patients at the same time. Therefore, medical billing services come to their rescue to deal with their payment matters. Besides, the front desk staff assists the patients for clarity in this regard.

  1. Verify If the Patient Has a Secondary Insurance

Often patients have secondary insurance. Only a certain amount of charges is covered by the primary plan. It is advisable to verify secondary insurance information too as described above.

Medical Billing Services for Small Practices

‘Medical billing near me’ is often the search phrase providers search in Google for the nearest billing services. However, it is not a matter of distance but experience. Whether you are a small practice or a big one, one cannot deny the value of experience. Moreover, if the company maintains quality staff; online and offline reputation; and, high first-time claims acceptance rates, practices are bound to flourish within no time.

As a matter of fact, they help physicians to join the insurance network and demonstrate efficiency. It is necessary to kickoff their revenue cycle.

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 of the whole insurance verification process?

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

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.