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Smartphones Can Help Your Practice To Achieve MU !

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What do you do when you go meet a physician ? Explain in detail about your medical history and pray that you haven’t left out anything. Now you just need to hand your smartphone to the doctor. The trend of accessing medical data through smartphones is growing at a fast clip.

And major smartphones such as iPhone and Android apps offer applications to, store, download, and manage patient information.

A success story…

The University of Pittsburgh Medical center found that patients joining the medical practice’s patient portal grew exponentially after reports were available through smartphones. The project launched in 2011 has been a roaring success with 700 patients joining the portal every week. Patients’ being able to access their medical records is a major criterion for qualifying for MU. And smartphones have just made it easier for doctors!

How do you get Mrs Linder interested ?

Despite the optimism and euphoria surrounding the success of smartphones to help patients use patient portals, engaging them is a key issue. Mayo clinic found out the hard way that engaging patient is no easy task.

Patient engagement ; an on-going challenge…

When they launched a web based portal three years ago, 240,000 patients joined. Reason to celebrate! But wait. The clinic is having a tough time getting patients to using the portal. To receive MU dollars patients should use the patient portal. Patients who are too old or those who are suspicious of technology need to join the bandwagon as well.

Show that you care !

To engage patients it is important that patient portals are designed from the patients’ perspective. Address their needs and make the portal fit in with their overall healthcare plan. Making the portal easily navigable and using images and text that are easy on the eye is important. And yes the assurance that their data is completely secure.

Not everybody understands encryption protocols or static passwords. Educate and train your patients in handling healthcare IT. Encourage patients to use graphical authentication techniques. And, to separate medical data, from, the other regular features, of their, mobile phones.

Fighting the good fight !

It can be frustrating, pointless and time consuming. But staying the course can help your practice not just receive MU incentive dollars and achieve compliance. But also make hundreds of your patients happy and more involved in their healthcare.

Here is the info-graphics with few stats on patient portal

patient-portal

Can Healthcare IT Help Physicians In Increasing Patient Collections?

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Are you neglecting patient collections? Technology to the rescue !

Adopting technology can help physicians not only stay in compliance but also collect more.patient-collections Patient collections have always been neglected by physicians. Getting a patient to pay is one of the toughest tasks a physician faces. The delicate doctor physician relationship means the doctor has to tread on eggshells to get paid.

With hundreds of patients walking in and walking out collecting reimbursement for every visit is an unenviable task. With latest technologies and electronic tools can help physicians increase their patient billing collection ratio.

Here is the presentation from Angomark on Are Physicians Losing Revenue? Concentrate On Patient Collections. 

How Can Misinterpreted ERA’s Affect Your Medical Practice?

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Do you understand what your insurer says ?

Being a part of a busy medical practice means there is no time to sit and analyse. Most medical practitioners hardly have enough time to communicate with insurers.Do you know that physicians are leaving most of their money on the table ? The major reason is not comprehending or following closely what the payer says.

insurer

An, ERA consists details, of the final claim adjudication and payment information. Being able to read between the lines is one skill that physicians need to develop to ensure they don’t get underpaid.

There are a lot many times when a physician just doesn’t know why his claim didn’t translate into a check. Blame it on inconsistent and varied payer policies. Or complicated, state specific, medical billing regulations. But the fact remains that an enormous amount of claims are underpaid or unpaid and most physicians don’t even know what went wrong.

Do you deal with workers compensation and auto injury claims ?

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Agreed it can be tough. Trying to deal with workers compensation laws can be cumbersome. The last thing you need is receiving an ERA that you cannot make sense of. The AMA has come to the rescue of physicians.

AMA has launched a new tool to help physicians make sense of ERAs better. The AMA Claims Assistant Workflow tool can aid physicians in puzzling out payment adjustments. It can help medical care providers easily locate reason and remark codes. Tackling non-payments and denied claims is going to be a whole lot easy at the medical practice, from now on.

No longer left in the dark…

What happens inside the insurer’s office has always been a mystery for medical billers. Why it is certain claims get paid and some don’t ? Why was a claim that was perfectly acceptable last summer now been given the thumbs down? Luckily physicians who deal with workers compensation billing will have an answer to these questions and more.

The Claims Assistant Workflow tool will give providers information about how a claim was processed. And what the codes on the ERA mean.

A smart way to e bill !

The tool developed by AMA also guides physicians on receiving accurate payment. And also offers several template appeal letters to help physicians appeal denied claims. It is definitely a welcome relief for over-burdened physicians and billing companies.

Patients Are Thronging Urgent Care Centers. Can Physicians Manage ?

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Are Your Patients Waiting Forever To Meet You ? 

Urgent care centers are sprouting all across the country. Recent studies indicate that urgent care centers have doubled over the last couple of years. As the healthcare industry undergoes major changes, cost cutting seems to be the new mantra.

Everybody is urging everybody else to cut down on costs. The latest to join the list are patients. Insurers are now insisting that patients explore more affordable options. Rushing to the ED for relatively minor ailments is not an option anymore. And patients are instead making a beeline to urgent care centers to reduce costs.

urgent-care

Is The Decline Of Primary Care Facilities A Reason ?

 Every healthcare news article in recent times has moaned the death of primary care centers. The shortage of primary care doctors only worsens by the day. The United States is reportedly short of over 9000 primary care doctors. By 2025 there will be a massive shortage of about 65,000 primary care doctors.

Urgent care centers offer the same medical services that primary care centers provide for acute care patients. This has led to a sharp increase in the demand for urgent care physicians.

40 Million Newly Insured Patients A Huge Driver !

There are going to be startlingly more patients waiting to meet the doc. The boom in urgent care centers can help thousands of patients meet their doctor on time. Hospitals are stepping up the plate to cash in on the demand for urgent care billing services. A lot many doctors have also started urgent care practices to cater to the huge influx of patients.

Too Much Of A Good Thing…

As the old maxim goes, too much of a good thing can be a bad thing. Physicians can, buoyed by the popularity of urgent care, bite of more than they can chew, inadvertently. Medical practitioners need to redesign their practices to handle patient demand.

Here is what urgent care centers can do to handle patient load :

  • Leverage physician extenders: Nurse practitioners can give tired doctors the respite they need. Instead of being at loggerheads with NPs, physicians need to work closer with urgent care NPs and leverage their potential, to ensure better patient care.
  • Have a smart patient portal: Patient portals can help automate tasks that will otherwise need an army of professionals to handle. Appointment scheduling, eligibility verification and most other front desk tasks can be automated to avoid long wait queues and flustered front office tasks.
  • Outsourcing billing and coding needs: More patients mean more claims to be transacted. Ass your claim traffic increases you’d need additional staff to manage huge billing volumes. You’d have to invest more on infrastructure and operational costs. Outsourcing can help urgent care centers contain costs and yet manage the vast number of patients waiting to be seen !

Want To Save $ 23,000 ? Switching To E-Billing Will Improve Your Practice’s Financial Health

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Still Stuck With Paper ?

What is your carbon footprint ? If you are still sending out paper claims, you are felling more trees. Agreed, this is an argument that is as old as fossils. Apart from saving trees there are a lot more advantages to using e bills ! It helps to track claims easily and lessens the amount of time your insurer takes to sign your check.

ebilling-infographic

Save More Dollars !

According to the American Medical Association submitting claims electronically can save a practice 55% of its claims submission costs. The AMA further states that physicians stand to gain above 23,000 dollars a year by switching to electronic claims.

Electronic billing also reduces the TAT of insurers. The overall efficiency and cost effectiveness of the process is just what overworked medical practitioners need. Paper claims are time consuming to generate, transmit, and maintain a record of. Electronic bills are quite simply put, the smarter way to bill !

Joining The e-club !

According to a recent survey of America’s health insurance plans the usage of billing electronically has doubled. From a measly 44% in 2002 to 94% in 2012 there’s been an exponential increase in providers who are switching to e billing.

Almost 79% of claims are now automatically adjudicated without manual support. Physicians are finding e billing helpful as it helps their staff to focus on patient engagement.

A Huge Relief For Billers…

What is the biggest headache of a medical biller ? No. It is not getting claims paid. The bigger headache is finding out which claim is in what stage of processing. An average medical office sends out dozens of claims per day. Keeping tabs on each one of them can trip up the most determined of medical billers.

ERA’s and EFT’s help medical billers to hasten the pace of the billing process. And make it easier for them to maintain a clear cut billing record.

Ask Your Insurer To Move On From The Stone Ages !

It is time for insurance companies to stop working with paper claims. Physicians need to put their foot down and ask insurers to accept electronic claims! Concerted and continuous effort across the continuum will ensure that the healthcare industry functions a lot more smoothly and efficiently. And yes, save a billion trees in the process !

Should Patients Be Allowed To Access Their Physicians EHRs? Weighing The Pros And Cons

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Whose EHR Is It Anyway ? !

 This far and no further, is the approach physicians are taking when it comes to patient EHR access. Patient electronic access is an important objective of Meaningful Use. It can help physicians to deliver better quality of care.  And to bring everybody across the care continuum in one single, secure platform.

EHR-access

Data security risks is the key reason why the debate on patients access to EHR is still up in the air. Nothing can scare physicians more than a data breach. The average housewife in New Jersey may not be up to date on HIPAA regulations  And there is also the potential threat of patients misinterpreting their medical data.

A physicians understanding of a medical problem is not the same as that of a patients. It could cause unnecessary stress and anguish, and make patients vulnerable to self-medication dangers.

I Don’t Want My Patients In The Drivers Seat…

According to a recent survey conducted by Accenture, around 65% of doctors feel that patients should be given limited access. About 82% of physicians endorse the view that patients should be actively involved in their healthcare. Around 4% of doctors told they’d like to ban patients from having an online access to medical records.

Most physicians were of the opinion that other than demographics, patients shouldn’t be allowed to edit or update any other medical data.

The Way Around This Catch 22 situation !

  • Talk to your EHR vendor about including patient identity proofing and authentication features.
  • Standardize the information you want your patients to access.
  • Educate your patients about your EHR.
  • Work with a  biller who has experience in working with your EHR so patient billing is streamlined to a great extent
  • Follow a clear cut privacy policy and usage guidelines.

The Face-Off Between Doctors And Nurse Practitioners!

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Working, without someone looking over our shoulder, is a secret wish of all of us. And that has led to one of the most heated debates in the healthcare industry. Coming, close on the heels, of the battle between, CRNAs, and, anesthesiologists. It is now physicians and nurse practitioners who are at loggerheads.

Endangering patients…

Physicians fear that working without their supervision can put patients at risk. And lead to fragmented, patchy patient data. Providing longitudinal care and unifying diverse factors across the care continuum is an ongoing challenge. Nurse practitioners functioning independently can lead to increased confusion, is the chief complaint of docs.

It is a known fact that recent regulations and compliance thresholds have put physicians under a lot of stress. To have nurse practitioners challenge their role in the medical fraternity. And compete for patients, is the last thing physicians need.

Nurse-practitioner

End the monopoly !

Do we know how to bill for services ? Yes.

 Do we know how to take care of patients in need of primary care ? Yes.

Do we need a physician to tell us what to do ? No.

This is the war cry of America’s nurse practitioners. They feel practicing under the supervision of physicians is unnecessary and restrictive. Despite being highly qualified and experienced, nurse practitioners feel they are being given a rough deal.

Not a turf war for money !

The request by NP’s to reduce physician interference can surprisingly prove to be beneficial. Obama care is going to result in a sudden influx of thousands of patients. As United States battles severe primary care physician shortage. Qualified nurse practitioners and a newer model of working might just be the right solution.

Once the dust settles down…

It is being hoped that once the storm settles down it will bring a lasting and mutually agreeable solution. The need of the hour is clear cut billing regulations. Reformed, payer policies, that don’t leave room for doubt. And, nurse practitioners and physicians, who work together towards a sustainable solution.

As a nurse practitioner there is enough on your plate already ! Here is the presentation on “Reimbursements guide for nurse practitioners to survive the storms in 2013 !”

Ten Tips For Surgery Centers To Pump In More Greens!

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surgery-centers

There you go ! Another rejected claim. Well, running a surgery center billing practice can be demanding, expensive, and on a bad week, thankless! With, surgery centers constantly battling with payers, and, patients who have no idea what their financial liabilities, are. It can be an uphill climb on a snowy day, to get paid !

Here is how you can fight those financial demons and come out at the other end a winner ! And also ensure your clinical documentation is never short of perfect !

10 ways to increase the revenue of your surgery center…

  1. Encourage your surgeons on-board to have a financial stake in your surgery center to avoid losing out on case load.
  2. Create a better atmosphere to work by upgrading to better systems and work processes to attract and retain a strong physician base.
  3. Collect copay’s and deductibles at the front-desk and have multiple payment options.
  4. Compare your staff members’ cost per case with your competitors, and how reimbursement varies across different specialties. Analyze and set benchmarks.
  5. Follow a rigorous claims follow up process and fight denied claims as soon as they reach your table, to increase the revenue and valuation of your center.
  6. Physician documentation plays an important role. Surgeons should dictate clearly, name the procedure. And ensure details and events are sequenced in the operative note.
  7. Don’t put off renegotiating with your insurer. If you put off renegotiating year after year there are little chances of your insurer ever giving you a reimbursement hike !
  8. Collect and verify patient information during the pre-registration stage to avoid fall outs.
  9. Call your patients prior to their appointment and inform them about their financial liabilities.
  10. Have a quick sheet that includes pertinent questions, such as, how many surgeries were performed, the number of co-surgeons etc for physicians to fill out after a surgery.

28 Million Dollar Fine,Prevent Your Practice From Being Booked Under The False Claims Act

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False Claims And A 28 Million Dollar Lawsuit !

false-claims-act

False claims, data breaches and billing errors happen to others right ? ! No. It can happen to your practice, despite your efforts and best intentions. Don’t wait for a watershed moment to catch you unawares and throw you off the course. Federal regulations are becoming stricter, and the penalties and punishments for fraud and abuse allegations, are more unforgiving.

28 Million Dollar Fine For Fraudulent Billing…

Even as this blog is being written a nursing home based in Illinois has been booked for charges against the false claims act. Two ex employees filed a case against the nursing home for providing inadequate care. And, sending, multiple fraudulent claims to insurance companies. The hospital was penalized for offering useless services and more than 19 million dollars for filing false claims.

The employees were awarded more than 400,000 dollars for bringing to light the billing malpractices of the nursing home.

What Is A False Claim ?

There are physicians who end up with summons for faults they were not even aware of. To safeguard your medical practice from false claims you must first be aware of what constitutes a false claim.

  • Submitting an unbundled claim when the claim could have been bundled and submitted as a whole.
  • Up coding a medical service.
  • Billing for medically unnecessary services.
  • Increasing time units or any units of services for acquiring more reimbursement.
  • Submitting secondary claims that have to be sent to a different insurer, to the primary insurer.
  • Inflating patient care costs.
  • Copy pasting records in the EHR can lead to duplication of claims content.
  • Making use of automated coding tools and claim edits can lead to over-billing errors.

Tips To Safeguard Your Practice From Being Booked Under The False Claims Act !

  • Ensure your claims are, bundled/unbundled appropriately. If you are not too sure pick up the phone and discuss with your insurer.
  • Always provide additional documentation substantiating the medical necessity of a treatment prior to transmitting a claim.
  • Document facts such as time units, complexity of a medical decision and gravity of a wound, always.
  • Communicate with your patients and explain about patient liabilities.
  • Submit primary and claims appropriately.
  • Avoid copy pasting billing details in your EHR as it creates “cloned” notes.
  • Review and update information in your EHR constantly.
  • Finally, make use of the features your EHR offers but don’t rely on them completely.

 

5 Ways Small Practices Can Thrive In A Hostile Economic Environment

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Will Private Practices Be Forced To Go Off The Grid ?

Independent practices are dying a quiet death all across the country. It is becoming increasingly difficult to manage expensive transitions, pay the bills, and focus on patient care. Every statistic about healthcare, points to one grim fact- it might be the end of private practices. Unable to withstand mounting financial and regulatory pressures, small practices are shutting their doors.Private-Practices

Between, A Rock And A Hard Place…

Most independent physicians feel like a fish out of water when working in the hospital environment. It means getting used to different terminology, processes and working hours. And it is not just adjustment issues. As with any big organization, the red tape involved can confound and trip up medical practitioners. Small, perfectly reasonable requests may take forever to be processed.

Small clinics are way below the food chain and will be treated that way.

Is Concierge Medicine The Answer ?

Forget third party payers. A, complicated, billing process. And those nasty cuts and audits ! Is concierge medicine a heaven-sent option? Yes, if you are a competitive physician who doesn’t mind being on call 24/7. If being at the beck and call of patients doesn’t scare the daylights out of you. Or, the “I paid you, you work for me” approach doesn’t deter you, opt for concierge medicine.

But the limitations, drawbacks, pressures and financial stability of the concierge model needs to be analyzed before you arrive at a decision. “Boutique practices” or “Personalized healthcare” sounds sweet. But for the physician who is not good at money or time management, it can spell doom.

For Those Determined To Stay The Course !

There are quite physicians who are refusing to buckle under pressure. “I am sticking to my private practice as I don’t know, and cannot stand, any other way of working” is what Terry Williams a private practitioner based in Mississippi has to say. And there are several physicians who echo his views.

Here Are Five Tips For The Small Practice Owner To Fight The Good Fight !

  • Consider relocating your practice to a neighborhood where there is a shortage of medical care, to get better reimbursement rates.
  • Become a micro practice to slash-down on operational expenses.
  • Optimize your workflow and outsource tasks that don’t have to be done in-house.
  • Focus on the business side of your practice.
  •  Market your practice and go active on social media sites.