The Winning Formula in These Times of Physicians Shortage

According to the latest data published by the U.S. Bureau of Labor Statistics, there is an acute shortage of physicians across United States; at least 26 states and 17 medical specialties have reported this fact.

The Association of American Medical Colleges has estimated that in the next decade, nearly one third of the existing physicians will retire from active service, the American population will increase by 25 million, 32 million patients will be covered by insurance, and 37 million retirees will need additional healthcare services from the physicians. 

How is this drastic shortage of physicians to be catered?

The answer lies in helping physicians to improve their efficiency so that they can attend to the needs of more patients. On an average an American physician spends 10.23% of his time in administrative jobs, either supervising or actively participating in the administrative process. They also spend as much as 14% of their revenue in an effort to get paid promptly and for the contracted amount. Physicians need to look for experts to handle their administrative work so that they can focus more on their core profession of treating patients. 

Medicalbillersandcoders.com has been following this problem of shortage of physicians’ for some time now and is actively working to cater physicians’ needs of optimizing operations and enabling them to focus on providing healthcare services to more and more patients. 

Medicalbillersandcoders.com helps physicians save time in the recruitment of in-house billers and coders. Physicians can log-on to the website, fill out a form and are able to recruit medical billers for their in-house needs within 2 to 3 days at no cost. Billers from Medicalbillersandcoder.com customize their work flow to suit the physician’s needs. Training of staff is almost negligible as billers and coders from medicalbillersandcoders.com are well-trained on various software and are certified on medical billing processes.

Efficiency of the clinics using medicalbillersandcoders.com has been the highest as the clinic is equipped with efficient, trained, local billers who are experts in their own specialties. 

Medicalbillersandcoders Deciphers the Intricacies in Medical & Dental Billing In A Dental Office

On–going advances in dental billing and coding are gradually leading to the involvement of the medical carrier for obtaining payments. Hence various dental practitioners across US facing these new complexities have been finding a way out with Medicalbillersandcoders.com dental billing services.

Identifying significant differences between Medical and Dental Billing in a dental office -

• Coding– Compared to dental carriers; medical carriers require more than just a procedure code. In case of medical carriers the reason for the procedures needs to be conveyed which is the patient diagnosis.

• Medical necessity – This is very important for successful dental-medical cross coding. A suitable diagnosis that supports and establishes the medical necessity of the procedure is mandatory in order to be paid.

• Updates frequency- Though medical codes go through the same process as dental codes in case of additions, deletions and revisions, which  are published in their respective manuals,  the most significant difference is the frequency and time period between these updates. All medical code sets update yearly; with no grace period offered for using outdated codes by medical carriers.

• Claim form- The medical claims form is different from the ADA claim form. Most medical carriers claim forms need to be red in color and not copies of the form in order to be scanned correctly, moreover hand-written claims and hand-written comments are not accepted.

MBC experts believe that understanding these differences and implementing them can tremendously help while billing for a procedure which involves both the dental and medical carrier.

Prioritizing between the medical and dental payer at your dental office-

As more and more dental carriers recognize the medical nature of certain dental procedures; opportunities of filing dental claims with medical carriers also increase.

Though it is common for trauma-related dental services to be billed to medical plans, there are other dental services that can also be billed to medical. Currently procedures which can and are beneficial to be filed with medical carriers include- Trauma procedures, TMD procedures, Sleep apnea appliances, Oral cancer screening,  Medically necessary oral surgical, laser, periodontal procedures, implant, endodontic, and prosthodontist procedures. In addition any medically necessary exams and X-rays (including CT Scans) which may be associated with these procedures.

MBC dental billing experts have been successfully filing medical claims for all these dental procedures. With their keen understanding of the relation between oral health and overall body health; they have been able to easily procure maximum payments along with handling the added documentation.

MBC has provided multiple benefits to various dental practitioners across US - With their in-depth industry knowledge MBC comprehends most variables attached to dental-medical cross-coding and have positively impacted various dental practitioners across US -

• Dental practitioners revenue has increased due to increased case acceptance for procedures that fall under medical
• Higher patient satisfaction as dental patients with both medical and dental insurance plans have been able to switch to their medical plan for medically-necessary procedures, while saving dental plan yearly allowances for dental procedures
• Higher patient satisfaction has led to increased number of referrals and patients for these dental practices

Each payer has its own plan as to how they will cover certain dental expenses, and as dentists realize the need of a certified professional to manage the billing side of their practice, there has been a steady increase of MBC’s billing requirements by various dentists across US.

MBC’s highly-trained medical billers have the experience and know-how on billing medical-related dental services to medical insurance plans. Dental billing experts at MBC are committed to recovering 100% of revenue as they stay updated with the latest billing regulations, industry changes and coding updates. Additionally MBC experts regularly enroll in continuing education managing to constantly decipher new changes in the dental industry hence managing to increase reimbursements and save 30-40% of the practice’s operational costs.

How will the Affordable Care Act Impact Cardiology Practitioners and Their RCM?

Healthcare industry has been undergoing steady reforms over the past couple of years and the changes are expected to continue. The objective of this ongoing transformation is to achieve improved healthcare services with increased focus on quality care. In such a scenario, Affordable Care Act is being viewed as a promising way of improving healthcare and strengthening financial conditions of the industry. However in addition to expansion of coverage, increased accountability of insurance companies, lowering of healthcare costs and enhancement of quality care for Medicare patients; ACA is expected to increase revenue risk for physicians as well. As a shift from fee-for-service to revenue and cost sharing model of ACOs (Accountable Care Organizations), Cardiology practitioners will face a lot of challenges in realigning their revenue cycles.

Some of the major RCM parameters that ACA will affect practitioners are –

• Due to bundling efforts, cardiovascular coding will undergo additional changes

• Medicare fee schedules will change for physicians in addition to the continued threat of reimbursement cuts by 30% due to SGR

• Penalties for non participation in federal incentive programs like EHR, quality reporting system and e-prescribing

• Government and commercial insurers will pay for value based services (pay for performance reimbursement model) instead of continuing with the volume based or fee for service model

• Increased number of Medicare patients to be covered by Cardiology practitioner participating in ACO project, meaning more financial risk and heightened burden on RCM

With rising focus on quality care and expected collaboration between hospitals and independent medical practitioners under ACA, to cut down costs and enhance care coverage, Cardiologists will have to adapt their practices and RCM as per the imminent changes.

 RCM or Revenue Cycle Management is the strength of any medical practice aiming to stay financially viable. RCM cannot afford to stagnate in its processes as the healthcare environment is changing on a continual basis. With industry changes, RCM of a Cardiology Practice must transform to better suit the needs of the practice. Given a high likelihood of ACO participation by most Cardiology Practices, some well planned changes in RCM can prepare a practice to absorb heightened risk and derive better revenue from ACO –

• Compliance to changing regulations and participation in federal programs designed to incentivize practice performance can save your practice a lot of future costs and penalties. Thus RCM of your Cardiology practice must comply with new regulations and keep your practice up to date

• Change in fee schedules and expected reduced reimbursements by Medicare would mean diminished revenues. Thus focus of your RCM must be to diversify the payers mix to absorb this inevitable decline in revenue

• Coding and billing changes due to bundling must be tracked and updated in your system to avoid any claim denial or audit complications

• RCM must strive to adopt value based reimbursement model for your practice and gradually shift away from fee for service payment model

As RCM and billing experts, delivering optimum medical billing and coding services across all 50 US States, medicalbillersandcoders.com can help add value to your revenue model and save you tremendous costs and expenses. Your Cardiology Practice can benefit from our billing and coding experts help and our accurate revenue cycle management can transform a high risk ACO project into a high return venture for you.

Medical Billers and Coders Professionals Extend Support to Mental Health Billing in San Diego and Chicago

The US Public Health Service has highlighted the fact that nearly one in five Americans suffers from some form of mental health disorders and that only a fraction of those affected receive treatment.

Illinois and California are the two states with the highest concentration of mental health patients among adults touching 38.6%, according to the 2010 data on Kaiserhealthnews.org. New York City is a close contender with 36.1% and 9th place among the 50 states. To compound the problem, Illinois also happens to be a state with a high 21.4% underserved population when it comes to mental health care services.

The physicians located in Chicago, Illinois, Californian cities such as San Diego and Los Angeles, and New York City have to cater to an ever-increasing Mental healthcare patient volume. Any successful intervention in their support will inevitably need to establish expert professional support for their non-core activities such as billing, coding, and other affiliated services in RCM, allowing them to focus on patient care.

Chicago medical billing, San Diego medical billing, Los Angeles medical billing and New York City medical billing

Medicalbillersandcoders.com has extended its established network of billers and coders with substantial hands-on experience in Mental Health billing and coding to support these physicians and their overworked staff.

Mental Healthcare is a busy specialty due to its interdisciplinary nature and also involves very complex billing and coding services. On top of that, there is a much greater Mental Health claims denial rate vis-à-vis many other specialties which calls for stringent pro-active measures in claims submission for effective reimbursement.

It seems imperative for these physicians to enroll very experienced specialized professionals for an efficient reimbursement process, so that the physicians can concentrate on providing optimum and meaningful patient care.

Along with these responsibilities, Mental healthcare physicians also have to ensure compliance of the recent healthcare regulations such as HIPAA 5010, ICD10, PQRI, CPOE (Computerized Physician Order Entry), HIE (Health Information Exchange) along with the latest EMR updates. Along with this, the various projected healthcare reforms such as EHR, PQRS, and ePrescribing as also the imminent inclusion of a large percentage of hitherto uninsured population are going to escalate the already burgeoning problem of expert billing and coding support to Mental healthcare specialists in New York, Chicago and San Diego as well as neighboring cities of San Francisco and Los Angeles.

MBC, with its large network of AAPC-certified, highly experienced mental health care billers and coders in San Diego  and Chicago with a track record of error-free and denial-free billing and coding services, can provide effective support to Mental health care physicians. We have a huge experience in processing claims with leading private insurance carriers as well as government sponsored Medicare and Medicaid. We effectively customize our services to cover overflows, backlogs, as well as part time requirements.

 “Even with dedicated in-house staff, it requires substantial amounts of money and effort on technology, equipment, and training to tackle these factors”, said the President, medicalbillersandcoders.com, “MBC can effectively support Mental Healthcare physicians to provide accessible and quality patient care through its network of proficient billing and coding experts in Chicago, San Diego, and the New York City”. Well-versed with the latest billing software as well as healthcare IT applications, and familiar with the nuances and implications of the latest changes in billing, coding, and healthcare reforms and regulation compliances, Medical Biller and Coders professionals can provide specialized service to optimize your revenue cycle management.

California Physicians Worried About Increasing Denials Turn to Medicalbillersandcoders.com for Assistance

Denial rates of California’s biggest payers being as high as PacifiCare -- 39.6 percent, Cigna -- 32.7 percent, HealthNet -- 30 percent, Kaiser Permanente -- 28.3 percent, Blue Cross -- 27.9 percent, Aetna -- 6.4 percent, the Denial rates in California are witnessed to be on an all time high, as reported by California Department of Managed Care. From 2002 through June 30, 2009, the six insurers rejected 45.7 million claims -- 22 percent of all claims.

Contradicting general expectation, the rate of denial by private players is lesser than the Government program, the Medicare program since its inception acknowledged the existence of regional variations in medical practice reimbursements and has sought to accommodate these differences in adjudicating claims but California denial rates seem to be standing out.

But according to the AMA‘s National Health Insurer Report Card annual, Medicare denied medical claims at nearly double the average for private insurers: Medicare denied 6.85% of claims. The highest private insurance denier across US was Aetna @ 6.8%, followed by Anthem Blue Cross @ 3.44, with an average denial rate of medical claims by private insurers of 3.88%

Even after these denial ratios dropped one year, the observed trend suggested that the denial rates are manipulated to suit the requirement of that fiscal year. Our Medical Billing and Coding specialists suggest the use of industry best practices to accomplish steady income and reduction in denial rates

Medical Billers and coders from our consortium having a base in California have had a close look at the trends in denial management in the past decade, they have managed to discover a pattern or particular reasons for every payer in the state denying claims.

These billers discovered that Carriers differed in how they treated incomplete claims, if information required by the payer to process the claim was missing, the carrier could:

1. Return the claim to the provider, this action of the carrier is like the claim had never been submitted
2. “Develop” the claim (delay adjudication and try to obtain the required information by contacting the provider)
3. Deny the claim, the provider then had to resubmit the claim or go through the appeal process to obtain payment for this service

Denial Management is getting tougher even for specialists as the Carriers even differed in how they interpreted certain national coverage, most specialists are confused as the charge raised by them for different carriers is being treated differently.

A decade long study has also been brought out by expert billers and coders from Medicalbillersandcoders.com, this study reveals resolutions and check list formats of how to bill for the top five deniers in the state of California in order to have maximum payout for physicians and minimum denials.

Some of the specialist practices even noticed a denial of 7% of claims submitted in the current fiscal year, with the reimbursements freezing physicians groups are definitely looking to manage profitability better. They are seriously looking for specialists who can handle their denials specifically. Medicalbillersandcoders.com members in California are highly specialized in working denials and depending upon the age of the claims and reasons of denial can even provide assurance of collections.

Physicians Collect Incentives as MBC Guides its 100th Physician Practice to EHR Meaningful Use

   In tune with the healthcare industry increasingly leaning towards healthcare data automation, Medicalbillersandcoders.com guided its 100^th physician practice towards Electronic Health Record (EHR) implementation. According to National Coordinator for Health I.T. – 2012 is to be a year in which HIT will excel, predicting that approximately 100,000 providers will receive EHR meaningful use incentive payments this year.

Meaningful use is poised to take off this year after 20,000 eligible professionals and 1,200 hospitals received incentive payments last year, however HIE requirements will now become even more precise in Stage 2 and MBC in this spirit are gearing up to help their physician practices and staff to implement this change successfully.  

Guiding physicians practices towards EHR implementation 

Even though there has been an upsurge of EHRs there still are a large number of providers still to adopt the EHR and practices face a challenge in choosing the right EHR platforms along with a need to allocate resources to train staff on these technology platforms; however with change being generally resisted - Medicalbillerancoders.com in this process guide their clients practice staff towards easily adopting the EHR services in a smooth manner.

Our expert consultants review the practice’s operations completely and suggest the perfect practice management solution for optimum utilization, providing vast long-term benefits for the clinic, some key MBC services towards EHR implementation include:

• Mapping the practice management flow of your clinic
• Choosing the right EHR
• Short listing an EMR and Targeting the key areas of your practice which require support
• Helping your staff overcome resistance to change
• Help you set standards to easily achiever meaningful use

Guiding its 100^th medical practice towards EMR implementation and eventual meaningful use, Medicalbillersandcoders.com a consortium unlike billing partners, creates an environment where practices are being able to cope with healthcare changes.

Medicalbillersandcoders.com has been a reliable source amongst medical practices for nearly a decade now. Through our industry network we apply a neutral approach in selecting the right EHR and associated with various EHR platforms – Altapoint, ChartLogic, Medisoft, ClearPractice, MediLink, Aprima, BioSoftWorld, CitiusTech, ChiroTouch, Dentrix, EnSoftek Inc, HealthTrio, eScribeHOST, OmniMD, Eclinicalworks besides 550 others – our billers with experience in varied software’s can quickly adapt their skill sets and use their expertise to work with most EHRs. MBC provides a complete solution to practitioners for better EHR implementation and wants to play an integral role in encouraging physician practices towards improved healthcare.

EMR Softwares :  Mental Health EMR, Behavioral Health EMR, Pediatrics EMR, Chiropractic EMR

MBC has the Highest Number of Medical Billers and Coders in Dallas, Texas Servicing Primary Healthcare Physicians

On–going advances in dental billing and coding are gradually leading to the involvement of the medical carrier for obtaining payments. Hence various dental practitioners across US facing these new complexities have been finding a way out with Medicalbillersandcoders.com dental billing services.

Identifying significant differences between Medical and Dental Billing in a dental office -

• Coding– Compared to dental carriers; medical carriers require more than just a procedure code. In case of medical carriers the reason for the procedures needs to be conveyed which is the patient diagnosis.

• Medical necessity – This is very important for successful dental-medical cross coding. A suitable diagnosis that supports and establishes the medical necessity of the procedure is mandatory in order to be paid.

• Updates frequency- Though medical codes go through the same process as dental codes in case of additions, deletions and revisions, which  are published in their respective manuals,  the most significant difference is the frequency and time period between these updates. All medical code sets update yearly; with no grace period offered for using outdated codes by medical carriers.

• Claim form- The medical claims form is different from the ADA claim form. Most medical carriers claim forms need to be red in color and not copies of the form in order to be scanned correctly, moreover hand-written claims and hand-written comments are not accepted.

MBC experts believe that understanding these differences and implementing them can tremendously help while billing for a procedure which involves both the dental and medical carrier.

Prioritizing between the medical and dental payer at your dental office-

As more and more dental carriers recognize the medical nature of certain dental procedures; opportunities of filing dental claims with medical carriers also increase.

Though it is common for trauma-related dental services to be billed to medical plans, there are other dental services that can also be billed to medical. Currently procedures which can and are beneficial to be filed with medical carriers include- Trauma procedures, TMD procedures, Sleep apnea appliances, Oral cancer screening,  Medically necessary oral surgical, laser, periodontal procedures, implant, endodontic, and prosthodontist procedures. In addition any medically necessary exams and X-rays (including CT Scans) which may be associated with these procedures.

MBC dental billing experts have been successfully filing medical claims for all these dental procedures. With their keen understanding of the relation between oral health and overall body health; they have been able to easily procure maximum payments along with handling the added documentation.

MBC has provided multiple benefits to various dental practitioners across US - With their in-depth industry knowledge MBC comprehends most variables attached to dental-medical cross-coding and have positively impacted various dental practitioners across US -

• Dental practitioners revenue has increased due to increased case acceptance for procedures that fall under medical
• Higher patient satisfaction as dental patients with both medical and dental insurance plans have been able to switch to their medical plan for medically-necessary procedures, while saving dental plan yearly allowances for dental procedures
• Higher patient satisfaction has led to increased number of referrals and patients for these dental practices

Each payer has its own plan as to how they will cover certain dental expenses, and as dentists realize the need of a certified professional to manage the billing side of their practice, there has been a steady increase of MBC’s billing requirements by various dentists across US.

MBC’s highly-trained medical billers have the experience and know-how on billing medical-related dental services to medical insurance plans. Dental billing experts at MBC are committed to recovering 100% of revenue as they stay updated with the latest billing regulations, industry changes and coding updates. Additionally MBC experts regularly enroll in continuing education managing to constantly decipher new changes in the dental industry hence managing to increase reimbursements and save 30-40% of the practice’s operational costs.

MBC’s Best Billing Practices For Bundled Payment Models in Texas

Medicalbillersandcoders.com experts have witnessed a sudden rush in Texas for billing professionals, triggered as much by concern as also in a panic about - how to transition to the innovative payment model like bundled payment platform which is gradually replacing the traditional pay-per-service.

MBC realizes that there is a lack of understanding among providers in Texas about the intricacies of bundled payments. Health authorities have proposed four bundled payment models as part of their Bundled Payment for Care Improvement initiative and are currently testing them out in participation with care providers-

• Retrospective Acute Care Hospital Stay Only – involves inpatient stay in acute care hospital, for which the hospital will be paid a discounted amount according to rates mentioned in Inpatient Prospective Payment System
• Retrospective Acute Care Hospital Stay plus Post-Acute Care – covers auxiliary services related to an inpatient stay
• Retrospective Post-Acute Care Only – covers post-care services given by facilities accredited skills to render such services, like nursing homes, rehabilitation centers
• Acute Care Hospital Stay Only – involves a single amount prospectively determined for hospitals which would encompass payment for all services provided during inpatient stay

Bundled payment, as the name implies is a single payment for various services provided for a particular treatment, which may include several providers in varied settings. MBC understands the dynamics associated with these payments and have been assisting providers in Texas to prepare themselves accordingly.

MBC’s experts while assisting providers in Texas perceived certain benefits linked with bundled payments, like - improved coordination between the various care providers involved, flexibility to support the method and place where certain care is delivered, simplified billing with only one bill instead of multiple ones and finally providing accountability of care for specified treatment.

However, MBC has also seen care providers in Texas face challenges like-

• Identifying the care services falling within and outside an episode
• Limited number of patients from one area if adoption of care is not widespread
• Need to avoid high-risk patients or those treatments that might surpass average episode payments

Additionally MBC witnessed with the bundled payment model a lack of motivation amongst care providers to reduce unnecessary episodes.
Read More : Texas Medical Billing

MBC helps physicians in Texas handle bundled payment models-

“I am not sure whether innovative payment modules are good or bad for me, but what’s clear is by the time I understand them properly I will have already incurred some losses,” rued a mid-sized medical practitioner in Texas.

Empathizing with this concern MBC‘s experts have the capability to provide a holistic approach to equip care providers to meet the various challenges associated with bundled payment model. Through its comprehensive Revenue Cycle Management services, MBC has helped various care providers in Texas to easily adapt to it by improving their internal operations by -

• Performing a thorough assessment of their revenue cycle
• Spotting gaps that fatten and slow down operations
• Tweaking existing software applications to meet reform needs more effectively and replacing them with new applications where required
• Identifying areas of training and training their staff

MBC team works towards helping care providers overcome the service-identification challenge helping to understand the start and end points of care services within an episode as also to identify the care services that form the part of an episode and ones that don’t. These activities plus assistance on negotiating schedules and payer contracts have helped care providers in Texas to effectively work with innovative payment models like bundled payments.

The healthcare landscape in Texas is made of big, small and medium-sized players with a thick and, in some cases, sole presence of small to medium-sized players; where MBC has been providing end-to-end billing and coding services along with guidance on easy adaptation of innovative payment models.

Medicalbillersandcoders Save Thousands of Dollars for Michigan Physicians

Michigan is one of the very high ranking states in terms of doctor to patient ratio, accounting for its enviable healthcare provider status; it is 8th in terms of the number of hospitals in the US and among the top 15 in terms of the number of physicians per 10,000 people. Being one of the most populated states of the US and with more than 10% of its employed population in healthcare sector, Michigan has a large physician population which inevitably requires a pool of competent healthcare assistance in terms of medical billing, coding, and other affiliated administrative processes.

Medicalbillersandcoders have been effectively providing well-qualified and experienced medical billing and coding support to share the burden of healthcare providers for more than 32 specialties in almost all the major cities of Michigan such as Detroit, Grand Rapids, Warren, Sterling Heights, Flint and many more. With constantly up graded knowledge base and skills, and exposure to a wide variety of healthcare providers and latest regulations, MBC billers are a useful and reliable support base for the Michigan healthcare providers.

The importance of efficient billing and administrative professional support to share the burden of physicians was reiterated by a 2010 MDCH (Michigan Department of Community Health) survey of physicians, where 34.8% physicians cited increasing administrative and regulatory burden while 24.3% physicians cited inadequate reimbursement for services as factors contributing to decisions to retire or reduce patient care hours.

These reasons indicate that complying with the latest rules and regulations in the dynamically changing healthcare scenario requires aggressive and pre-emptive efforts from the physicians and their staff which takes its toll on their essential core competencies of patient care, research, and teaching. In fact, the routine processes involved in medical billing and other RCM functions are inevitably intricate requiring specialized skills and are better outsourced to expert professionals for optimum realization.       

Chicago Medical Billing, Los Angeles Medical Billing and San Diego Medical Billing

Keeping in with this context, MBC have expanded their RCM and consultancy services across big cities such as Detroit, Grand Rapids, Warren, Sterling Heights and Flint as also in smaller cities and towns in Michigan. MBC offers comprehensive and customized solutions for optimizing your revenue cycle management as well incorporating the latest innovations in healthcare technology, regulations and compliances; it also focuses on actively motivating the physician’s team to adopt these changes by underlining their relevance and scope in effective patient healthcare and improved revenue cycle management.

“The sweeping changes experienced by the US healthcare industry require considerable investment in terms of finance, resources, as well as training by healthcare providers if they are to be translated meaningfully in to their routine processes and operations”, says the President, medicalbillersandcoders.com, “however, outsourcing the management of these changes to experts such as MBC can significantly ease the process of transition as well as implementation of these upgrades.”

Highest Number of Radiologists in Ohio

Radiology practices across the State of Ohio have been rushing to seek MBC’s medical billing services as an increasing number of radiology practice managers in Ohio face complex billing problems in the current healthcare environment.

As a growing number of radiologists face rising costs and reduced payments, billing errors, obsolete technology, business communication problems, recruitment challenges– they are left with little time to focus on their practice and are proactively turning towards MBC to combat declining reimbursements and concentrate on patient care.

Understanding & dealing with Radiology Billing Challenges in Ohio

“The conventional trade of radiology billing in Ohio is quickly changing and becoming increasingly challenging making it crucial for groups to embrace the use of technology and automation¨ stated Aman Gupta CEO at Med DataCare Pro.

The primary radiology challenges facing radiologists in Ohio include -

• Declining reimbursements
• Healthcare reforms
• Conversion of conventional healthcare payment models
• Increasing bad debt as a result of the weakening economic conditions

Impact of challenges & changes in radiology billing in Ohio include -

• A statewide effort to reduce costs and increase efficiencies as the state witnesses a move to electronic claim transmission - an initiative taken by the Department of Jobs and Family which also governs Medicaid
• An increasing trend of teleradiology picking up in Ohio
• Increased numbers of emergency centers opting for outsourcing their radiology services
• As radiology plays an ever increasing role in hospitals in terms of revenue; radiologists are opting for means to acquire optimized hospital revenue management services.

Ohio being a progressive state is taking these changes within their stride and hastening to find solutions. Aman Gupta believes that “most radiology practice and hospitals are looking to overcome increasing billing challenge by acquiring a specialized billing service in order to secure maximized revenues”.

Role of MBC in helping Radiologists in Ohio

Faced with these obstacles and uncertainties, there has been a high increase from both small and large radiology groups opting for radiology billing services in Ohio. Medical billers and coders have been able to successfully accommodate the large amounts of billing and coding volumes in the past few months. Additionally providing revenue cycle management, denial management, interaction with payers, HIPAA compliance for hospital based radiology departments MBC has successfully managed to cut costs, free up time and resources for various hospital radiology departments.

Inviting radiology practices to acquire MBC’s radiology billing to get access to-

• Medical billers and coders who are regularly updated with latest radiology billing trends
• Strong clientele-base and voluminous operations which help in offering highly competitive professional rates
• Physician credentialing with both commercial and public payers
• Commitment to quality and reliability with pre-qualifications such as certification by the American Association of Professional Coders (AAPC); and expertise at applying standard CPT, HCPCS procedure and supply codes, and ICD-9-CM diagnosis codes

The biggest advantage we offer to radiology practices in Ohio is our long standing presence across all major cities like Columbus, Cleveland, Cincinnati, Toledo and Akron. In tandem to the above benefits radiologists can utilize Medicalbillersandcoders.com services known for its affordability and efficient reimbursement of Radiology Billing.

New York Physicians’ Monthly Collection Enhanced by 32% in the First Month by Medical Billing Services

MBC by applying innovative medical billing solutions has successfully helped individual physicians, physician groups and hospitals across the State of New York - with its specialized team of billers and coders managing to enhance most of their physician’s monthly collections by 32% within the first month itself of taking up the account.
Recognizing New York Practitioner’s billing needs
Though the Medical billing requirements coincide in a certain way or another, each State’s billing needs are unique in their own way and MBC’s team endeavors to ascertain these State specific needs of all our clients. New York Physicians and especially Cardiologists find it tedious to balance patient care and admin needs mainly due to the large number of patients they need to cater to amidst time constraints.
MBC’s billing experts are aware about this crucial factor and New York practitioner’s requirement for both timely posting and follow up of claims to help maximize revenues. Additionally the health care reforms are likely to have considerable amount of impact on the New York’s Medical billing and hence physician’s revenue, for which the NY’s medical practitioners need to constantly update themselves.
Health Care Reform: will affect New Yorkers differently than other states
With the Federal health care reform there are to be changes to public and private health coverage in New York, including increased integration. Additionally advances in technology are likely to facilitate improved coverage and help streamline processes.
However with a number of prime consumer health insurance protections already in place in New York State it is likely to go through less transition than many states with respect to these reforms, never theless the number of insured will increase and MBC’s team is prepared to handle this situation for its clients and prevent them from struggling to balance these changes with patient care.
How we manage to collect more for you?
Running a medical practice in New York and maintaining an efficient medical billing department can be quite challenging. Generally denials can run up to 30% or more of a practice's billing; however MBC works towards a much lower denial rate and higher collection rate - with the principal of getting paid only when our clients get paid.
By and large the last 20-30% charges are not paid on first submission- requiring up to 10 times more effort to resolve, most practices or billings services have limited resources to do this work. MBC due to its large set-up can routinely and consistently apply collection efforts to these claims to generate higher and more consistent collections.
Guiding New York physicians towards better medical billing practices
MBC has been helping providers with all their medical billing needs located throughout New York, in major cities such as New York City, Rochester, Buffalo, Syracuse and Albany. MBC experts constantly update themselves about the health insurance systems, managed care systems, medico-legal and ethical responsibilities, confidentiality, drugs, and prescription records along with other industry changes – with an aim to achieve higher collections.
Get more information: New York City Medical Billing, Rochester Medical Billing, Buffalo Medical Billing, Syracuse Medical Billing, and Albany Medical Billing
Keeping in mind the large number of patients their New York practitioners attend to everyday Medicalbillerandcoders.com have been working diligently and also have a dedicated department for our providers based solely in New York. Providing comprehensive medical billing and practice management services for over a decade; our professional billers know the ins and outs of medical billing practices, regularly updating themselves about the changing procedures and legislation that affect New York providers.

MBC invites all providers across New York to access our services depending on their needs – of professionals to handle the practice’s entire billing process or during a temporary staff shortage. Our well-informed billers are constantly applying new methods and trends are available to help you enhance your collections.

Medicalbillersandcoders.Com - The Winning Formula in These Times of Physicians Shortage

According to the latest data published by the U.S. Bureau of Labor Statistics, there is an acute shortage of physicians across United States; at least 26 states and 17 medical specialties have reported this fact.

The Association of American Medical Colleges has estimated that in the next decade, nearly one third of the existing physicians will retire from active service, the American population will increase by 25 million, 32 million patients will be covered by insurance, and 37 million retirees will need additional healthcare services from the physicians. 

How is this drastic shortage of physicians to be catered?

The answer lies in helping physicians to improve their efficiency so that they can attend to the needs of more patients. On an average an American physician spends 10.23% of his time in administrative jobs, either supervising or actively participating in the administrative process. They also spend as much as 14% of their revenue in an effort to get paid promptly and for the contracted amount. Physicians need to look for experts to handle their administrative work so that they can focus more on their core profession of treating patients. 

Medicalbillersandcoders.com has been following this problem of shortage of physicians’ for some time now and is actively working to cater physicians’ needs of optimizing operations and enabling them to focus on providing healthcare services to more and more patients. 

Ithelps physicians save time in the recruitment of in-house billers and coders. Physicians can log-on to the website, fill out a form and are able to recruit medical billers for their in-house needs within 2 to 3 days at no cost. Billers from Medicalbillersandcoder.com customize their work flow to suit the physician’s needs. Training of staff is almost negligible as billers and coders  are well-trained on various software and are certified on medical billing processes.

Efficiency of the clinics  has been the highest as the clinic is equipped with efficient, trained, local billers who are experts in their own specialties. 

MBC Helps Internal Medicine Specialists In Florida Tackle Medicare & Medicaid Fee Parity Initiative Challenges

Medicalbillersandcoders.com’s internal medicine experts have recently witnessed an increasingly high demand for medical billing services in Florida. MBC recognizes that this is partly due to several professional challenges intrinsic to the discipline, and also due to the fact that Florida is amongst the lowest paying states for Medicaid internal medicine specialist rates.
This dismal state of payment owes mainly to the fact (apart from Florida being a low fee center) that the services provided by internal medicine specialists come under Medicaid which involves much lower rates than Medicare. To bring about a balance between Medicare and Medicaid, medical authorities have equaled Medicaid rates with those of Medicare on a pilot basis applicable until December 2014.
But, alas, at a state level, this will significantly alter policies, claims systems, provider databases and data reporting. MBC realizes that these state-level policy and procedure alterations will drill down to change the way internal medicine specialists make claims and track claim-related documents. MBC has been helping many internal medical specialists in Florida to handle challenges arising from this new rate parity.
MBC noticed the following areas will be of prime concern for internal medicine specialists-

• Only physicians practicing in certain areas of primary care (internal medicine specialists being one of them) qualify for the increased rates from Medicaid. Physicians have to fill out appropriate forms and furnish accurate documentation to establish their credentials with Medicaid authorities to procure the rate hike
   
• Physicians will have to establish that at least 60% of their Medicaid reimburse claims submitted the previous year to Medicaid were made using primary care codes recognized by Affordable Care Act

The challenges outlined are going to affect internal medicine specialists in all states that are undergoing this fee parity initiative. But MBC understands that the challenges are going to affect the specialist differently depending on size and nature of the practice and consequently has a different approach depending on the practice.
MBC’s role in assisting Internal Medicine physicians in Florida
The challenges outlined above evidence various areas of concern like- right documentation, staff training for appropriate use of codes, tracking codes which have been used previously etc.
As part of the Revenue Cycle Consulting services, MBC performs-

• Thorough assessment of your operations
• Improved documentation and accuracy in billing and coding
• Works out areas of operational lapses and revenue leakages
• Improves in-house operations by spotting areas of revenue leakage and staff training
• When required helps replace old software applications with new
• Helps implement improved RCM and regularly tracks the process

Many internal medicine specialists from small to large sized set- ups, in Florida, have opted for MBC’s services entirely shipping out their billing and coding responsibilities to MBC – so that their staff can continue to focus on medical activities even as they seamlessly realize claims becoming beneficiaries of the rate increase rather than its victims.
MBC has helped internal medicine specialists overcome challenges linked to fee parity initiative-

• MBC guides those physicians who qualify for the rate hike to understand which areas of their medical services qualify and realize payments by helping submit appropriate medical information to establish their credentials with Medicaid authorities
   
• Most internal medicine specialists use Medicaid primary codes; but proving a year later that at least 60% of their reimbursements were procured with Medicaid may be a challenge. MBC helps physicians identify proper documentation and furnish appropriate details

MBC guides Family Medicine Practitioners to effectively tackle the ACA impact!

With the Family Physicians revenue cycle management in a state of transition due to the upcoming Affordable Care Act (ACA), Medicalbillersandcoders.com has witnessed a large demand from Family Medicine practice centers across US keen on outsourcing their billing functions to MBC in order to enhance their RCM.

The ACO impact on Family practice billing and coding  

The impact Accountable Care Organizations (ACO) will have on these practices explains the reason behind increased number of Family practices currently rushing to MBC for their billing solutions.

Though the ACO environment may benefit these practices by promoting primary care hence making it accessible and improving provider reimbursements; it also brings with it many changes as it prompts federal and commercial payers to change the way they make payments. The challenge it provides to Family Practice billing and coding is that they would require transitioning their reimbursement models from volume-based to value-based to a higher number of patients with little time left for billing.

MBC’s billing and coding experts believe that “Family Physicians within the next five years; will need to adopt the new revenue reimbursement models as a result of ACA. Though this may seem simple enough, practitioners will need to work much harder to maximize their revenues.”

Identifying resulting revenue transition challenges

MBC understands that in the ACO environment accurate medical coding and billing is vital to maximizing revenue, being aware of the resulting issues they face with this transition, -

• Lack of knowledge – Most Family Practices from a recent survey understand the value of population health management, but are at a loss on how put these strategies into practice
• Increased administrative burden, cost and time –practices need to prepare and gear up for short-term disruption of patient care and resulting administrative activities, to procure maximized eventual longer term benefits of improved patient experience and reduced costs
• Lack of management- Though an avenue for practices to successfully move forward most practices lack guidance and support in this area; to help them  acquire maximum benefits

How MBC has been guiding Family Medicine Practitioners?

Medicalbillerandcoders.com is aware that improved Family Practice revenue cycle management requires in-depth, insider industry expertise of the new coding, billing and compliance regulations. MBC specialists continuously correlate higher practice revenue to timely billing and account reimbursements, offering best billing strategies, models and consultancy and providing guidance in areas like population health management.

MBC’s certified coders and billers understand that correct procedures are essential for revenue maximization. By providing accurate, quality control and legal compliance, MBC has successfully undertaken Family Practice revenue cycle management coding for larger groups as well.

Family Medicine Practitioners maximize their revenue with MBC as-

• Billing experts manage to stay updated about rules, edits, coding regulations and documentation requirements unique to the Practice’s revenue cycle management; providing the required knowledge and guidance to implement the best strategies
• Family practice billing specialist with the right expertise can handle the complexities presented during billing and correct usage of modifiers, helping reduce costs significantly

As smooth processes and efficient technology support Family Practice centers to effectively reach out to a higher number of patients, it also increases their chances of increased revenue. Healthcare specialists across all 50 US States ( Arkansas Medical Billing, California Medical Billing, Florida Medical Billing, Georgia Medical Billing,New Jersey Medical Billing ) considering streamlining their RCM process are engaging themselves with MBC to utilize revenue management & consultancy services.

Medicalbillersandcoders.Com Unravels The Finer Points Of Dental Billing & Increases Savings For Dental Practices!

Medicalbillersandcoders.com experts familiar with the inner working of Dental billing have been providing customized billing solutions to dentists across US. With in-depth industry knowledge they can easily understand the finer points of dental billing like-

• Prior to starting any procedure it is imperative to obtain pre-authorization or pre-certification from the dental  carrier or at times the medical carrier
• Ascertaining if coordination of benefits clause has been included. This usually states if the dental carrier makes the payment then the medical carrier will not be liable and vice versa
• In a case of no coordination of benefits clause the dentist can maximize payments and minimize the patient’s expenses by- billing both the medical and dental carrier
• While billing both carriers normally the dental carrier is billed first; however the medical carrier is billed first when the biller is confident that the medical carrier will make the payment

Commonly for procedures like impacted wisdom teeth, gingivectomy/gingivoplasty, subepithelial tissue grafts, alveoloplasty, and osseous surgery the medical carrier makes the payment.

Billing the medical carrier for dental procedures - MBC experts generally cross reference a CPT code to determine if the dental code to be used has a compatible medical code. In case no compatible medical code (CPT) exists, the CDT “D” codes are used for submission.

Additionally during submission the CMS-1500 form (formerly HCFA-1500) is used instead of the commonly used dental ADA form, along with a copy of the denied EOB (explanation of benefits) or request for primary carrier denial from the dental carrier.

The most common billing and coding problem that dental practices face is determining how to bill a procedure which involves both the dental and medical carrier.

Other problem areas that currently plague dental billing include- appeals process, coding surgical procedures, understanding an EOB, credentialing with medical carriers, and so on.

MBC experts are of the opinion that – “by outsourcing their billing requirements; numerous US dental practitioners have been able to counteract challenges and increase their savings significantly.”

How MBC experts ensure maximum savings for dental practice revenue?

MBC helps reduce payment delays, claim resubmissions and avoid under or non payments by-

• Ensuring accurate payment settlement with - suitable depiction of dental services under their various categories and subheads in the billing system
• Avoiding unnecessary denials by - providing accurate details of the surgery and the treatment devised by the physician
• Attaining the right level of detailing-  as in certain cases detailing can be directly proportional to the rate of payment reimbursed

As nearly 75% of dental claims get denied due to inaccurate assessment of dental insurance eligibility;MBC’s dental verification services ensures minimum rejection by -

• Accurate verification of patient’s insurance eligibility through calls or online checks
• Constant checks done of preauthorization number, deductibles, plan exclusions, claim mailing address, policy status, etc
• When required obtaining additional information by contacting the patient

The billers and coders at MBC are well acquainted with American Dental Coders Association (ADCA) are also constantly updated with industry information, coding tactics and skill sets required. They can easily - handle cases where dental services are provided as part of a larger or another treatment, work through bundled up medical data, and split non-dental from dental. MBC experts have been working with dentistry centers for over a decade now and are able to easily understand the intricacies of dental billing hence ensuring maximized reimbursements.

Medical Billers and Coders’ professionals Extend Support to Mental Health Billing in San Diego and Chicago

The US Public Health Service has highlighted the fact that nearly one in five Americans suffers from some form of mental health disorders and that only a fraction of those affected receive treatment.

Illinois and California are the two states with the highest concentration of mental health patients among adults touching 38.6%, according to the 2010 data on Kaiserhealthnews.org. New York City is a close contender with 36.1% and 9th place among the 50 states. To compound the problem, Illinois also happens to be a state with a high 21.4% underserved population when it comes to mental health care services.

The physicians located in Chicago, Illinois, Californian cities such as San Diego and Los Angeles, and New York City have to cater to an ever-increasing Mental healthcare patient volume. Any successful intervention in their support will inevitably need to establish expert professional support for their non-core activities such as billing, coding, and other affiliated services in RCM, allowing them to focus on patient care.

Chicago medical billing, San Diego medical billing, Los Angeles medical billing and New York City medical billing

Medicalbillersandcoders.com has extended its established network of billers and coders with substantial hands-on experience in Mental Health billing and coding to support these physicians and their overworked staff.

Mental Healthcare is a busy specialty due to its interdisciplinary nature and also involves very complex billing and coding services. On top of that, there is a much greater Mental Health claims denial rate vis-à-vis many other specialties which calls for stringent pro-active measures in claims submission for effective reimbursement.

It seems imperative for these physicians to enroll very experienced specialized professionals for an efficient reimbursement process, so that the physicians can concentrate on providing optimum and meaningful patient care.

Along with these responsibilities, Mental healthcare physicians also have to ensure compliance of the recent healthcare regulations such as HIPAA 5010, ICD10, PQRI, CPOE (Computerized Physician Order Entry), HIE (Health Information Exchange) along with the latest EMR updates. Along with this, the various projected healthcare reforms such as EHR, PQRS, and ePrescribing as also the imminent inclusion of a large percentage of hitherto uninsured population are going to escalate the already burgeoning problem of expert billing and coding support to Mental healthcare specialists in New York, Chicago and San Diego as well as neighboring cities of San Francisco and Los Angeles.

MBC, with its large network of AAPC-certified, highly experienced mental health care billers and coders in San Diego  and Chicago with a track record of error-free and denial-free billing and coding services, can provide effective support to Mental health care physicians. We have a huge experience in processing claims with leading private insurance carriers as well as government sponsored Medicare and Medicaid. We effectively customize our services to cover overflows, backlogs, as well as part time requirements.




 “Even with dedicated in-house staff, it requires substantial amounts of money and effort on technology, equipment, and training to tackle these factors”, said the President, medicalbillersandcoders.com, “MBC can effectively support Mental Healthcare physicians to provide accessible and quality patient care through its network of proficient billing and coding experts in Chicago, San Diego, and the New York City”. Well-versed with the latest billing software as well as healthcare IT applications, and familiar with the nuances and implications of the latest changes in billing, coding, and healthcare reforms and regulation compliances, Medical Biller and Coders professionals can provide specialized service to optimize your revenue cycle management.