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MIPS Quality Measures 2020, MIPS incentives, MIPS Quality measures, MIPS data submission, MIPS quality reporting, submit mips data, MIPS registry, healthcare Solutions, MIPS 2020, MIPS consulting firm, MIPS consultant, MIPS data via clinical quality measures, MIPS solutions, MIPS CQM

MIPS Quality Measures 2020 and Specifications for MDs and DOs

Am I eligible for MIPS incentives in 2022?

The question that we hear a lot. And, I have to say it is your right to know.

Whether you are a general physician or a surgeon, submission of MIPS Quality measures leads the way to incentives.

Why?

The government started MIPS back in 2017 to incentivize eligible clinicians, and in return, improve the quality of healthcare. In short, it ensures ECs submit measures for the good of their patients – they will have permanent access to quality care.

The purpose here is to write down a MIPS Quality measures list that includes at least some measures and leave the rest to update in the future. Therefore, you’ll see some of them if not all; we’ll keep updating it, hopefully.

I also hope to provide info not only for family and general physicians but for specialists too. In an ideal system, the MDs, and DOs work in rhythmic harmony for better care coordination and patient experience.

Difference between an MD and a DO

For those of us who don’t know what an MD is, it is short for Medical Doctor, while DO stands for Doctor of Osteopathic Medicine.

Although both of them may use all the available methods to treat their patients, including drugs and surgery, DOs believe in a more holistic approach. DOs emphasize preventive medicine, musculoskeletal health, and holistic care. It doesn’t mean MDs are any less skilled or something like that. Both are equally capable.

The Expertise of Both Specialists

Both specialists, MDs and DOs, can choose to practice in any specialty. Both lend their expertise to promote the quality of healthcare to patients translating CMS MIPS quality measures.

AMA (American Medical Association) studied that in 2018, up to 57% of more DOs preferred to practice in primary care compared to 32% of the MDs.

The total statistics for DOs participation in primary care were:

  • 9% went for family physicians
  • 8% went for internists
  • 8% went for pediatricians

However, both programs offer a license, thus, it does not matter what program a student pursues.

Define the Quality Performance Category

One of the categories of the Merit-based Incentive Payment System (MIPS) is the Quality performance category! It holds a 45% weight in the total score.

What does it account for?

It measures your performance in clinical activities and patient outcomes. MIPS data submission through Quality measures helps assess health care processes, manage results, and patient experiences. As a result, we can expect the highest quality of care while keeping expenses to a minimum. Hence, the achievement of the value-based care purpose.

Understanding CMS MIPS Quality Measures

  1. Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) 

Diabetes, a menace, to say the least, shadows quite a part of the US population. How can we put a lid on it? Well, the answer lies in value-based care. More importantly, it is MIPS quality reporting that will eventually decrease the number of diabetics across the country.

This particular measure says to submit data on your patients from the age of 18-75 with diabetes who had hemoglobin A1c > 9.0% during the measurement period.

A CMS eCQM is available for this outcome measure. The collection types for this measure include:

  • Medicare Part B Claims
  • eCQM (electronic-clinical quality measure)
  • CMS Web Interface
  • MIPS CQM (clinical quality measure)

Since one of the collection types of this measure is MIPS CQM, you can submit it through a registry. It is one of the most effective of all the MIPS data submission methods thus far.

You can submit it if you are part of the following areas, provided you fulfill the low-volume threshold for MIPS:

  • Family medicine
  • Internal medicine
  • Preventive medicine
  • Nephrology
  • Endocrinology
  • Nutrition/dietician
  1. Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

Measure number 2 is related to the heart. American Academy of Cardiologists

It includes people aged 18 and above who were diagnosed with heart failure (HF) with a present or past left ventricular ejection fraction (LVEF) < 40% and were prescribed beta-blocker therapy either within a year of procedure in an outpatient setting or at each hospital discharge.

Reporting MIPS through this measure sets the tone for the management of chronic conditions. Gladly, it is available in both eCQM and CQM type, thus acceptable through various sources.

Specialties for which this measure is suitable to include:

  • Cardiology
  • Family medicine
  • Internal medicine
  • Hospitalists
  • Skilled nursing facility
  1. Anti-Depressant Medication Management

Psychiatrists act as pillars of healthcare when it comes to mental health treatment. Especially, their role is critical through the COVID-19 pandemic. Could there be a worse time for mental health issues to rise? Well, it could be worse!

Being grateful and using empathy as a tool to interact with people around us is needed for sure. The description of this measure that we have with us is mostly for eligible psychiatrists. MIPS 2020 presents numerous measures to report with accuracy and data integrity as the two requirements.

It is quality measure #9, according to the official fact sheet released by CMS.

How do we describe it?

It aims to find a percentage of people aged 18 years and above who were treated for mental illness and prescribed antidepressants. As per their depression symptoms, they have prescribed medication for months. You should report the following two types:

  1. First, the percentage of patients who were on antidepressants for at least 84 days (12 weeks)
  2. Second, the percentage of patients who were on antidepressants for at least 180 days (6 months)

Why is this measure meaningful?

It is in line with the prevention and treatment of opioid and substance use disorders. A MIPS consulting firm helps you select the right measures to report. More importantly, it is the accuracy and data completeness that matters to maximize MIPS incentives.

The collection type available for this measure is eCQM. Moreover, the specialties that this measure services include:

  • Family medicine
  • Internal medicine
  • Mental/behavioral health
  1. Age-Related Macular Degeneration (AMD): Dilated Macular Examination

Eyes let us see the beauty around us, thankfully. They show us the world as it is. In this quality measure, people aged 50 years and above are to participate. As an EC, you are to report it once they are diagnosed with age-related macular degeneration (AMD), followed by a dilated macular examination.

Further, it led to the recording of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the intensity of the damage caused during one or more office visits within the 12-month assessment period.

Henceforth, this measure assesses the chronic conditions management area. Ophthalmologists are to report it through their MIPS consultant. MIPS solutions and to send MIPS data via clinical quality measures type is doable with plenty of support from qualified registries.

The collection type for this measure includes:

  • Medicare Part B Claims
  • MIPS CQM

In fact, it is only available for ophthalmology specialty.

Conclusion

Thus, paying special attention to the MIPS quality measures can maximize the chance to earn positive adjustments and even incentives.

It all depends on the CMS MIPS quality measures that you submit to CMS. Therefore, MDs and DOs, take time to strategize MIPS solutions properly and improve your financial situation.

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 the 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.

MIPS 2019 reporting, Healthcare Solutions, MIPS QPP, MIPS 2020 reporting, MIPS quality measures, Medicare and Medicaid Services, MIPS qualified registry, MIPS consulting services

3 Points to Consider Before MIPS 2019 Reporting

Physicians! It’s time to prepare for the MIPS 2019 reporting period. There’s only a little time left.

This time may be hectic and stressful, even for MIPS qualified registries. But don’t worry, P3 Healthcare Solutions has come up with effective tips to target high MIPS scores.

Let’s be honest, MIPS QPP can be a daunting approach to earn incentives for those who are not careful.

On the other hand, it can be rewarding and tends to appreciate clinicians’ efforts for showing remarkable performance.

Now, the bad performance can’t be blamed over a misunderstanding. It’s been three years since MIPS if you still can’t perform well, you should expect financial setback.

Financial Risk Is Increasing!

  • This year, the performance threshold is thirty points.
  • Financial risk is up to 7%.

You can imagine that the reporting complexities will be higher than the years before. Some people will win this game while others will lose. The only way forward is to strategize beforehand and report according to the specified guidelines.

So, just let’s dig into three important points to consider before MIPS 2019 reporting.

Understand the Criteria for the Minimum Performance

Did you know that only by correctly reporting for Improvement Activities (IA) and Promoting Interoperability (PI) categories can give points up to 40? It is at least 10 points more than the minimum threshold that can save from the penalty.

Speaking about the reporting strategy, keep in mind that this year, PI category data submission has especially been strict. Now, it’s not enough to just say that yes! I did it. You have to provide substantial evidence for the performance.

Pay Attention to MIPS Quality Measure

You might be thinking that if reporting for just IA and PI is enough to save your face, why not just stop there.

But we suggest, NO! You should not only be considering penalties but the goal should be incentives and bonuses.

Striving for better opportunities give margin to stay ahead of game from those physicians, who might only have taken measures to prevent themselves from penalties.

So, working not only to save yourself but to earn incentives and bonuses should be included in strategies, and reporting for MIPS quality measure is an efficient way to do that.

Don’t Wait Until the Very End for Data Submission

CMS – The Centers for Medicare and Medicaid require data for 90 days of PI and IA performance categories. The same is not the case with Quality and Cost measures.

CMS also has a specified timeline in which eligible clinicians can report data to them. However, if you consult a MIPS qualified registry, you are able to save data and make relevant changes from time to time.

March 31, 2020, until 8 p.m. EDT is the last date for QPP MIPS 2019 data submission. During this period, eligible clinicians can also update their data if required. So, until the submission window stays open, you have time to make changes to comply with the CMS requirements to score high in the end.

This strategy reduces the chances of errors and data redundancy. MIPS is a bit complex, but the key to success is comprehending the reporting criteria, which is an easy process when collaborated with MIPS consulting services as P3 Healthcare Solutions.

Small medical practices or hospitals need their time to plan, but a smart strategy can go a long way to maximize returns, optimize time, and efforts.

So, start planning today.

Learn about MIPS quality measures specifications 2019 in a nutshell.

MIPS reporting in 2019, Physical Therapist, MIPS meaningful use, healthcare system, Quality Payment Program, QPP, MIPS Qualified Registry, Medicare & Medicaid Services, Healthcare Solutions, CMS

A Guide to MIPS 2019 Reporting for Physical Therapists

Physical therapists are included as one of the groups of healthcare practitioners eligible for MIPS reporting in 2019. It was time their duties were rewarded with an open heart and a clear head. Physical therapy is a serious branch of medicine that, now, comes in the quality circle of the government where physical therapists (PTs) can receive incentives based on their performances. Moreover, MIPS measures relevant to their line of work highlight the broader spectrum of the US healthcare system.

Merit-Based Incentive Payment System (MIPS), as some of the PTs must already know, is where the disadvantaged gets rewarded equally as one with advantages. By advantages, I mean those clinicians who have to face geographical constraints or practices working in the countryside where there are fewer facilities as compared to ones in the city.

So, a system that speaks of justice is a system that works for people everywhere in the world.

MIPS is a combination of programs such as the Physician Quality Reporting System (PQRS), the Meaningful Use (MU) program and the Value-Based Modifier (VBM). Promoting interoperability (PI) category correlates with the MIPS meaningful use.

The four categories in which the performance of clinicians and clinician groups are measured are –

  • Quality,
  • Promoting Interoperability (PA),
  • Improvement Activities (IA),
  • And, Cost

Generally, PTs will only be scored in two categories in 2019 – Quality and Improvement Activities. The American Physical Therapy Association (APTA) participates actively in every provision of the Quality Payment Program (QPP).

MIPS 2019 Reporting for Physical Therapy Made Easy by P3Care

With the pre-designed MIPS 2019 reporting packages in the form of MIPS Essentials, MIPS Budget Neutral and Benchmark MIPS, P3 Healthcare Solutions is tailor-made for it. Doctors falling across various specialties, now, adopt one of these packages to report data. Their MIPS final scores in the 80s and 90s are a clear manifestation of the efficiency of P3 Healthcare Solutions.

Give it a try by talking to us at this number: 1-844-557-3227.

Being a MIPS Qualified Registry gives us an edge to report with consistency and data completeness. The latter qualifies as one of the factors judging the quality of data by the Centers for Medicare & Medicaid Services (CMS).

The Deadline

Another important factor that keeps us on the edge of our seats is deadlines. In this case, Physical Therapists (PTs) can report MIPS measures until December 21 as far as improvement activities are concerned. However, the submission of Quality occurs all over the year, P3 Healthcare Solutions, Ontario, CA has done it in the past and continues to report MIPS Quality measures for eligible clinicians year after year.

Submission deadlines vary according to the submission types. For those who undergo MIPS claims-based reporting in 2019, the claims must get processed “no later than 60 days after the performance year ends”. Groups using the CMS web interface option have to submit within 8 weeks after the performance year. The time window for this 8-week reporting opens from January 2 to March 31.

As a general rule, participants must submit measures before March 31 of the year after the performance year.

MIPS Consulting Services with Results

Physical Therapists (PTs), Occupational Therapists (OTs) and Speech-Language Pathologists (SLPs) are three crucial branches of health care. All of them can make use of P3Care to report MIPS performance categories, score high, and get a chance at incentives. That’s right. Leverage our services to convincingly compete in the Quality Payment Program 2019.

Improvement Activities (IA) category measures their performance in terms of practice improvement over an elaborate period. Ideally speaking, a MIPS Qualified Registry is suitable for reporting IA for

PTs and OTs as they can work on measures such as enhancing care coordination, expanding patient access to care, and improving patient-doctor decision-making. All of this to land the best score out of a total of 40 points.

How to Avoid Penalties in MIPS 2018, 2019 and Beyond?

Please comment to assist the other readers.

HAPPY THANKSGIVING

Happy Thanksgiving

The holiday of Thanksgiving is a tradition started by the Pilgrims and Indians. Together they shared the fruits of newly settled America. Its origin can be traced back to the 16th century when the first thanksgiving dinner is said to have taken place.

It is time for gifting your family and friends. The day is about gratitude and respect for your elders, friends, and your siblings and also your colleagues. Popular gifts include flowers, jewelry, baked cookie hampers, chocolate gift baskets, candies, and wine.

Thanksgiving Day is a family festival celebrated with a lot of enthusiasm in the U.S and Canada. It commemorates the feast held by the Pilgrim colonists and members of the Wampanoag people at Plymouth in 1621.We wish you happy thanks giving day

On this day P3 Healthcare Solutions pays tribute to the blessings they have as a company and for their workforce who is responsible for its success so far. In-person, we are thankful for the love and respect we have for each other.

Thanksgiving dinner is an integral part of the day celebrations. The entire family sits at the table during dinner and offer prayer to the Lord Almighty for His continuous grace. The traditional stuffed turkey adorns every dinner table during the feast.

Thanksgiving is the official start of the holiday season – which means it’s totally acceptable to turn up Dolly Parton’s Home for Christmas album and try memorizing The 12 Days of Christmas all over again.

My family’s tradition around the dinner table is to share one thing we’ve been thankful for in the past year. It’s an emotional time and brings everyone together in a warm way.

PHI, Protected Health Information, EHRs, Electronic Healthcare Records, Healthcare, Healthcare Solutions, HIPAA, Medical Billing and Coding, medical billing company, Medical Billing Services

What every physician needs to know about PHI?

Protected Health Information (PHI) refers to data that is collected and managed during the diagnosis or treatment process and identifies each patient.

In simple words, PHI is all the information in medical records including the conversations during the treatment, medical billing and coding, and the health insurance data. Generally, medical billing services have to deal with all such information. Therefore, they must conform to the HIPAA rules.

HIPAA – Compliant Medical Billing Services

Any information related to patients and their healthcare plan is sensitive and can be misused. Thus, medical billing companies should compile medical claims in a protected environment to prevent confidential data from being leaked under the rules of HIPAA.

HIPAA – Health Insurance Portability and Accountability Act focuses on:

  • Making identification information private
  • Using patients’ information only during the course of healthcare
  • Disclosing private information only to relevant and trustworthy parties

PHI Includes

  • Billing information from medical billing services or clinicians
  • Contact information
  • Medication and prescription statements

Information like blood pressure reading and burned calories are not considered in the PHI category.

Securing healthcare information is one of the major responsibilities of medical billing services. Any medical billing company failed to take measures in this regard unconsciously exposes their clients to a serious financial threat.

It is to remember patients have the right to access medical records anytime. However, HIPAA restricts access only in specific circumstances.

Healthcare organizations or medical billing companies on their behalf need to educate patients about their rights; otherwise, the idea of the progressive healthcare industry won’t work.

What Can We Do to Protect Data from Hackers?

As technology is evolving and offering reliable storage solutions, managing data on papers is not feasible. Electronic healthcare records (EHRs) propose a better solution, provided strict actions are taken to secure data in all formats.

Healthcare organizations and other stakeholders of the healthcare industry need to design and implement a strategy that safeguards the integrity of data on all levels be it technical, physical, and administration.

Such small steps lead us towards a reliable and seamless data transmission, making an empowered healthcare system.

Medical Billing Services for Dentists by P3Care, Ontario, CA

Medical billing services will agree that getting reimbursements for dental surgeries is quite difficult. Dental insurance benefits are not as elaborate as other healthcare plans. Therefore, many dentists don’t support this approach and have adopted the pay-per-service method. But the fact is getting money from patients is a daunting task.  If patients are insured, insurance companies pay at least 70% for the incurred expense.

Medical Billing for Dentistry Is Also In Favor of Patients

If dentists adopt the medical billing process, patients will not have to stress about payment.

Consulting a medical billing company like P3 Healthcare Solutions would indeed be a 180-degree turn over for dentists and fellow assistants.

However, the shift will save physicians’ time from running after patients for reimbursement.

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

How P3care, Ontario, CA Manages Medical Billing For Dentists?

All the medical billing companies, who wish to create accurate claims for dentists, here are some tips to make the billing process accurate.

Accurately Document All the Specifications

Medical billing services have to prove to the insurance company that dental surgery was necessary for the patient’s oral health.

P3Care searches for the most relevant ICD and CPT codes to report for dental surgery. We make sure to state the reasons for surgery as precisely as possible.

We suggest you submit medical claims with explicitly stated,

  • The situation of the patient, when he came to the dentist
  • The causes of the damage oral health
  • The diagnostic code for the treatment
  • Surgical procedures

This particular information leaves no room for the insurance companies to deny the medical claim. Moreover, it helps them understand that the patient has not simply a minor dental problem but is a severe case that needed surgery.

Go for Pre- Authorization of the Benefit Plan

Surgeries of any kind don’t happen suddenly. Physicians often have the time of a day to two, before the surgical procedure. Medical billing companies can use this period to pre-authorize insurance benefits from the insurance company. It helps to know if the insurance company will pay for the treatment or not. It will be like an Explanation of Benefit (EOB) statement.

Pre-authorization of the process saves physicians time and patients as they get to know about the payment responsibility at the early stages. Moreover, the benefits patients have in their health plan and the deductible that the patient has to pay becomes clear.

Hence, like all other medical specialists, dentists should also progress with changing times and switch to medical billing services for reimbursement purposes.

4 Tips to Improve Patients’ Payments via P3Care, Ontario, CA

Medical billing companies have the responsibility to make physicians’ survival easy by collecting reimbursements. Insurance plans are of many types, and in case of a private healthcare plan; patients are required to pay deductibles from their pockets.

The healthcare expenses in the U.S have already reached a limit; where even a middle-class patient finds it difficult to clear off his bills. Therefore, getting deductibles and co-payments from patients prove to be a hectic job for medical billing services.

Apart from the strict rules of insurance companies, medical billing companies have a hard time collecting patients’ payments. Then, how can they ease their burden and reduce accounts receivable (AR)?

It might seem like an impossible job, but via 4 simple tricks that P3Care has learned over the years, medical billers can achieve success in this regard.

  1. Medical Billing Companies Should Allow Multi Channels Payment Methods

Suppose you and your friend have to pay some bills, it is not necessary that you both will pay through the same method. Maybe you like paying cash and your friend might like to pay via credit card.

According to research, customers make payments based on the fact that what is convenient for them. The same is the case with patients. When there are multiple payment methods, patients can opt for the most suitable method. Medical billing companies should encourage clinicians to have a flexible payment method. Otherwise, hospitals would be missing out on some major revenue.

The Omnichannel approach of the payment model doesn’t restrict patients with minimum access to choices. It will also have a positive impact on the patients’ satisfaction level.

  1. Adopt Automated Payment Method

Automated payment refers to paying bills on a predetermined date. This payment method ensures secure and confirmed payment by the patient. As the patient already knows about the scheduled payment, medical billing companies thereby, need lesser staff for payment collection.

Generally, via this method, patients make payments on time, especially the ones with high deductibles. Moreover, the billing staff can reduce unnecessary expenditure. For Instance, on paper files.  Automated bills also help to reduce the efforts for follow-up services.  The front desk of medical billing companies doesn’t have to go after each patient for payment. They only have to decide upon a specific date, and the process goes by easily, other than in exceptional cases.

P3 Healthcare Solutions being among the best medical billing companies in Ontario, CA recommends that medical billers should inform about the total payment while deciding upon the payment plan to the patient, rather than asking for a fee each month.

Visit: https://www.linkedin.com/company/p3-healthcare-solutions for the latest knowledge of healthcare and medical billing.

  1. Educate Patients about their Payment Responsibilities

Medical billing services should be clear about one thing; you can’t expect patients to pay deductible and co-payments at once, particularly, if they’re in significant numbers. Nobody likes such surprises. Therefore, a better approach is to educate patients in the early stages of their financial responsibilities.

It is also proven from research that around 91% of patients like to know the complete payment model prior to the visit. Clinicians in association with the medical billing service should map out every payment detail in front of the patients. Only this way, physicians will manage to increase revenue for themselves.

It also brings forward a good reputation of the physicians and makes patients trust more on the medical practice.

  1. Ensure HIPAA-Compliance in Payment Model

Patients’ data security is everything. However, healthcare data is always at risk. We have seen many scenarios where data breaches lead to huge revenue losses. While creating medical claims and collecting payments from patients, medical billing staff works with sensitive information, be it, credit card information and healthcare records.

Taking exclusive measures to protect the misuse of data requires the allocation of dedicated resources, which some companies might not be interested in. However, this step can’t be neglected. Besides streamlining other billing operations, patients’ data security also adds to revenue increment.

Moreover, designing a comprehensive security plan as per the Payment Card Industry (PCI) standards don’t necessarily require a huge investment.

P3Care is one of the renowned names in the medical billing world.  We have worked for several years in this industry and increased revenue for many clients. By implementing the above-mentioned tactics, we have managed to generate fruitful results. Hopefully, it’ll result in the best possible way for minnows of the billing industry.

In What Ways Medical Practices Can Take Risks to Increase Revenue

Everybody agrees that healthcare professionals, no matter in what capacity they serve, require every bit of applause. Working in hospitals is indeed a hectic job, and clinicians work tirelessly from day tonight.

When it became difficult for physicians to meet up with ever-changing scenarios, medical billing companies came to their rescue.

Now, insurance companies have strict rules and regulations, and physicians get reimbursements only when they meet the standards. Also, with the already complex U.S healthcare system and value-based incentive programs as MIPS, physicians tend to put greater efforts for their survival. It also put pressure on the medical billing services, as they could not afford to perform below average.

Besides, the focus on value-driven healthcare services has increased. Patients’ engagement level and integrated healthcare infrastructure have also gained more importance than before. Thus, medical practices ought to implement strategies that benefit them in the long run.

According to a survey report of Healthcare Financial Management Association (HFMA), more than 7 medical facilities in a group of 10, aim to take risk via

  • New commercial payers
  • Medicare advantages
  • Medicare contracts

One thing is interesting to note that many healthcare leaders support the idea of a revolutionary healthcare system that benefits both, patients and physicians.

Provider-Sponsored Healthcare Plans (PSHP) is gaining much attention even from medical billing companies as patients get insurance plan owned by a hospital or physician. 25% of the medical practices are already going to be part of the PSHP system, and 19% of hospitals want to launch their own healthcare insurance plan in the upcoming years.

Alongside this, Medicare and private payers are also increasing their range of insurance benefits.

What do Benefits Will Physicians get?

If medical practices take chances to go for new payment models, both payers and physicians will be equally benefitted. Physicians will be able to implement accurate value-based practices while being closely in touch with the payers. The communication gap will be reduced, and the medical billing companies will reduce the rate of denied medical claims.

The Use of Healthcare Technology

Use of Healthcare technology

By taking bold steps to increase reimbursements and efficiently run revenue cycle management, physicians will be able to use the latest healthcare technology successfully.

Hospitals will manage to spend efficiently upon the technological infrastructure to increase engagement between physicians, patients, and payers. Surprisingly, many physicians are ready to spend money on new technology avenues.

What are the hurdles that might come?

Even in 2019, there is not much demand for drastic risks in the healthcare industry. Although, many physicians like the idea to try something new. Still, they are comfortable with the Fee-for-Service (FFS) payment model.

What Should Physicians Do?

You can always take risks whenever you want.  On the contrary, you can also benefit yourself from the existing payment model and generate revenue by focusing on the betterment of the following parameters.

  • Engagement rate
  • Standardized clinical procedures
  • Cost-effectiveness

If you’re struggling in managing accounts receivable (AR), taking risks may seem like an appropriate option, but the transition process is also tiring. You can’t expect to achieve everything within a little time. The best approach is to keep improving healthcare strategies gradually and consult a professional medical billing company that creates medical claims with up-to-date knowledge. Like, P3 Healthcare Solutions- A professional medical billing company in Ontario, CA that has years of experience in the billing field and helps in generating revenue for its clients.

What are your thoughts? Let us know if you’re willing to take risks regarding revenue generation?

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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.

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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.

News

Provider billing services, COVID-19 Cases, Healthcare, Healthcare Solutions

New York is All Set to Safely Reopen Schools This Fall

The world at large holds its breath as life is about to normalize. It is going to take more than just the will to reopen amidst COVID-19, especially the schools. What we need to do is act upon a persistent, consistent, and watchful approach. Because one small mistake can cost us precious lives.

We have all missed so much of life during the past few months, especially for the kids it was debilitating enough. The news to reopen schools seems like the right thing to do.

If COVID-19 has taught us one thing, it is gratitude. Quarantine taught us to appreciate the good times before they become extinct. That is for sure!

Every state had its share of COVID-19 cases. However, New York State was hit the worst. Going back a few months, we saw a steep rise, plateau, and then gradually a fall in the curve COVID-positive patients. It took a ton of patience, reassurance, and action from healthcare officials and essential workers to get us out of that desperate condition.
We bounced back big time with our determination and complacency as a nation; now, health experts say, New York is one of the safest places to reopen schools. Governor Andrew Cuomo asks the state officials to make it happen.

Governor Cuomo Says Schools Can Hold In-person Classes This Fall

Provider billing services, COVID-19 Cases, Healthcare, Healthcare Solutions

Governor of New York, Andrew Cuomo, is confident to reopen schools this fall. He reassured on Friday, August 7, that it is possible to hold in-person classes even if other districts continue to see a surge in COVID-19 cases. Authorities in other states have to decide whether or not to reopen according to the percentage of active COVID-19 cases per day.

CDC & WHO Report A Favorable Time to Bring Kids Back to School

Provider billing services, COVID-19 Cases, Healthcare, Healthcare Solutions

New York is the capital of the world, once it used to be London; health experts such as doctors, epidemiologists, and others confirm conditions are favorable for reopening of schools throughout the state with safety measures in place.
Not one, but many mental and physical health practitioners consider staying home to do more harm to kids than the virus itself could possibly do.

Since Wednesday, there were fewer than 1 percent active coronavirus cases across the state; that is considerably below the 5 percent positivity limit that both the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) agree on as the safety benchmark to reopen schools.

What Does the Mayor think?

Provider billing services, COVID-19 Cases, Healthcare, Healthcare Solutions

Mayor Bill de Blasio says if more than 3 percent of tests come back positive, schools will remain closed. The daily infection rate if crosses 3 percent per day, it is not a good idea to reopen, says Harvard’s Global Health Institute.
P3 Healthcare Solutions encourages the act of reopening educational facilities this fall. It is for the best because schools will give students something to look forward to every day. We can’t go on like this forever.

P3 caters to provider billing services involving infectious disease experts and pediatricians. For kids to ideally thrive, clinicians reimbursed in full for their services could be the difference.

What do the Experts Say?

Provider billing services, COVID-19 Cases, Healthcare, Healthcare Solutions

Dr. Uche Blackstock, an urgent care physician in Brooklyn and founder of Advancing Health Equity, says and I paraphrase:

If there’s any city worthy of reopening, it should be New York City.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University, is confident about the reopening of schools, according to the New York Times. Besides, initially, it may appear to be a trial run or a social experiment.
Additionally, he believes that New York’s chances of success, regardless of its dense population, are higher than many rural areas where there is a lack of seriousness to control the spread of the virus.

New York Falls within the Yellow Zone

The number of cases per capita criterion is also in favor of this reopening. The Harvard report categorizes regions into zones; 1 to 10 cases per 100,000 people form the yellow zone. The yellow zone regions are safe for in-person classes if the safety precautions such as social distancing and proper infection control measures are in place.
Currently, New York records 3.5 cases per 100,000 daily that puts it in the yellow zone. Yellow zone recommendations are first about reopening for kids from early kindergarten through fifth grade and last about high schoolers.

What Safety Measures to Follow?

Provider billing services, COVID-19 Cases, Healthcare, Healthcare Solutions

The COVID-19 experts are in favor of precautionary measures for schoolers that include mask-wearing, physical distancing, and improved ventilation in buildings.

Other districts have to come up with their own reopening plans. For the protection of both students and teachers, each region must come up with a plan to test them. It is subject to approval from the state’s health and education departments.

In general, experts believe the chorus, band, and sports with physical contact should not be part of the daily routine. Children, instead of eating in cafeterias, are to restrict eating in their classrooms. Schools should also ensure crowds stay away from gathering in hallways at different times of the day.

Earlier, we saw the Trump Administration encouraging practices to reopen as America strives to bring things back to the way they were. What are your thoughts on this?

P3Care, medical billing, MIPS 2020 reporting, Misconceptions about Coronavirus, Coronavirus

P3 Clears Five Misconceptions About Coronavirus

P3Care counters misinformation around topics of medical billing or MIPS 2020 reporting about the much-talked-about coronavirus. Yes, the Wuhan-born virus is breaking news on every news channel in the world.

A session held on Friday in New York City by the Center for Disaster Medicine at New York Medical College (NYMC) about the virus recorded someone from the audience asking, “Is it safe to eat Chinese food?”. That is what news without investigation can do to you. There is much wrong information floating around that it has become hard to differentiate between facts and fiction.

There are 5 common misconceptions about the virus with counterarguments for the greater good of the people.

And, yes, eating Chinese is safe. It is ‘not’ a safety hazard by the World Health Organization (WHO) or the Centers for Disease Control and Prevention (CDC).

Misconception 1: Coronavirus is more dangerous than any other virus and is spreading fast

P3Care, medical billing, MIPS 2020 reporting

Wrong. The measles virus is much more dangerous than coronavirus (2019-nCoV). The only reason it has not spread quickly is that most people are already vaccinated for measles. Voila! It doesn’t make it to the news or social media.

The experts say that this virus can affect 2 to 3 people around. However, this data has a lot of uncertainty because it has not gone through scientific-peer assessment yet.

Misconception 2 – It can kill you

In a session, held by NYMC, Mary Foote, MD, MPH, Senior Medical Coordinator for Communicable Disease Preparedness at the NYC Department of Health said that it is believed that everyone who gets affected by the new virus eventually dies. But people are at greater risk from heart disease, cancer, old age, and any other life-threatening disease than by this virus.

People are at greater risk of influenza and chances of them ending up in hospitals from influenza are higher. Stating a fact, Flu kills tens of thousands of people every year in the US and 291,000 to 646,000 people in the world (according to a study published in The Lancet). CDC stresses on getting flu shots on their website and social channels for public protection as we speak. Hence, people ought to be more concerned about protecting themselves from the flu rather than the coronavirus.

Misconception 3 – It was manufactured in a laboratory and is being used as a biological weapon

medical billing, MIPS 2020 reporting

The news that was spread earlier by a large number of Russian domestic channels suggested the involvement of the United States behind this outbreak. The misinformation further spread like fire saying the US has created this bioweapon against China and that US pharmacists were making billions from this.

Similar conspiracy theories are creeping up in China and, oh surprise, surprise, some of them are coming from within the U.S. All of these are just conspiracy theories and nothing more. No, there is no evidence that this was a human-designed strain of the virus created to destroy countries or dismantle governments.

Misconception 4 – A cure is available

A vaccine is not developed in the blink of an eye. There hasn’t been a vaccine until now because it is a new virus and producing a vaccine to counter will take some time. Public and private organizations are cooperating to assist scientists in finding a remedy for this virus as quickly as they can.

Misconception 5 – Every person with fever and coughing is infected with coronavirus

This is misinformation #5 on this list. Since the public is unaware of reality, they think every person with the common flu is infected with the coronavirus. CDC has stressed the importance of flu vaccination several times. Medicare offers to reimburse providers if they claim for giving flu shots to their patients. The same facility is for the beneficiaries to get their flu shots on time in which they don’t have to pay any out-of-pocket costs. Health plans are in full support of this cause.

Qpp Mips Penalty for late reporting

Small Medical Practices Can Save Themselves from QPP MIPS 2019 Penalty

QPP MIPS participation offers a golden opportunity to target incentives and bonuses. Especially when the CMS has been favoring and rewarding small medical practices then why not take advantage of this chance.

Small Medical Practices! If you’re wondering how to play safe and avoid a penalty in MIPS 2019 reporting. We have come up with a few tricks that help you to achieve your goal.

The first step would be to check the eligibility status of the small group. Verify your Tax Identification Number (TIN) under which you’re participating.

You can enter your National Provider Identifier (NPI) on the QPP Participation Status Lookup Tool https://qpp.cms.gov/participation-lookup to know about the details.

Reporting for MIPS Quality measure is crucial in MIPS 2019 reporting, and it is a requirement that can’t be missed. Therefore, submit data for at least one patient that fulfills all the quality performance requirements with six quality measures.

Physicians are required to report data for “Improvement Activities” (completed for ninety days) with two medium or one high-weighted measure of the respective category.

While reporting for MIPS performance categories, make sure to document every procedure accurately. For Instance, while reporting for medication, document procedures with the up-to-date list of medication.

Small Practices! MIPS 2019 reporting is not complex to the extent where you can’t achieve a total of thirty points. MIPS Qualified Registry such as P3 Healthcare Solutions offers affordable packages for QPP MIPS reporting. If you don’t find any way out, consult us for a FREE consultation. Read more in this article.