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4 Reasons to Outsource Credentialing by a Medical Billing Company

Medical billing companies save revenue cycle management for clinicians. Without the assistance of medical billing services, we doubt the efficient running of medical practice.

Healthcare industry is quite sensitive and responsible one. Physicians are supposed to practice their skills for the ideal health status of individuals. Especially in the on-going approach of the value-based healthcare system, physicians need to modernize their treatment methods now more than ever. Hereby, medical billing companies create medical bills and handle the billing tasks to get them reimbursements. Consequently, physicians can pay attention to their actual work.

However, in addition to the billing process, a professional medical billing company also offers credentialing services for clinicians, which is a vital part of revenue generation.

What is Credentialing?

It is a process, in which hospitals, insurance companies, or healthcare authorities verify and legitimize the educational background, expertise, and qualification of a clinician. Generally, this process takes place before including a physician in the working network.

Why is Credentialing Important?

When physicians are credentialed, they get timely and rightful reimbursements from the insurance companies.

Medical credentialing is not an easy process and requires extensive focus from the start of the process to the end.

No Immature can look into clinicians’ past and derive professional outcomes. The credentialing process is legal and can result in penalties if done unethically. Hence, this responsibility should only be given to medical billing companies.

What are the Challenges that Occur During This Process?

Credentialing Takes Time

Checking one’s background is a complex process. Therefore, it requires at least 60-90 days to fully credential a clinician.

Medical billing services when enlist a physician for credentialing, they are required to complete the whole process before he takes up a new patient. There is no room for error as the process involves the verification of sensitive fields such as employment history, education, medical training, licenses, and more.

Peers Don’t Cooperate

It is obvious that physicians are always tight on their schedule. Hence, there is little possibility that peers, who can give a vote of confidence for the physician will be able to respond to inquiries on time.

To avoid this delay in the credentialing process, physicians can inform their peers prior to the process. Moreover, they can also set a time to complete this task.

No Access to the Latest Information

Physicians need to have access to up-to-date information. However, medical practitioners are so busy in their lives that they remain oblivious of the latest information. For Example,

Clinicians working in the ambulatory surgical centers (ASCs) have to reevaluate their credentials after 1-3 years. When different clinicians have a different schedule for credentialing, it becomes hard for ASCs to manage all.

Thus, no access to the information at the right time creates issues for the credentialing service providers and the confirming authorities.

Inability to be Compliant with Value-Based Healthcare

Different states have different healthcare plans and so physicians are supposed to stay true to all the state exchange and federal healthcare plans.

Another challenge that a credentialing medical billing company faces is that physicians have to treat a reasonable number of patients to handle revenue cycle management. Moreover, medical practices should implement the right healthcare strategies. Otherwise, they’ll not be able to get reimbursements for the rendered services.

Considering the difficulty, medical practitioners choose to outsource for credentialing services. There is no way that unprofessional individuals should not take responsibility for this task. After all, physicians’ revenue generation is based upon it. Thus, only, a medical billing company as P3 Healthcare Solutions can outrun all the above-mentioned challenges for credentialing and insurance enrollment and offer an efficient solution.

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

4 QUALITIES OF MEDICAL BILLING SERVICES BENEFITING HEALTHCARE

What do you think is the main reason behind hiring or outsourcing a medical billing service? Follow https://www.linkedin.com/company/p3-healthcare-solutions/ to stay ahead in this field.

In the end, payments that you derive as a healthcare professional are the reason behind your survival, both socially and morally. If you are famous among your patients, it gives you satisfaction, but not for long if the revenue stream is unstable. The reimbursements are the lifeline of any practice, and hence, the role of a billing company becomes vital at this point.

Outsourcing medical billing improves the net collection rate as it gives a push to the reimbursements. It also speeds up the RCM process by not delaying the billing and coding of claims.

However, you should choose medical billing solutions cautiously, when you are in the right frame of mind. It means when you have nothing against them in any sense.  Read reviews, carry discussions, talk to co-workers, and the best way is to use Google for the best services nearby. Qualities below will keep you on the right track.

1. Top Medical Billing Services are Specialty-ready

Any company you’re looking to hire for your finances needs to be aware of your specialty. For instance, if you are a heart specialist, the HIPAA medical billing service company has to be familiar with the right billing codes and other standardized information.  Since there are constant changes in the system, it is not easy to keep up with it.

If they are a bunch of trained individuals who have experience with specialized healthcare practitioners in the past, it can be your best bet.

Some billing companies manage finances only for general practitioners such as physicians and physician assistants. Sometimes, it also goes to show their inexperience in medical billing.

Specialty medical billing services in the US are elaborate in their skills and work areas. They manage insurance companies by understanding the work process that goes in the acceptance or rejection of claims. The billers know their way around payers; understand them in a way better than the inexperienced billers.

It brings both the payer and the billing company closer to a point where they can produce better results. In addition, they also know how to avoid denials by creating insurance-friendly claims.

2. What Is Your Take On The Experience?

The answer to this question clears up any doubts about the ultimate selection. It is inadvisable to ask a newbie to handle your finances.

Your revenue cycle management is best suited in the hands of a veteran company with a multitude of satisfied clients. You need someone dependable who knows their way around the constantly changing healthcare system. It can only be someone with experience, the right attitude, and downright skills.

Given the current frequency of complex updates in the healthcare industry or Meaningful Use (MU) Stage 3 payment risks, it is sensible to find experienced medical billing services. In addition, they must provide 24/7 support and be at an arm’s length in case of developing situations.

Furthermore, if you need to talk to a person about a specific issue, the right technical person should always be reachable.

Ordinarily, with experienced companies, most bills see the light of approval rather than an outright denial.

3. Bear Advanced Software and Hardware Systems

Since an electronic health record (EHR) system has become a mandatory part of practices since 2017, you must be sound in practice management systems (PMS) and the use of EHR technology. It is clear that once both the systems corroborate with each other, the expenses drop and your practice prospers. It shows in the form of charged up reimbursements.

When three systems come together (PMS, EHRs and Patient billing systems) and form a solid alliance, there are fewer errors and the visit-to-billing cycle starts to roll.

Some medical billing services in the US have the latest machinery to keep an eye on the future and flexible enough to adapt to situations. Become one of those enterprises which use advanced computers and communication tools to meet the dynamic and ever-changing medical billing field.

4. Ready to Share Knowledge with Staff

The medical billing service companies not following the rules or adhering to the contractual agreements are not a good option. Despite the fact they are a professional team of billers, they must be ready and willing to bend a few rules just for your sake to make you feel well supported.

They should train the staff on the premises working for you. Moreover, the company has to be more than willing to educate someone in your staff that may help relieve the billing stress. Resultantly, when a situation builds up in real time, there will be someone to offer a potential solution.

3 DEFINITIVE METHODS TO SKYROCKET YOUR MEDICAL PRACTICE

When we talk about regaining health, it is time to stay in that thought for a little longer and think about those who cure us – the healthcare professionals. We can’t leave them too far, behind when we know health is only a matter of time. Falling ill to a disease awaits us at the other end of the road we know as life.

Since medical professionals are the healers, the motivators, the role models, the mentors in some cases, and without them, the US healthcare system will come to a halt, we will find ways to uplift their practice.

If anyone deserves a reward, it is them. The system depends on them to survive and move forward. Whatever the case may be, when we get sick, we go straight to the hospital. If we decide to stay at home and do nothing about the situation at hand, we only make things worse.

It’s time to give something back to them which may benefit them in some way.

Revenue Cycle Management (RCM) is like the central nervous system of medical practice. If it flows flawlessly, it enables steady revenue and things are good. We will touch upon medical billing services, accounts receivables (AR Management), follow-up on the pending claims, promoting interoperability (PI) and HIPAA compliance. All of these factors contribute to the success of medical practice.

1. Outsource Medical Billing Services

It may come more as a reminder to you. By relieving the in-house staff of the medical billing process, providers are able to improve the cash flow. It allows them to care for visiting patients and listen to their problems attentively.

The nurses and clinical professionals are not there to figure out the next accounting glitch or remember thousands of medical codes. It is the job of the medical billing and coding professionals to do that for the practice.

P3Care is one of those positive startups which only recently came to the scene and made it big. To reach the top in only a few years pays heed to their hard work and willingness to excel.

To find and hold on to the right medical billing solutions is probably the best way to increase overall collections. When someone authentic comes on board, physicians are able to see the overlooked pile of accounts receivables and ample delay in claim submissions.

The first-time clearinghouse acceptance rate suddenly goes up in the mid-90s. No matter what you do, denials are still going to happen but what matters is the time you take to work the appeals and resubmit the claims.

2. Demonstrate HIPAA Compliance

It is necessary for medical professionals to show HIPAA compliance. Every individual or organization that interacts with Protected Health Information (PHI) is bound by law to implement measures for its safety, physically and virtually.

You must be aware of the minimum requirements of HIPAA as a covered entity and a business associate because they will keep you safe from penalties. When there are no extra fines, the practice becomes an automatic success with a smooth flow of revenue.

OCR penalties are happening and relate to the nature of HIPAA violations. Therefore, get rid of the non-compliance issues as early as possible to save your medical practice from a big financial & reputational loss. Patients are aware of their rights and if there is a breach in their electronic health records, they may just never see you again.

As a doctor and a hospital, HIPAA compliance brings in reputational advantages along with the trust of the patients.

3. Make the Practice Interoperable – Meaningful Use (MU) of EHRs

The EHR incentive programs now turn into Promoting Interoperability (PI) programs. The name says it all for them. CMS changed their name to promote interoperability – The health information exchange (HIE) between providers and hospitals regardless of the variety of EHR systems.

PI becomes the new meaningful use of EHRs. All of this facilitates and spreads the data across networks so that it is available to the healthcare professionals on demand. If you use a CEHRT and you are on the list of providers signing the Trusted Exchange Framework and Common Agreement (TEFCA), it will take you a step ahead of others and the Department of Health and Human Services (HHS) may consider you as a compliant healthcare services provider.

It adds to your reputation and status as a medical practitioner. Patients vote in favor of those providers who follow the principles and regulations in order to improve the quality of care.

Final Thoughts

The above-mentioned techniques can push your practice to a new level that favors you and your patients. In addition, if you take these three steps, the federal authorities will be on your side. They will mention your name as someone showing compliance with the law on their social channels, web portals, and newsletters.

The methods are unique to what people usually expect to read under this topic. They bring in more patients as the ‘trust’ in the institution motivates them to do so. Apply them and become a successful value-based clinician.

Follow P3Care on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions/ to stay updated with the US healthcare industry.

MEDICAL BILLING – OVER 50% AMERICANS CAN’T AFFORD TO GO TO THE DOCTOR

The sorry state of affairs in the American medicare industry reflects the inability of many Americans to afford quality healthcare. Many can’t afford medical billing despite having insurance. The Obamacare premiums are making it difficult for them to continue with the payments.

Can’t Afford To Go To the Doctor – HealthPocket

A recent survey by HealthPocket revealed the difficulties that many Americans face. The Affordable Care Act is reducing people’s ability to afford health insurance. They have so many other expenses that they can’t afford to take out money for health insurance.

The survey results show that a lot of Americans can only afford $100.

Here are the results.

  • Around 52.5% say that they can only afford $100 or more.
  • Only 15.95% can afford $200 each month.
  • The number of Americans drops 11.6% who can pay $300 each month.
  • The percentage further reduces to 5.5% for $400 in health insurance deductible assistance.
  • Only 4.8% say they can set aside $500 each month.
  • Only one out of ten Americans or 9.8% say that they can give away $500 a month for health insurance.

Medical Billing – A Difference of Perception

If you talk to someone who represents the health providers, you may not get a clearer picture of medical billing. However, if you talk to someone who is at the receiving end of the medical billing, you understand the underlying issues.

Here is how a medical billing advocate, Maureen Lamb explains the situation.

“If you are talking to someone who is sympathetic but unable to fix your errors or negotiate a discount, you are wasting your time. It may require unique approaches to break through the resistance. When phone calls, faxes, and emails don’t work, it’s time to write a letter documenting your request for a discounted bill, and request help from the management team of an organization.”

Crowdfund Provides Limited Relief

Many Americans are turning to other options. They consider crowdfunding as a way to get assistance. If they can’t afford to go to the doctor, they turn to crowdfund. It may include relying on different options including business startups and charitable organizations. However, they only offer limited funds and many find it hard to meet their medical bills.

There is a long way to go before we can see these crowdfunding sources catching up to the medical needs of many Americans. However, their strong social presence does suggest a ray of hope for the future. These platforms relying on websites like Twitter, Facebook, and other social media networks to get assistance.

We are hearing many success stories from the charitable institutions helping troubled patients. Cassidy did come up with thousands of dollars for the chemotherapy. However, she had to manage so many other expenses that it was becoming difficult for her to afford her medical bill. She was able to get some funds to get herself treated in the hospital. Such efforts show a strong community, willing to stand with each other and overcome the difficulties in paying medical bills.

Some Ways to Overcome the US Healthcare Problems

Here are some fixes that can help the struggling US healthcare industry.

  • The current NIH spending stands at around $34 billion. However, it does not have the purchasing power which hurts the welfare of patients relying on medications. The increase in taxation on the pharma industry would help sort some of those issues out.  Here is what CEO of Dana-Farber Cancer Institute has to say about NIH. “I believe they’re the crown jewel of the healthcare system. Glimcher says of the NIH. They train the next generation of American doctors. They take care of very complicated patients. They are the place where new ideas are born, but we are starving.”
  • There is a hope that smartphones would help revolutionize the way healthcare industry uses IT. The use of smartphones can help increase patient engagement, a significant step towards improving the quality of healthcare.
  • Some healthcare industry experts also believe that patients need to have adequate housing and high-quality food. Access to healthy food and safer housing will help them fight many of the illnesses caused due to these reasons.
  • Bring the scientists to the forefront of the research in the healthcare industry. The innovators need to be rewarded and incentivized for their contributions. It will help motivate more scientists to come with cures of the most deadly diseases.