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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 to night.

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 over 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 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

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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5 Things Every Medical Billing Company in Ontario, CA Needs to Do!

If you own a medical practice or work in a hospital, you might have hired a medical billing company for claims submission. Whether you are a reliable medical billing company in Ontario, CA or not, the discussion today is important in the general sense.

If the respective medical billing service is an established one, there’s a 100% chance that it would have overcome all the loopholes in its medical billing process. If not, you should be a little careful while hiring medical billing services.

It is observed that up to 20% of medical claims are denied due to poor medical billing practices. As a medical billing company, you surely don’t want to have a bad reputation in the healthcare industry. So, given below are few tips that you might want to follow. It will help you work better in favor of clinicians.

  1. Focus on Training Medical Billing Staff

If your medical billing agency recruits medical billers and coders, who have little or no experience in the respective field. You should immediately do something to train your staff because it might be causing major revenue loss for physicians.

Without the proper knowledge, medical coders are unable to choose correct codes for the diagnosis. It is possible that they might be using the wrong modifiers for treatments.

Medical billing services should properly train employees as per the CMS guidelines to create and submit medical claims. So, there remains no chance of error.

  1. Tighten Up Your Follow –Up Services

Medical billing services need to interact with patients and physicians simultaneously while creating medical claims. It is a lot of work. Reporting accurate diagnostic and surgical procedures along with double-checking them takes a lot of time. Moreover, they also get faxes and emails every day in bulks.

When there is so much to do, things can pile up. However, despite a busy schedule, it is compulsory to keep a check on the submitted medical claims. Know about the claims’ status that either they are in process or have been denied. It has a crucial impact on revenue cycle management. Also, the follow-up services are time-specific, meaning, you can resubmit denied claims within a specified time. Otherwise, they get lost in the piles of papers.

Thus, professional medical billing companies never look down on the follow-up services.

  1. Keep Check on the Accounts Receivable (AR)

Some of you may not consider this point significant. But, it indeed plays an important part in the revenue generation.

Patients and even insurance companies generally don’t keep a check on the payments. However, medical billing companies should verify if a bill is fully paid or not. The unpaid reimbursements can take your revenue journey down.

If a bill is unpaid, you can always go for follow up services until accounts receivable are paid.

  1. The Filing Time Plays an Important Role in Revenue Generation

There’s a time limit for submitting claims to insurance companies. If a medical billing practice exceeds that time period, the claim will not add up in the revenue.

Even, you submit a claim within the time limit, there’s a chance that it might be rejected. Then, why take risk submitting it after time.

  1. Improve the Denial Management System

The percentage of denied medical claims is rising day by day due to strict rules of payers and governmental authorities.

Therefore, the medical billing and coding staff should be up-to-date with the latest news and criteria. Instead of ranting over denied claims, medical billing services should rectify errors and resubmit claims within time. An even better option is that the medical billing and coding process should be so transparent and precise to crash the chances of denied claims.

An experienced medical billing company straightens its billing process to maximize physicians’ revenue. P3 Healthcare Solutions is such a company that ensures high-quality medical billing for its clients.

Tell us if you think, above-mentioned tips can help a medical billing company generate more revenue at

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3 Qualities a Good Medical Billing Company Must Have

In what cases do medical practices think of hiring a medical billing company? Maybe they don’t have resources to spend on the denial management system. It may be possible that their submitted medical claims keep on coming back to them due to poor coding and billing techniques. Or, despite their utmost efforts, they don’t get reimbursements for all rendered services.

There can be many situations for healthcare organizations, where they feel themselves in troubled waters. Instead of ranting over issues, the least they can do is to hire medical billing services. The dream of getting the reimbursement rate up to the mark can only be true with a professional medical billing company.

Either the clinicians don’t have medical billing and coding experts or time and budget to spare for in-house medical billing; medical billing companies seem like the best option.

Medical Billing Company Helps Stabilize Cash Flow Efficiently

Medical billing services have the responsibility to get clinicians their rightful reimbursements. The goal is to improve revenue cycle management to such extent that physicians face no trouble incurring expenses.

Moreover, when physicians are relaxed from the tension of handling medical billing process, they focus attentively on their patients.

Whatever reason encourages physicians to consult a medical billing company, it is important is to research well about them. Where an experienced, medical billing service takes your revenue journey up the ladder, an immature and unprofessional one can restrict your growth.

Here are 3 qualities upon which you can choose the ideal medical billing company.

Specialty- Specific Billing Solutions

Experienced medical billing companies offer billing solutions, which are compatible with your practice. The documentation and billing codes are different for each specialty.

It is advisable to choose a medical billing company that has experience in your specialty. Their staff is often well familiar and trained with the related new trends and rules. They generally have an understanding of mistakes that can cost a lot and rectify them on time.

For Instance, P3 Healthcare Solutions is one of the leading names in the healthcare industry. Their experts have skills and training to create and submit accurate medical claims to insurance companies, and happy clients are the proof of their success.

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

Working Experience in Medical Billing

There is always the first day for every company, but physicians can’t rely on any immature medical billing company, who don’t know about the healthcare industry. The entire revenue cycle management system of medical practice depends upon their performance. If you hire a minnow, you can’t expect to have 100% results.

Especially, when the healthcare industry undergoes several changes to facilitate patients and physicians, you can’t go to a company, which doesn’t have an accomplishment record. Such companies don’t know how to manage risk factors and often don’t perform HIPAA-compliant medical billing.

They may not have the latest technology or knowledge to create medical claims with 100% accuracy with poor follow up services. Then, why choose them and risk your revenue process.

 Adequate Medical Billing & Coding Staff

When you hand over your medical billing process to another company, make sure that they have adequate staff to handle your all burden.

A professional and experienced medical billing company not only knows how to handle the bulk of data, but they have proper infrastructure and equipment to implement strategies. They also are able to streamline operations and enable interoperability seamlessly. They have secured way of exchanging data between patients, physicians, and insurance companies.

Their error rectification system is faster, and they can help medical practices save a lot of money.

There are also some other factors that demonstrate the success of a medical billing company, such as, how well they communicate with their clients or if they train their employees with up-to-date skills and knowledge.

A healthcare organization hires a medical billing company to strengthen its revenue cycle management. It is indeed a great decision. If the chosen medical billing company has a good reputation in the healthcare industry, you can set an appointment with them and proceed to have an official contract.

Do you think that above-mentioned qualities should be important in a medical billing service provider? Or, there are some other qualities, that you deem necessary.

Let us know.

How Does A Medical Billing Service Benefit the Physicians?

Most practitioners are well aware of the advantages of outsourcing a medical billing company. However, some of those merits are of continuous vitality and worth a discussion.

Medical billing service to physicians’ matter when they suffer at the hands of EHRs! American doctors need a break and nothing better than a medical billing specialist to take you out of the financial mess.

Essentially, they reduce costs, increase collections, keep up with the coding updates, ICD-10 guidelines and are on the lookout for new codes. We will go on with their advantages one by one to highlight their tangible usefulness.

Decreased Staff Cost

Medical billing firm gives power to physician practices in terms of the doctor/patient time, personal time, and finally, the staff finds relief from accounting burdens. They don’t have to be meticulous in their CPT codes or around the complete coding mechanism of claims for that matter. It is a designated duty of the medical billing service to assign charges against procedures performed.

According to Barbara L. McAneny, MD, the American providers spend almost 20% of their medical revenue to ensure the accuracy of billing. They usually hire staff which is responsible for the collection of the authentic medical history of patients, entering specific codes and making claims.

If the doctors go with medical billing outsourcing, it will hugely reduce the costs and expenditures which they have to spend on their staff. The point is to choose cost-effective solutions and most companies are willing to provide just that!

Enhanced Transparency

One more thing is to look for a service with clear and consistent reporting mechanism. Revenue reports at the end of the week or month can either be satisfying or a red sign for the future. In other words, the process of transparency becomes prominent in case you hire a credible medical billing service.

It is a good deal to find software assistance, EMR training and guidance to increase your practice’s revenue under one roof. If you find a service with extra capabilities, which is rare, don’t let this chance slip away.

Transparency further materializes into the design of an accurate claim. To track the charges for each procedure and medication is difficult and demands focus. In the case of claim denials, providers have the right to ask for reasons and evidence in support of the argument. A good practice is to state the reporting requirements on the agreement forms.

Technology Commitment

A medical billing service company brings technology commitments with them. Purchasing the latest software for complex billing tasks costs are part of the investment. For a business which wishes to make a difference depends on generous spending. Quality is what matters to them. Therefore, a company with intricate design, infrastructure, and knowledgeable health IT consultants must be better at billing.

The software and latest technology tools are necessary for creating accurate claims and enhancing the revenue cycle management (RCM) process. Moreover, the experts also incorporate tools to improve patient reminders, online bill payments, and access patient portals in an elaborate revenue cycle system. The experts can make use of technology to generate expected results.

Increased Efficiency of the Work

There is an overall improvement in the ability to work for practitioners with outsourced medical billing service in comparison to those with an in-house billing team. The doctors who are running their independent clinics have administrative duties to fulfill. It is insane to burden them with additional workloads. It is as if we don’t want them to concentrate on patient care.

Ordinarily, the doctors with a medical billing service have more time for their patients and serve them with greater focus and care. Outsourcing enhances the efficiency of the practitioner.

Accurate Billing and Coding

It is the primary responsibility of expert medical billers and coders to code accurately. To be able to submit precise insurance claims to the insurance company is an actual art. Because, if there are errors, it is going to come back from the clearinghouse!

The insurance companies have a set time limit for practitioners to collect reimbursements. The billers ensure to collect claims on time. It helps in increasing revenue per year and the medical practice moves forward day after day.

For accurate medical billing claims, please follow us on LinkedIn –

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What do you think?

Attention! Medical Billing Companies are Charging More than Usual!

The Institute of Center for American Progress states that clinicians and insurance companies spend about $496 billion in the medical billing process. Either it is in the form of insurance or the cost incurred while hiring medical billing companies to create bills.

However, the alarming fact is that only about one-half of the huge money of administrative costs accounts for profitable billing. Moreover, medical practitioners and hospital staff also spend millions on providing value-driven healthcare.

For many time now, the debate is on that American healthcare industry is spending way too much on the administrative burden. Medical billing companies also suffer in this regard. They need to upgrade their systems to match the quality of administrative work.

What Should Be Done?

The high spending in healthcare with no particular outcomes has always been a concern. Thus, healthcare leaders have voiced the need for structural reforms in medical billing services.

Can We Expect to See Decrement in the Healthcare Expenditure?

As per the Revcycle Intelligence, it is estimated by the governing authorities that if no major changes are done, healthcare expenditure will increase by 5.5% on annual basis with an increment of 19% in GDP.

America spends double the money on healthcare as compared to other nations, and still, it is not among the top healthcare systems of the world. Provided these facts, you can get an idea of where healthcare will be going in the coming future.

Reasons for High Expenditure on Medical Billing Companies

As mentioned above, the major reason to blame is the administrative cost. It has also influenced the physicians’ performance as they are forced to spend half of their precious time in counting numbers rather than doing their actual work. Thus, when they spend so much time on medical claims that may result in denial, how can they improve revenue cycle management?

In addition, the little revenue they generate is not solely spent on them. But, a significant portion has to be added in the accounts of medical billing services.

Different Billing Rates for Different Medical Procedures

Another reason that researchers found out is that different types of healthcare visits cost differently. For Instance, a study report of an academic health system highlights the following data set for medical billing.

  • Primary healthcare visit costs about $20.49.
  • Inpatient stay costs about $124.26.
  • Emergency department visit costs about $61.54.

Based on these facts and the revenue associated with each type of visit, emergency department visit accounts for the highest billing cost, up to 25.2% of revenue.

On the contrary, inpatient stay cost the lowest as associated with the patient’s stay in the hospital.

Time Spent on Billing Services is Huge

With administrative cost, comes increased time consumption while processing medical claims. On an average, medical billing companies spend 13 minutes for primary care visit, 32 minutes for emergency department visit, and 73 minutes for a general inpatient stay.

The more time, medical billing services spend on analyzing medical claims, the more they charge physicians for their time.

Healthcare Industry Needs to Take Serious Actions!

Simple healthcare systems that have an easy reimbursement system can be a guiding light for the U.S healthcare industry.

Healthcare leaders propose that a single-payer healthcare system is a way forward towards the progressive route. However, only reducing administrative burden will not generate favorable results for revenue cycle management.

Healthcare quality should be the focus along with setting forth reasonable rates for the medical procedures. Moreover, the centralized processing of medical claims can also reduce healthcare expenditure.

Comment if you believe these reforms will somehow show a positive influence on the US healthcare system, or, do you think the opposite?

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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.

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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.

Now, in 2019, when we comprehend Obamacare, we see that it was supposed to increase the rate of health insurers in America. Moreover, it also meant to reduce healthcare cost relatively.

However, with the burden of increased taxes, it seems impossible to cut down major cost in healthcare expenditure. It has also become difficult for medical billing companies to help physicians earn more revenue.

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. For Instance, the use of electronic healthcare records is an efficient way to strengthen physician and patient relationship. Via this system, patients can easily communicate and even keep track of the medical claims.
  • 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.
  • Another problem is the increased administrative burden that restricts physicians from providing value-based healthcare to the community. It is generally not their fault, but the strict claim eligibility parameters and incentive payment programs have made it difficult for them to rationalize their time accurately.