Orthopaedists Hiring a Medical Billing Service to Sail through Rising Expenses

Rising expenses amidst reimbursement cuts is one of the biggest challenges faced by orthopaedists in today’s time. It has not only affected the financial health of practices but it might also lead to restricted care for some patients in future.

Billing issues:

Decline in reimbursement has affected orthopaedic surgeons and healthcare providers across the US. Timely billing has become a challenge since new medical billing and coding changes were introduced for orthopaedics in 2013. In order to ensure that billing issues don’t reduce their payments further, orthopaedic practices are being compelled to invest money on hiring and training a team of skilled billers and coders who will ensure that the practice gets paid for all the services on time

Compliance with latest health IT:

Amidst Medicare cuts and reduced fee schedules, orthopaedic practices are being required to comply with latest health IT standards to conduct operational functions. This has also increased pressure on practices as implementation of required technology can be quite expensive

Recruitment of clinical and business staff:

In order to give an edge to your practice and offer excellent care and services to patients, recruitment of skilled and certified clinical and business office staff has become vital. This is also an area where orthopaedic practices will have to spend money for hiring and training

How can a billing partner help save your practice?

Apart from Medicare cuts, orthopaedic practices are also facing reimbursement cuts in the form of 10-15% insurance underpayments. Since these services are expensive, even 1% underpayment can result in significant revenue loss. In order to ensure that silly billing and coding errors don’t lead to payment cuts, many practices are seeking help from a billing company to streamline their billing procedure.

Orthopaedic practices can reap various other benefits through outsourcing such as:

• Quality assurance checks on a regular basis
• Effective account receivable management
• Progress report of filed claims in a timely basis
• Transparency in revenue cycle management
• Round the clock claim processing
• Usage of secure network to solve billing issues
• Enhanced cash flow
• Quick access to financial information and patient data

Hiring a billing partner will eliminate the cost involved in employing or training coders and billers, implementation of health IT, compliance to HIPAA and so on. It will not just result in timely payment, helping practices sail through rising expenses but also give enough time to physicians to concentrate on offering quality patient care.

Medicalbillersandcoders.com has the largest consortium of well-trained resources that can help you face the challenges of reimbursement cuts and rising expenses. MBC has affiliation with orthopaedic medical billing specialists across 50 states in the US and our team of certified coders and billers offer effective medical billing services to small as well as large orthopaedic practices.

From solving underpayment issues to ensuring error-free claim submission for timely payment, MBC makes sure that revenue cycle management of your practice is strong. We also focus on reduction of billing and coding changes on the revenue flow of your practice.

Accuracy in Documentation Vital for Effective Optometry Medical Billing

Maintaining accuracy in documentation is extremely important for optometry billing. This is not only required for error-free coding, billing, claim submission and follow-ups with insurance companies but also for avoiding malpractice lawsuits.

Insufficient and inaccurate documentation have cost medical practices millions of dollars. Rate of errors may have dropped for optometry practices but even a small fraction can lead to disrupted cash flow. 2014 has brought various challenges related to healthcare reforms, increased federal scrutiny and rising costs. Amidst all these complexities, it has become essential to concentrate on documentation in order to avoid delayed or lost payments.

Missing information leads to inaccurate coding:

Identification and correction of coding gaps has become essential during optometry billing to get paid on time. This has pushed the need to improve clinical documentation. Audit plans have become stricter and with the Medicare Physician Fee Schedule cuts, providers cannot afford to lose more money due to inaccuracy in documentation.

With the implementation of ICD-10 in October 2014, codes relevant to eye care will expand to over 100 pages of codes. In order to choose the correct diagnosis codes and ensure high level of specificity, you will be required to provide accurate documentation to your coders.

Optometry Billing Challenges in maintaining documentation accuracy:

There is no doubt that optometrists can now provide a wide range of professional services to patients but managed care has forced them to attend more patients every day. This has not only reduced the time they usually spent on each patient encounter but also reduced the time required for accurate documentation.

Providers need to be in sync with latest documentation trends. They also need to be aware of guidelines related to optometry billing in order to document properly. With ICD-10 round the corner, they also need to be conversant with ICD-10 related optometry billing and documentation as it will be required when the diagnosis system will change.

Seeking help from an Optometry billing partner:

Improper documentation leads to improper coding which results in penalties and your practice can get expelled from managed care programs. Therefore, it is important to be compliant and proficient in optometry billing and coding.

Thorough knowledge of optometry coding, billing and documentation is required for supporting claims and considering the lack of time and resources; hiring a billing partner makes a lot of sense. MBC Optometry billing team of skilled coders and billers have the required experience and expertise to handle optometry coding. Since a team of experts is assigned for maximizing revenue and minimizing claim denials, providers can utilize their time to pay full attention to documentation and patient care.

Medicalbillersandcoders.com offers effective optometric billing and coding solutions to practices across 50 states in the US. For optometry practices with an in-house billing department, MBC can help optimize revenue management system and prepare it for meeting modern medical billing and coding challenges. While we handle the daunting tasks of coding and billing, you can make use of the spare time to concentrate on documentation and other vital tasks.

Overcoming Gastroenterology Billing Challenges with Efficient Billing Services

Gastroenterology is a sprawling discipline dealing with multiple anatomies and diseases that afflict them. And this makes a gastroenterological treatment episode very dynamic, one where  an episode starting with a normal screening can lead to surgery, bringing in divergent care components within a treatment episode making claim preparation, which includes assigning proper code to each care component deciphering where one started and ended and whether the incursion of a new care service changes the character of the treatment from a billing perspective – very difficult. On a specific note, there are mainly three components of a gastroenterological treatment – screening, diagnosis and biopsy and an episode can include all of them.

Two years ago, a patient showed low-risk symptoms and had a screening colonoscopy but now displays symptoms that warrant diagnostic colonoscopy. Will Medicare reimburse the second procedure?

This is just one of the many instances directly related to treatment billers and coders face. Similarly, there are multiple issues related to areas around a treatment, like:

·         The code to use for a first time visit

·         The code for an emergency room, etc.

And if not paid attention to, the result is inaccurate coding, claim rejections and shrunk finance.

To increase the number of successful reimbursements, you have to make sure that you are thoroughly familiar with all aspects of gastroenterology mediacl billing, your knowledge of codes and related matters is frequently updated and you have records to support your claim.

This necessitates three things: sound documentation gathered and archived such that they can be easily retrieved when preparing claims, training for billers and coders which will help develop a sound knowledge of billing and coding modalities and appropriate software platform to ensure efficiency and regulatory compliance.

It’s little wonder that gastroenterology practitioners are increasingly turning to professional billers and coders to handle their billing and coding activities.

MBC’s Revenue Management Consultingservices can help you to put your revenue management cycle in order by assessing it and ensuring that revenue leakage gaps are closed through smooth flow of gastroenterology data, installation of proper software applications and staff training in how to handle gastroenterology codes.

Medicalbillerandcoders.com, the largest consortium of billers and coders in the US, has also been helping several gastroenterology care centers, in big and small cities of the US, with its Outsourcing services handling the entire range of activities involved in billing and coding starting from preparation of claims through submission to post-submission follow-ups. Our service modules are flexible that allow you to pick and choose only those bits and pieces of our services that meet your coding needs so  that you can avoid paying additional cost.

Chiropractors Avert Escalating Denials with Medicalbillersandcoders.com!

   Medicalbillersandcoders.com billing services has recently become the preferred choice amongst a high number of Chiropractors across all 50 US States, to reduce AR days and avert escalating denials. This is mainly because MBC experts with vast industry knowledge can completely focus on optimizing billing and collections, equipped with their intricate understanding of Chiropractic billing.
Challenges which may delay Chiropractor payments-

• Various different injuries which require to be treated, multiple patient issues and therapies all eventually result in overwhelming billing concerns which need to be tackled appropriately

• Constantly changing billing regulations and coding recommendations poses another challenge, hence needing someone experienced in pain therapy billing, to handle the claims accurately

• The topmost challenge for most Chiropractors’ is creating a positive culture amongst the practice staff and provide proper training to help attain a consensus between employer and employee in order  achieve complete accuracy in medical documentation and billing

• Practices need to alter their billing to the changing payer environment and its various challenges such as declining reimbursements, decreased Chiropractic patient benefits, higher out of pocket expenses for patients, fear of potential CMS and other payer audits. This makes it essential for the medical biller to be completely educated on coding, billing and documentation requirements

• The earlier business model is not applicable anymore for running a healthcare business in 2013 and the Chiropractor practices require to regularly update all its systems especially the billing, operating and financial systems to improve their bottom line

• Primary billing challenges due to which Chiropractors payments get denied or delayed are – modifiers, incorrectly reduced codes, incorrect payments, claims in review for an excessive amount of time, coverage issues (pre-existing condition, no coverage, lapse of coverage, no chiro benefits) and insufficient documentation

MBC Chiropractic billing experts believe as change is constant - streamlined billing and updated technologyis the answer to help resolve most of the above challenges. This would help insure minimized risk, due to improved documentation, scheduling and billing systems.
Resolving the Problem with MBC billing services …
MBC Chiropractic billing experts reduce AR days and denials by ensuring-

• Completed forms and documentation before filing claims
• Properly done insurance verification to eliminate increased A/R days
• Regular updating of all the new payer regulation and norms
• Evaluation of the practice set-up and assisting the Chiropractor to ascertain the areas which require technologic up-gradation to improve documentation, etc.

MBC experts also regularly undergo training to be able to provide the highest level of billing and collections service. Being experienced in handling various insurers and with knowledge about the latest chiropractic billing procedures and codes, MBC team easily help procure maximum reimbursements.
MBC also customizes their services to fit the chiropractic practices billing needs, helping the practice save money and also optimize the patient’s health.

My Staff is Reluctant to Change to ICD 10, What Should I do for my Billing and Coding?

  Billing and coding procedures are set to become more complex due to ICD-10. So, if you want to minimize claim denials and maximize revenue you need to have well-trained staff at your practice. Providers need to understand that coding complexities will affect the productivity of in-house staff. They will be confronted with requirements for updated, complex encounter forms and super-bills along with greater knowledge of medical terminology and anatomy.
ICD-10 changes are going to be extensive and with less than a year left, staff should be encouraged to learn the new coding system to eliminate chances of errors. Early preparation and timely review can help overcome any challenges that arise due to ICD-10.

What measures need to be taken by practices?

Practices can either invest time and money in providing procedural training to the staff or outsource their coding and billing requirements to a billing company.

• Money needs to be spent on conducting training sessions and buying learning materials for the staff
• Sufficient time will have to be invested by providers to learn accurate documentation which will eventually help coders
• Staff needs to be trained on new systems and procedures including EHRs, practice management system and computer assisted coding
• They will also require training on handling super-bills and ensuring compliance to HIPAA and other reforms
• Practices will have to retain employees by increasing their payments as they will be handling increased workload due to ICD-10

Is lack of time and resources posing problems?

With so much to do in such less time, it becomes challenging for the doctors to focus on quality patient care. Small practices with limited staff and resources will be the worst hit with ICD-10. Hiring new staff and ensuring their retention becomes a challenge due to lack of money whereas training existing coders becomes a challenges due to time constraint.
Since they can’t afford to reduce cash flow or affect the provision of care, outsourcing billing and coding needs makes sense. A billing company will eliminate the headache of hiring new coders or staff to handle complexities of ICD-10.
Such companies have a team of expert coders and billers who are constantly updated with the reforms in the healthcare industry. Since a well-trained team will be assigned to handle the billing tasks of a medical practice, doctors will be able to focus on patient care rather than internal ICD-10 testing and training.

Medicalbillersandcoders.com offers expert help to practices in smooth transition to ICD-10. We not just offer effective solutions for maximizing practice revenue but also help providers in finding drawbacks in their billing procedures. Latest technologies are used at MBC for handling daily operations of a practice. Apart from offering services related to payer interaction, HIPAA compliance, consultancy and research MBC can also help you in placement of trained coders and billers for your practice. While we work towards strengthening your financial health, you can concentrate on patient care.

Latest Medicare cuts and their Impact on Chiropractors Deciphered by Medicalbillersandcoders.com!

Chiropractors across US impacted by the recent Medicare cuts are approaching Medicalbillersandcoders.com for specialized billing service and advice. Especially due to the federal budget sequester cuts (click link to read Medicare notice), where for any Medicare services performed post April 1st, 2013, chiropractic reimbursements are to be deducted by 2%.
MBC experts with more than a decade of experience in Chiropractic medical billing are assisting practices across US to manage the impact of the Medicare cuts in the best possible way, and help procure maximum reimbursements. To do this billing specialists at MBC first assess the impact of the cuts will have on the Chiropractic practice before providing a solution.
Medicare & Chiropractors-

• The cuts are going to impact all Chiropractic practices including those consisting of a small portion of Medicare patients.  This is because most third party payers use the Medicare fee schedule as a basis to calculate their own reimbursement decisions. (For example- certain Payers Insurance reimbursement equals 150% of the Medicare allowable or few insurance fee schedules are set at 175% of Medicare).

• With Chiropractors going past the 60 day mark, of the federal budget sequester cut of 2% mentioned earlier, many have noticed a decline in their Medicare reimbursements. However the Medicare patients at these practices are also not on the receiving end of these cuts and continue paying their co-insurance, deductibles or co-pays. This means that Medicare now simply pays the participating physician or the patient in case of a non- participating physician 2% lesser. Hence neither the chiropractor nor the patient benefits, which is along with decreasing the already low Medicare reimbursements; also reducing physician satisfaction.

• Though in the July 19, 2013 Federal Register, Medicare has depicted interest in whether chiropractors should be paid for Evaluation and Management (E/M) services however, Medicare is not promising to cover E/M services for chiropractors and don’t have any definite plan as of now.

MBC experts in this scenario are regularly updated about any federal changes in regulations and also extra careful while filing Medicare claims for their clients. They are constantly working towards streamlining the practice’s billing process and looking for any gaps in the process to ensure maximum reimbursements.

How does MBC help Chiropractors handle the Medicare Cuts?

In–depth research and expertise in Chiropractic billing has helped MBC billing specialists tackle the Medicare cut implications, and help reduce the negative impact on revenue for various Chiropractic practices across US. MBC billing experts are able to reduce the impact of these cuts by-

• Constantly tracking the reimbursements for any reduction in payment by payers
• Studying and evaluating average payments that the practice receive from each of the payers
• Constantly researching and updating on any new Medicare rules to insure complete accuracy
• Advising the Chiropractic practice of the most successful pattern of procuring payments
• Guiding the practices on areas due to which they may be losing more money and methods through which they can procure higher reimbursements
• Sending  regular reports to the clients and also following up regularly with payers

In this manner MBC helps reduce the impact of the Medicare cuts. MBC billing experts additionally also provide guidance to Chiropractic practices after studying their practice set-up. On identifying the area which are not working well and require streamlining, due to nearly 14 years of industry expertise MBC then provides the best way to tackle these areas, offering a complete practice analysis of your Chiropractic practice.

How can Outsourcing Help Identify and Solve Orthopaedic Billing Challenges

2013 brought new changes to orthopaedic billing and coding, making timely reimbursements even more daunting for physicians. At a time when reduction in fee schedules and Medicare cuts have affected the financial health of orthopaedic practices, preparation for ICD-10, compliance to new technology and dealing with varied payer mix has increased billing challenges for them

Are these billing challenges eating up your revenue?

Due to time constraint and lack of skilled staff, a significant number of insurance claims get denied and are not re-submitted for appeal, disrupting the cash flow. Billing has become daunting for orthopaedic practices due to various factors including:

• Various procedures are used by orthopaedics to treat different conditions and diverse payers value and interpret these conditions differently

• There has been extensive revision in orthopaedic coding in 2013 with 500 code changes in orthopaedic surgical coding along with a complete overhaul of nerve conduction study codes, new spine fusion code and two new sets of elbow and shoulder revision codes.

• ICD-10 will make coding even more complex and small orthopaedic practices with limited resources will be the worst hit

• Patient numbers are rising and a hectic schedule is leading to errors in documentation, coding and billing

• Considering cash flow issues, practices are not able to hire expert billers or invest in the latest equipment and technology

How can you overcome these challenges?

Physicians handling the operational and clinical procedures are left with very little time to balance between the rising billable targets, new coding, billing changes and patient care. Orthopaedic procedures are expensive and since a small error can lead to huge revenue losses, outsourcing your billing services can reap benefits for your practice.

• With streamlined billing services your account receivable will be managed effectively
• Your income will improve as experts will be performing round the clock claim processing
• You will get to enjoy easy access to patient date and other financial information
• There will be transparency in the revenue cycle
• A secure network will be solving issues related to billing
• Quality assurance checks will be performed on a regular basis
• You will be able to access timely progress reports of a filed claim

If you outsource your billing services, your practice will have a team of experts entirely focused on managing your revenue cycle, dealing with unpaid claims, solving any billing or coding issues and offering you timely feedbacks and reports.

Billing partners such as Medicalbillersandcoders.com have an expert team that offer quality billing and coding services to orthopaedic practices across 50 states in the US. MBC not only helps orthopaedics identify billing challenges caused by healthcare reforms but also offer remedial solutions for tackling underpayments. Our aim is to help you reduce the impact of coding and billing changes on your revenue cycle. While our team of experts handle the headache of claim filing, denial management and follow-ups, you can give more time towards quality patient care.

Improve Clinical Workflow and Increase Revenue with Specialized Billing Services

Healthcare reforms have not only increased workload but also forced physicians to concentrate on quality patient care. This leaves them with less or no time to handle the medical billing procedure. When compared to maintaining a regular in-house billing system, outsourcing is more beneficial in boosting efficiency and cash flow of medical practices.

From increasing revenue and payment collection to reducing the cost and headache of hiring and training employees, a specialized billing service can offer various advantages to your practice.

Reduce cost and minimize administrative workload:

• Your cash flow will increase as the billing partner will ensure accurate submission of medical claims. Since a team of experts will be solely responsible for your billing system, chances of claim denials will reduce

• Staff size will reduce which will save operational costs of your practice by 30-40% as the expense of paying employee benefits such as insurance benefits, vacation pay, sick pay will be eliminated

• The cost of training the staff and buying latest equipment and software will also be eliminated because reputed billing companies make use of the latest technology to handle revenue cycle management for clinics or hospitals

• A specialized billing service will offer you complete transparency and supply you regular comprehensive reports on performance

• Since you won’t have to micromanage your billing operations, you will get ample time to concentrate on patient care

• There will be no staff turnover which means no cash-flow interruptions and even while you are on a holiday, your revenue cycle management will continue to function

The best part about hiring a specialized billing partner is the opportunity to utilize latest technology and professional expertise at a low cost. You will not just have better control on your operating costs but patient scheduling, insurance verification and patient enrolment will also become easy.

Outsourcing- a boon for small practices:

A specialized billing team will also help you in making the necessary changes and preparations for HIPAA-5010 and ICD-10. A large number of physicians, especially small practices are outsourcing their billing procedure and related tasks to a billing partner as they have limited staff and limited time to implement new changes, train staff and streamline their billing cycle.

Medicalbillersandcoders.com is the largest consortium of billers and coders, offering one stop solution for all medical billing requirements. Our team has the required expertise to choose the right software for your billing requirements, ensure compliance to HIPAA, help you understand and sail through the new payment models and prepare your practice for ICD-10.

Our aim is to help practices increase revenue flow by reducing claim denials. We also provide consultancy services to practices. MBC has a job board from where you can hire a qualified medical biller or coder for your clinic or hospital. While our experts will be working hard to strengthen your financial health by managing your revenue cycle, you can use the free time to focus on provision of quality patient care.

Rural Hospitals Surviving Healthcare Reforms with a Billing Specialist

In many ways, healthcare reforms have opened doors of opportunities for rural hospitals but the changes in healthcare system have also imposed certain challenges. Rural hospitals are not just facing pressure due to rise in cost of care but reduction in reimbursements has also increased their trouble.

Challenges affecting rural hospitals:

• Payment from government is declining as rural hospitals are small in size, having modest financial reserves. Majority of patients coming to these hospitals are Medicare patients, typically older and sicker compared to their urban counterparts

• Amidst financial challenges, reforms have forced rural hospitals to comply with various regulatory requirements such as ICD-10 and HIPAA

• Hospitals are finding it difficult to provide quality care through aging equipment and there is no money to implement EHR technology, which makes them lose out on incentives

• Rural hospitals don’t get trained staff, including billers and coders as not many show interest in moving to a rural area. Lack of financial reserves and delayed reimbursements make it difficult to retain them for a long time

• Lack of skilled staff results in coding and billing errors, which leads to delayed or no payment

• Due to lack of finance, rural hospitals are at times unable to buy expensive IT and train the staff on how to use new technology

Why is outsourcing- a cost-effective solution?

Considering the financial, operational and regulatory challenges posed by healthcare reforms, the trend of outsourcing billing and coding services to a billing partner has become a popular trend among rural hospitals.

Since a team of skilled billers and coders focus on error-free coding and billing, filing claims, following up with insurance companies, documentation and other administrative functions, rural hospitals don’t have to worry about hiring or retaining staff for such tasks. Effective coding and billing results in reduced claim denials, leading to timely reimbursements.

Timely payments strengthen the financial reserves of rural hospitals, which can be used for buying better equipment for quality care. As the outsourced team handles major tasks, hospitals get ample time to concentrate on patient care.

By outsourcing billing services, rural hospitals don’t need to invest in latest health IT (computer software or hardware) as the assigned billing team will be updated and trained to use the latest billing software at their end. Billing partner will work as per the latest reforms and help the hospital with HIPAA, ICD-10 and other compliance.

The cost incurred in hiring staff, buying software, conducting training sessions and managing other administrative functions at the hospital would be any day higher than hiring a billing partner.  Outsourced hospital billing and coding services offered by Medicalbillersandcoders.com, the largest consortium of billers and coders in the US, have helped medical practices improve their finances. The team at MBC is licensed and trained in accurate claim development, timely follow-up, unique, error-free procedure coding, documentation and electronic filing. While we fulfil your reform requirements, you can concentrate on provision of quality patient care.

Meeting HIPAA Requirements with a Specialized Cardiology Billing Specialist

Cases of HIPAA violation are rising and even if you are a small practice, you can get on the government’s radar if you fail to protect healthcare-related data. Patient-related information is traded by cardiologists for various purposes, including medical coding and billing and if your staff happens to misuse the data accidentally or intentionally, it can result in criminal as well huge monetary penalties, damaging your credibility and revenue flow.

• Health data breaches (involving 500 or more patients) increased from 619 to 646 in 2013
• Theft of patient-centric data has been the major reason for such breaches whereas unauthorized closure/access was the second leading reason
• Largest number of breaches in 2013 were caused due to paper records, followed by laptops, desktop computers and other portable electronic devices
• Federal breach notification requirements under HITECH act have been made stricter, increasing legal scrutiny on practices
• The final HIPAA omnibus rule has included penalty revision for each HIPAA violation category. While one time violation remains under $50k, repeat violations in same year will cost fine of %1.5 millions across all violation categories

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Preparation for HIPAA compliancy:

At a time when cardiologists are suffering from reimbursement cuts, handling the enhanced privacy and security enforcements has increased their difficulties. In order to meet the HIPAA requirements, they need to:

• Conduct assessment of any potential security risks to patients’ electronic data
• Review established security policies and procedures to determine if enhancements are required in the practice for complying with the rules
• Perform a risk assessment to find out if your practice is vulnerable to breach of patient information because any incident that involves your patient records will be reported as a breach
• Remain extra cautious in regards to paper creation, especially if your cardiology practice is sending a fax containing patient data to a third party outside the practice
• Take the HIPAA rule into account and map your current security program based on it
• Create unique contractual provisions with business associates of a health plan as HIPAA monetary penalties now apply to a range of vendors and their subcontractors

Time constraint has made it difficult for cardiologists to keep extra vigil on data system, train staff and implement comprehensive set of measures on a regular basis. Many practices are hiring a HIPAA compliant billing specialist who can perform billing and coding tasks while maintaining confidentiality of patient and practice information. A specialized billing partner ensures errors-free coding and billing for timely reimbursements and offers quick response, AR follow-up, EMR solutions, insurance authorization and several secured services with the help of trained staff and latest technology.

Medicalbillersandcoders.com offers HIPAA compliant medical billing services to cardiology practices across 50 states in the US. The expert billers and coders at MBC aim to maximize account receivables by streamlining medical billing and help cardiologists avoid litigations in accordance to the HIPAA Act norms. Our team is well trained in HIPAA compliant healthcare data management processes and systems and can help you balance between your clinical and operational functions.