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Are patients with high deductibles a threat to medical practices?

September 22, 2014 by Ango Mark Leave a Comment


It is time for medical practices to focus on patient collections!

Does high deductible mean low chances of getting paid?

Patient responsibilities have risen under the latest healthcare reforms. Coming forward, most patients would pay most of their healthcare bills by themselves. With payment responsibilities shifting to patients, managing patients with high deductibles is a risky proposition for medical practices.

High deductible insurance plans are the order of the day and physicians, who fail understand this emerging trend, will find themselves in an unenviable position. By the end of this year, an estimated 20 million patients will join the healthcare system and an alarming 80% of the newly insured patients, are at high risk for non-payment.

In a perfect world!

Higher out-of-pocket expenses are going to leave physicians with the unsavoury task of making patients pay their bills. In a fair world, patients would pay prior to treatment and coordinate with the doctor’s office regarding payment options. Patients would be well informed about insurance plans and guidelines.

But the healthcare world is anything but perfect. Everyday physicians face irate patients, lawsuits and threats to move to another provider.

Sounding harried over the phone?

The average time medical practice staff spend over the phone has increased and a call can last anywhere between 10 to 40 minutes. Blame it on complicated health plans and insurers who change payment regulations, constantly. Most private practices are understaffed and find it difficult to handle the deluge of patient calls.

Patient portals have been of tremendous help, but again, patients need constant support and education to access and use patient portals. Which leaves medical practices with one question- who does the tough job of receiving payment from patients?

Handling patient payment is a tough nut to crack!

Receiving patient payment isn’t just about sending sporadic statements, now and then. It requires close coordination with patients prior to a visit. Educating patients and helping them discover plans and payment options that best suit their needs, is essential. As is, following up with patients and sending out patient statements regularly.

And, always, ensuring, that patients don’t feel like, they are being cornered. Medical practices, now, rely mostly on collection agencies to handle their patient billing process. It avoids bad blood between patients and the medical practice. Trained professionals do a much better job and can free up in-house staff to focus on clinical activities.

Filed Under: Medical Practice Tagged With: Healthcare reforms, Medical Practice, patient billing, patient portals, patients, Physicians

Medical Billing Tips for Optimal EHR Usage

October 21, 2013 by Ango Mark Leave a Comment

Renovate your EHR strategy

Doctors Fed-up by EHRs with Inefficient Billing Workflows :

Healthcare practitioners have implemented EHRs/EMRs to comply with federal stipulations. However, many of them are unable to make optimal utilization of these EHRs/EMRs. Hospitals and clinics fail to receive complete payments for their services rendered – due to sloppy billing processes. Such improper billing workflows pose many revenue collection problems for doctors. Overworked doctors find it difficult to cope up with the requirements of healthcare business. They do not have the time to ensure optimal revenue collection and adhere to changing federal/state regulations and stipulations of insurance companies. Rather, they would prefer focusing on patient care.

What is the Expert Opinion ?

EHRs/EMRs with inefficient billing workflows continue to cause dissatisfaction among physicians. Holly Knapp, President of Loveland-based Medical Billing Advocacy of the Rockies (MBAR), LLC, and member Medical Billing Advocates of America (MBAA) claims:

  • A. Patients do not know whether their bills are correct.
  • B. Clinics and hospitals are not sure whether the insurance company has correctly reimbursed medical claims.
  • C. Only 20% of prepared claims are correct.

Need for Professional Billing Experts :

Any EHR without the right billing option is like bread without butter and will not meet the revenue collection requirements of clinics and hospitals.This requires a team of experienced and knowledgeable professionals, who are well-versed with the intricacies of existing and changing codes and resulting billing processes across the US.

Increase the Efficiency Of Your Medical Practice :

There is an imperative need to enhance the functionality of the EHR by :

  • 1. Ensuring streamlined, accurate and thorough clinical documentation. This documentation covers all workflow stages in a hospital or clinic, right from the time the patient reports at the reception and passes different stages of diagnosis, treatment, and discharge, and finally collection of patient’s dues.
  • 2. Correct selection of codes and related modifiers based on clinical documents.
  • 3. Ascertain medical necessity of diagnosis and treatment from the point of view of insurance agencies.
  • 4. Check whether the patient is eligible and covered by the insurance for claiming reimbursements.
  • 5. Prepare the insurance reimbursement claims correctly based on the combinations of codes and modifiers.
  • 6. Prepare the claims in time and send to insurance payers.
  • 7. Check the progress of claims sent to insurance.
  • 8. Analyze rejected claims and resubmit corrected claims.
  • 9. Make tight follow up for every claim.
  • 10.Collect patient’s payment dues through aggressive follow-up.

You are free to contact MedicalBillingStar for any problems related to EHR/EMR or medical billing.

Here’s the presentation view on “12 tips to rebuild your EHR strategy”.

Filed Under: EHR, Medical Billing Tagged With: EHR, EHR Implementation, electronic health record, insurance claims processing, patients, Revenue Cycle Management Services

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