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Ways to Supercharge Your Medical Practice Revenue in 2019

Grey Metal Case of Hundred Dollar Bills 

A new year brings new opportunities and challenges for a medical practice, especially when it comes to growing revenues. Your goal will likely be to increase your revenue levels from last year and grow your practice in a healthy way.

For any practice that has this goal, it is essential to adapt with the times and take advantage of any new opportunities that can make an impact on your bottom line. Equally important, successful medical practitioners will review their current operations and search for ways to improve processes, systems, and general operations.    '

So what can a medical practice do to grow their revenues in 2019? Check out some of our tips below to start the new year off to a good start:  

Revisit Your Billing & Coding Operations

Woman Holding Pen While Using Calculator

One of the most important things your practice can do to increase revenues in 2019 is reviewing your existing billing & coding operations. Many medical practices have outdated and inefficient processes in place that contribute to significant revenue losses and missed opportunities. Unfortunately, as time goes by, the medical billing industry is only getting more complicated and difficult to understand.   

There are always new innovations and coding changes that need to be stayed on top of. Thankfully, medical billing specialists, like Billing Savi, are stepping in to meet the need and help practitioners establish solid billing foundations. By outsourcing to a trusted billing specialist, a medical practice can focus more on it's core strengths and cut back on lost revenue at the same time.   

Improve Your Communication Strategy  

Red Corded Telephone on White Suraface

The success of your medical practice is connected to many individuals and organizations. Taking a good hard look at exactly how your organization communicates with patients, vendors, and employees can reveal simple ways to boost efficiencies and in turn, revenues. Thankfully, it is 2019 and there are a host of different communication channels and platforms your practice can use to connect with different parties.   

For example, establishing an internal digital communication channel can really cut down on how long it takes your employees to gain access to files, get answers to important questions, and in turn respond to your patients. Externally, connecting with vendors and patients is critical to building a solid reputation and keeping your operations running smoothly. It may also be helpful to establish some templates and procedures for handling different processes that repeat themselves. This way, your employees don't have to develop their own systems and can instead rely on a tried and trusted process that has been known to work.   

Designing a communication strategy that aligns with today's technological capabilities is key to boosting seamless operations, reducing stress and redundancies, and cutting back on unnecessary staff hours and overtime.  

Focus in on Scheduling  

Tilt Photography of Calendar Schedule Number 18

Most practices don't think too hard about how their scheduling is being handled. However, this one area has an enormous impact on a practice's overall revenue. By establishing an effective scheduling process, your practice can greatly cut down on lost revenue while building patient loyalty and reducing patient losses. It is worth it to dedicate the new year to mastering your practice's scheduling process. By doing so your staff will have more time to focus on treating your patients with better service and care.   

Start by hiring the best scheduling professionals you can find. It is worth it to invest in this individual instead of hiring a low-level employee that doesn't know how to optimize your scheduling operations. Work with your staff to establish scheduling guidelines and policies that will increase patient flow in the long-term. Additionally, look into the most efficient digital scheduling systems that make sense for your practice. Using outdated methods is unnecessary in 2019 and will hurt your income growth as the years go by.   

Promote Your Specialties  

Person Massaging Man While Lying on Bed

Does your practice have any unique specialties? If so, try to build a niche for yourself by establishing your practice as the go to organization in this area. Specializations can help your practice gain traction in a small field and help you build your reputation as the master within that niche. Eventually, you can build a nice stream of patients who get referred to you via word of mouth.   

For more information on how your medical practice can supercharge revenues in 2019, please contact Billing Savi by clicking here

Revenue Cycle Management: Everything You Need to Know

Revenue Cycle Management: Everything You Need to Know

What is revenue cycle management exactly? Read on to learn everything important you need to know about revenue cycle management.

Keyword(s): revenue cycle management

In every branch of the healthcare industry, administrative costs are quickly rising. If you haven't put in place a solid revenue cycle management process, you're going to struggle to keep the lights on. Understanding the process will require making a few mistakes but will help you to keep money flowing into your practice.

Here's everything you need to know about the process.

Understanding Revenue Cycle Management

Revenue cycle management in the healthcare field is an important process to keeping your business running. If you don't manage your revenue carefully, you can quickly spend beyond your means and run into problems. If you overspend beyond your bills or beyond your payroll, you can run into trouble generating revenue, breaking down your cycle.

As your business manages claims, processes payments, and works to generate revenue, each part of this process requires adequate attention. With software the help manages your practice or at least handle your billing, you can keep track of the comings and goings at your office.

In a broad range, the healthcare revenue cycle will manage elements like your patients' eligibility for insurance and collecting their co-pay. Every claim needs to be coded correctly and claims need to be tracked accurately. When you collect claims and follow up on the ones that are denied, you can ensure that you're accurately juggling your revenue.

Every element of the collection process helps contribute to the revenue that you can use to provide more services. This, in turn, will require more collection efforts and the cycle will continue.

Training is a Hurdle

In the revenue cycle, you need to ensure that you have adequate staff. If you run a small practice, you may struggle to keep on top of your patient billing. If you don't bill people on time, you can't expect to get paid on time.

If your staff hasn't been trained properly, you'll find that could be a hurdle to optimizing your revenue. The money that flows in and out of your practice is much like a supply chain in that if one person fails to do their job, the rest of the chain could suffer failure.

If your staff isn't properly trained to look for errors in their claims or to understand the depth of medical coding, that could lead to poor data entry. When patient information is entered wrong, the bill for the patient may never arrive. You could end up with some costly mistakes if you don't carefully manage your supply chain or let your employees know why their mistakes matter.

Communication is Important

Communication can make or break any business. In the context of a revenue cycle, you need your staff to be communicating clearly even on the busiest of days in your office. When everyone knows their role and how they rely on one another, they can help the revenue cycle roll on.

Your office managers and physicians need to be in regular communication. They need to feel comfortable talking to one another about financial reports and what's going on in your office.

When everyone in your office understands the important details about collections, revenue, and how their actions matter, they'll help lead you to success. If your basic accounts receivables data isn't in on time, you could be lagging behind on payments and your whole workflow could be upended.

Communication requires a strong workflow. You need your intake to check for your patient eligibility and the copay situation before your patient arrives in your office. This will help you work smoothly.

Your staff needs to be able to follow up on your claims quickly and promptly. If you don't have a workflow established, you could end up dropping tasks or ending up with delays. The more errors that your office incurs, the more money you could be losing.

Finding The Right Solution

When you're searching for revenue cycle management solutions, you're going to have to look at the nitty gritty details of what your solutions can offer. The results that you're searching for should be one that relies on efficiency.

In order to become financially efficient, you need tools that will help you to optimize your revenue cycle. Every tool that you use should be putting you one step closer to increasing revenue for your office.

Billing is a headache for every medical office under the sun. There are a lot of pitfalls in the healthcare industry and a lot of mistakes that can be made.

When you're managing employees and trying to find a tool, you need one that's easy to use and doesn't take too long for your office to train on. Without the right processes in place, you could be losing some revenue from your office. However, don't let that drive you to put things off and wait too long to solve your billing issues.

Expect a learning curve when it comes to managing your revenue cycle, but find be sure you find a company who offers great customer service. They'll be able to guide you through any difficulty you have in using their tools.

Revenue Cycle Management Requires Buy-In

In order to achieve the revenue cycle management that you need in your office, you need everyone to buy in at the same time. You need to have a steady management process where you work together to get over problems.

IF you're considering outsourcing your medical billing, follow our guide to ensure that you choose the right company and everyone runs smoothly.

How to Choose the Right Payment Processing System for Your Healthcare Business

How to Choose the Right Payment Processor

Are you trying to decide on what payment processor to get for your healthcare business? Read on to learn how to choose the right one.

Keyword(s): Payment Processor

Most healthcare providers report it takes longer than a month to collect on the bills they send. The number of unpaid healthcare bills has also been rising over the last few years.

Some challenges in healthcare billing are less about the ability to pay and more about payment processing. Support for electronic payments is universal among patients, but providers still use paper. The accepted methods of payment are usually limited as well.

One thing is clear. The right payment processor can help you manage the revenue cycle more efficiently. With the right payment process, you can overcome the challenges of the revenue cycle.

How do you know you've found the right processor for your healthcare business? Our guide can help you determine the best selection for your business.

Look for Key Features with a Payment Processor

Not every healthcare provider has the same needs. The payment solution you choose for your business will need to reflect your unique needs.

There are some key features almost any processor should provide with a solution. These include:

  • Online bill payment services
  • Follow up, such as text reminders
  • Security features
  • Point-of-service devices
  • Data collection that accommodates your needs
  • Preauthorization and certified payment processing

Other features should work to shorten the payment cycle. In addition, everything should be offered in one convenient, integrated platform. If a provider doesn't offer these features, it's time to look somewhere else.

Think about Data and Security

There are many rules about the collection and use of data in the financial sector. In the payment processing industry, the largest credit card processors created security standards.

The regulatory framework is different for the healthcare sector. For example, you'll need to make sure your payment processing system is compliant with HIPAA. It's one reason data collection must be customized to your business's needs.

Security is another important consideration, whether you're in healthcare or not. Credit card information and other client data can be quite sensitive.

In the healthcare industry, though, you have additional concerns. For example, information about a diagnosis can harm a patient's job prospects.

You're already aware that data security, storage, and management are important. They're just as important when you select a payment processor for your business.

Look for companies that go above and beyond. They do more than meet the bare minimum set out in standards and regulations. They're always one step ahead, creating better security for your data and your clients.

Take a Peek Under the Hood

What's powering the payment processing system you're adopting for your business? We've already mentioned that the provider should supply point-of-service devices.

Integration is key. Your business already uses solutions for everything from patient intake to scheduling appointments. If your new payment processing system doesn't integrate, you're in for a mountain of trouble.

You can avoid this costly scenario by taking a peek at what's behind the services you're signing up for. Ask about how any payment processing system will work with your current systems. If the platform doesn't integrate with your accounting software, it's time to consider another provider.

Think about Value, Not Price

Price is a particular sticking point when it comes to credit card processors. It's one reason so many businesses choose not to offer credit card payments at all.

You might be tempted to go with the payment processor who offers you the lowest price. This is often a mistake.

Instead of thinking about price, take a look at value instead. One payment processing system might be more expensive than another. That might be because it offers you more services and flexibility.

In other words, the most expensive option provides better value.

Don't forget about the importance of customer service when you're calculating value. A company that charges more might be a better bet because they offer you more support. The bargain system may offer little to no support at all, which actually costs you more in the long run.

Ask about Scalability and Flexibility

How big is your healthcare company right now? Maybe you're a start-up getting off the ground. You might be a well-established private practice, but you've brought on a new partner and want to grow.

Can your payment processor grow with you?

Many companies make the mistake of signing up for a system that offers them no room for growth. The solution looks right at the time, but the healthcare provider soon finds the processor can't keep up.

Ask about the different services your processor provides. Can you upgrade services or add services as you need them? Can you scale back on services you're not using as much as you thought you would?

You may need additional services, such as collections or electronic medical record management. The best providers can help you integrate these functions for a streamlined process.

The best payment processing system will be able to grow with you every step of the way.

What Payment Options Are Available?

Another key aspect to look at when you select a system in which payment options you can offer to your patients. Bill payment times are often improved when patients choose from several payment methods.

We've already talked about credit card processing. Another option you want to make sure is available is electronic payments. This is often the easiest and fastest way for patients to pay you. It benefits both you and patients.

Build a Relationship with a Partner You Can Trust

The right payment processing solution can help you conquer the challenges of the revenue cycle. More than anything, you need a payment processor you can trust. Look for processors that are recommended by others in your industry.

If you're still not sure what the right payment system for your business looks like, talk to us today. We can help you determine your needs and find the perfect fit for you.

Taking Steps to Build a Profitable Medical Practice

 

Three Person Looking at X-ray Result

Profitability.

If you want your medical practice to last for the long-term, focusing on profitability is key. Unfortunately, many medical professionals lack the knowledge needed to run their practice like a successful small business. Understanding how to take care of your patients and offer great services is obviously important, but having the skills to nurture your bottom line is just as essential.   

By increasing your practice's profitability, it will be much easier to grow and sustain your practice for many years to come. We've compiled some tips to help you boost your practice's profits, check them out below!  

Treat Your Patients like Royalty

Medic Treating Patient

Businesses always say 'the customer is always right'. However, medical practices rarely take this sort of approach towards their patients. As a healthcare organization it is important to realize that you are not the only practice in town and patients can easily switch to a different provider for a number of reasons.   

Because of this reason, it is so valuable to create a plan for ensuring your patients have the best possible experience when they come in for a visit. Think about what it must be like them at all points of interaction with your practice. From the moment they call for the first time, are they having to wait unnecessarily? Is your staff able to answer all their questions with efficiency and expertise?   

Making your patients the focus of your efforts will help put all your other operations and priorities in perspective. Once your practice is making strides in creating better experiences for patients, your patients will increase their loyalty and also spread the word to their friends and family. Positive word of mouth referrals are one of the best ways to increase your base of patients and in turn - your bottom line!  

Understand Your Industry

Syringe Floating Near Person's Hand

The healthcare industry is constantly changing these days. With new innovations, fast-moving mergers and changing marketing strategies, it is vital to understand the larger picture that surrounds your practice. Creating a strategy for the future of your practice can help you create a nice niche to further concentrate your resources. In fact, focusing on specific expertise or areas of medicine can really help avoid the waste of energy in unprofitable areas.   

What are some profitable areas in which you could leverage your medical expertise? What are the growth trends within your industry that you could incorporate into your practice? These are the types of questions you should be asking if you want to grow and become sustainably profitable in the long-run.   

Keep your attention on macro trends and leverage them in any way you can. By creating and implementing a plan for how you want your practice to grow, your profitability will surely rise.   

Get Smart About Your Revenue Management

Person Holding Black and Grey Pen

Collecting revenue and processing billing is a much more difficult task than it used to be. The rules and regulations change often as do billing codes themselves. For a medical practitioner it is important to stay focused on their skills in medicine and outsource more complicated areas of their business to specialists.   

Billing and revenue management is a great area in which to outsource an important function of your practice and improve collections and profitability at the same time. Great providers like Billing Savi can help your practice thrive in this area and grow more successful. 

To learn more about great building a profitable medical practice, please contact us by clicking here

Easy Ways to Maximize Your Medical Billing Revenue

Two Person Shaking Each Others Hands

As you can imagine, running a medical practice isn't easy. On top of that, it is becoming harder to collect and maximize the revenues healthcare organization collect. The American healthcare system frequently changes rules and regulations in regards to billing and consistently brings in more complex compensation models.   

Unfortunately, medical billing providers lose out on billions of dollars in uncollected revenues every year because of their inability to keep up with these constant changes. To make things worse, rising healthcare costs such as deductibles and out of pocket expenses are making it even more difficult for patients to afford care and pay their medical bills.    

So what can be done to mitigate these risks? The best thing a medical practice can do is to take a proactive approach and increase their chances of overcoming future hurdles. With that in mind, here are a few ways to build a smooth billing system within your company.   

Outsource When You Need To

Person Pointing at Flowchart

Take a look at your practice. Do you have multiple fires to put out? If there is a lot on your plate, you may want to ease your billing burden by outsourcing the task to specialists, such as Billing Savi. Getting professional help can save you a ton of headaches and time while helping ensure your billing operations get off to a solid start. Freeing up your practice through outsourcing can have many benefits such as helping to increase focus on patients and giving a much-needed boost to claim submissions.   

Reduce Potential Coding Errors  

Person Writing on White Book

It's a good practice to always check your codes multiple times before submitting a claim. There are also certain errors that are common and can be useful to be aware of, such as:  

  • Upcoding: Whether done intentionally or by mistake, upcoding happens when codes are switched out for more expensive medical procedures. This is a very common coding error and one that is also illegal. Make sure your practice isn't adding in or exchanging codes to boost revenues falsely.   

  • Undercoding: Unlike upcoding, undercoding happens when a medical practice leaves out or switches codes for less expensive procedures. To avoid this from happening, make sure communication lines are clear and no funny business is happening within your billing staff.   

Set Up a Clear Collections System   

Woman Standing in Front of Sitting People

Collections are at the core of a medical practice's operations. To ensure success, work with your staff to make sure they are clear on the important steps that need to be taken to ensure a smoothly running system.   

It is also important to make sure patients are aware of the expectations your practice has when it comes to collecting payment from them. Here are a few important things to establish with patients to improve collections:  

  • Clearly communicate to patients about their bills and remind them repeatedly about upcoming deadlines and amounts that are outstanding. Doing so ensures you have done your part to boost awareness and reduce the likelihood of patients forgetting about what's due. 
  • Make sure to collect their most recent contact information so your practice can reach them when needed. Ensuring correct addresses and phone numbers lowers wasted time spent trying to reach customers that simply don't live at their previous address or have a new contact number. 

In general, taking steps to establish clear and consistent communication channels between your practice and its patients is a good idea. The more they know about what's due, the easier it will be to collect revenues and keep your organization running smoothly.   

Along the same lines, having your staff be aware of common mistakes can help them avoid these errors in the future. Additionally, if your practice is overloaded and needs some help getting billing operations in order, outsourcing to professionals like Billing Savi can be a lifesaver.   

To learn more about great medical billing practices, please contact us by clicking here

 

Common Myths About Medical Billing Outsourcing

Red and Black Stethoscope

Medical billing outsourcing solutions are revolutionizing the way healthcare professionals work. Thanks to amazing providers, like Billing Savi, medical practices are able to focus on the work they love, outsource the things they don't, and build profitable organizations that genuinely help patients improve their lives.   

Unfortunately, many medical professionals encounter myths about medical billing outsourcing when considering whether or not to take advantage of these incredible services. We wanted to take some time to clear up these myths and get to the truth behind the wonderful benefits of utilizing a great medical billing outsourcer.   

Myth #1: Billing Outsourcing is Just Another Unnecessary Expense

Piggy Bank With Coins

Many owners of medical practices think that outsourcing their medical billing is just a 'nice to have' service. They think it will just leave a bigger dent in their wallet and would rather put in the elbow grease required to get the work done in-house.   

This couldn't be further from the truth!   

Great medical billing outsourcers typically save their clients money by turning their organization's revenue cycle into a well-oiled machine.

Although it can seem like paying an external medical billing provider will cost you more money, it can actually boost your total revenues significantly. By improving the collections process, outsourcing companies like Billing Savi are able to actually increase total collections for many different practices.  

By outsourcing medical billing processes, medical practices are able to submit claims much faster, helping speed up the payments they receive.     Additionally, medical billing outsourcing professionals have the expertise to reduce errors and detect denials which can be reworked and submitted for payment as well.    

Myth #2: In-House Staff Can Handle Billing Tasks Just as Well

Free stock photo of marketing, man, suit, people

Medical practices also tend to believe that in-house staff can do just a good job of managing revenues and billing as an outsourcing company. Although staff may be familiar with many billing tasks, it is highly unlikely that they have the capabilities to handle billing operations as well as the specialists.   

The medical billing industry is constantly changing and it takes specialists to be able to keep up with the innovations and alterations that regularly take place. Additionally, new software and technology requirements are always hitting the market, requiring billing professionals to upgrade over and over again.   

For these reasons, it makes sense to let billing professionals handle these important revenue based tasks. A great medical billing outsourcer will know of the latest and greatest ways to handle billing procedures and also be stocked with the latest software and technologies that are needed.   

Myth #3: Only Established Medical Practices Should Outsource

Two Person Doing Surgery Inside Room

New medical practice owners tend to think that they should outsource billing operations after they have been established for a while. In reality, new medical practices have a ton to gain from outsourcing their revenue management in the early days when they're getting started.   

A new medical practice requires the coordination of hundreds of tasks and the establishment of countless procedures and business systems. Trying to figure out how to properly handle and execute on billing and revenue management during this time can cause a lot of friction and bottleneck issues.   

By outsourcing these complicated tasks, new medical practices can focus on more important tasks while starting their organization, such as taking care of their patients and establishing a stellar reputation.   

Outsourcing medical billing makes sense for so many reasons. By allowing specialists to handle billing processes, healthcare practitioners can focus on their crafts and ensure their revenues are being managed by professionals. 

To learn more about how medical billing outsourcing can benefit you, please contact Billing Savi by clicking here. 

Why Medical Practices Should be Outsourcing

Depth of Field Photo of Man Sitting on Chair While Holding Cup in Front of Table

Although it may sound counter-intuitive to some, outsourcing can have a tremendously positive impact on the operations of a medical practice.   

The benefits are numerous. From cutting down on costs to freeing up resources for core business activities, outsourcing menial tasks can provide medical practitioners the support they need to build a successful organization. 

The benefits are numerous. From cutting down on costs to freeing up resources for core business activities, outsourcing menial tasks can provide medical practitioners the support they need to build a successful organization. 

  In 2016, Deloitte released a survey which revealed that 59% of participants were outsourcing to save money, and 57% wanted to dedicate their time to their core business activities. Additionally, over 50% of respondents found outsourcing helped add value through various business development and strategic activities.   

In fact, almost 80% of participants felt great about their decision to outsource and their outsource partners. When considering outsourcing options for a medical practice—especially medical billing processes—the benefits can be substantial.   

Doing so can give employees the ability to focus on other more important responsibilities while simultaneously helping build a consistent revenue stream for your practice.   

Boosting Medical Practice Revenues 

Want to get paid faster? Then focus your attention on cash flow! How much time you spend in revenue cycle time has a huge impact on your profitability.   

Grey Metal Case of Hundred Dollar Bills  

By outsourcing your medical billing processes, your practice can submit claims much faster, helping speed up payments you receive.  

Additionally, the medical billing outsource professionals you hire have the expertise to reduce errors and detect denials which can be reworked and submitted for payment as well.  

Outsource the Boring

Running a business means that a number of responsibilities will need to be taken care of by your staff, whether they want to do them or not. Tasking staff members with things that don't apply to their skill set can lower the quality of service at your practice. 

Free stock photo of people, coffee, working, writing  

Thankfully, outsourcing menial tasks can help employees refocus on what they do best, like providing incredible care and attention to patients.   

Outsourcing projects that could be handled by those that specialize in those tasks can free up your staff to focus on things that really matter and make a difference to your practice.    

Save Money by Spending It 

By outsourcing, your medical practice can actually save money as the years go by. By outsourcing to specialists, practices can save thousands in yearly salaries and benefits for in house staff.   

You also won't have to buy a bunch of different software, maintenance services or annual upgrades for these additional requirements.   

 Black and Gray Laptop  

When staff doesn't have to worry about menial responsibilities, their stress levels go down and workplace satisfaction goes up.   As you can see, these changes also have a positive effect on employee turnover. These savings can really spike up profit margins while making both your staff and patients happier at the same time!    

In Conclusion 

Although you may think that outsourcing is the last thing your practice needs, you will definitely see and understand the benefits once you start making the investment.  

Hire skilled staff members and let them focus on what they're really good at - not repetitive menial tasks they don't understand. Outsource the things your practice doesn't specialize in and focus your energy on satisfying your patients instead.   

 

To learn more about how Billing Savi can help you save on your medical billing process, contact us by clicking here.   

 

 

Everything You Need to Know About HIPAA Compliance

Being HIPAA complaint is very important. Read on to learn everything you need to know about HIPAA compliance.

Keyword(s): hipaa compliance

What's a physicians least favorite animal? A Hippo, since it's only one letter away from Hippa!

You can have that joke for free, as a bonus to this article. Consumers love HIPPA since it makes it easier to get personalized and sometimes secret care. However, it can create a lot of problems for practitioners and their staff, if they don't follow the regulations.

Correct HIPPA compliance is essential to any functioning clinic. But how long do you take to tell each new employee what it is and how to follow it?

Sometimes it takes weeks. That legal language is hard to wrap your head around. Instead of trying to translate - read our guide instead.

What is HIPPA?

The five letter acronym stands for the Health Insurance Portability and Accountability Act. It came to be in 1996, but we didn't hear it really talked about until the mid-2000's with the passing of Obamacare.

Its purpose is to protect patients from having their information and health history spread. It protects specific patients from being mentioned in research or papers. If Suzy Q had an interesting reaction to a hysterectomy and her doctor wanted to do a study on it, her name would be patient x.

Or something of the like.

Why Have HIPPA?

Before they put HIPPA into place, almost every health care network had their own processes for claims. HIPPA changes that by making everyone use the same system.

It's like if some clinics in the states were using the metric system while others used imperial. If an imperial clinic had to send records to a metric, that would be a pain. So now, everyone is on the HIPPA system.

It also came from some security breaches of patient confidentiality in the 90's. Along with that, the legislators behind Obamacare knew there would have to be some stricter regulations with a government controlled system.

What Does it Change?

Other than giving everyone the same system, HIPPA changes what different people at different points of the medical process see. If the doctor needs to share information with another doctor, they can see the patient's whole file.

However, if billing is processing a treatment the patient had, they only have enough information to get the job done. That may just mean name, age, a treatment code, and insurance information.

It puts regulations and restrictions on the number of eyes that can see sensitive details of a patients file.

What Must I Change?

Most of us are already familiar with HIPPA compliance, which means we avoid the use of certain "unique identifiers" when discussing patient history. Unique identifiers are anything that could give someone the true identity of the patient in question.

Here's a comprehensive list of all the HIPPA identifiers.

  • Name
  • Address (smaller than state)
  • Telephone number
  • Fax number
  • Email address
  • Medical record number
  • Serial numbers of any device (medical or other)
  • Images of the patient
  • Account number
  • Social security number
  • Health plan number
  • Fingerprint or other biological identifiers
  • IP address
  • Personal websites
  • Anything else that separates patient A from patient B in identity or personality.

Let's look at an example. Say you were doing an experiment on two patients for a medication.

A HIPPA friendly report wouldn't have any identifiers. So the following information could not go anywhere until the identifiers are removed.

Information with identifiers:

We are studying the effects of medication A on two patients, Thomas and Andrew. Both patients agreed to take the medication for a reduced cost in exchange for follow up appointments.

The appointments are every Wednesday from 3-5 PM at the patient's home hospital, ABC hospital. Patient Thomas has a heart pump, serial number, 3234234.

See how much information is in that about Thomas and Andrew? Here's what that information looks like as HIPPA compliant.

Two patients agreed to test the side effects of Medication A at ABC hospital. They are receiving reduced cost in exchange for follow up appointments and research tests. One patient has a heart pump, which is a potential extraneous variable to track.

Patients check in once, weekly, for two hours to talk to researchers and run tests.

See the difference?

You still understand the purpose of the experiment and what's going on without identifiers. That way both Thomas and Andrews's identities stay safe and they can go on with their lives.

HIPPA After Death

One a patient dies, they're still protected by HIPPA regulations. As the law stands now, their records need to stay compliant for fifty years from the day they died.

There are some cases where identifiers of the deceased can be shared, but it required approval by family or specific doctors.

HIPPA Exceptions

Finally, there is one situation where you can share the identifiers of a person. If the patient gives you reasonable reason to believe they're going to hurt themselves or others, the doctor is allowed to share that information for prevention.

This could be to parents, law enforcement, or social workers. Doctors do need to tell patients that they're required to report this information, which is part of the reason we require HIPPA consent forms.

Maintaining HIPPA Compliance Practices

The information covered in this article as identifiers can also be referred to as PIH, or private health information. The same PIH apply to all sectors of medicine, dental offices, and the like.

If you handle health information and records, you're required to work with Hippa compliance. If you're not, your clinic could be fined large amounts, sued, or even shut down completely.

That's not something you can risk. Make sure you use our billing services and programs - we build our compliance in. Check it out here.

Common Medical Billing Mistakes to Avoid

Doctor Pointing at Tablet Laptop Running a successful medical practice comes with its own set of challenges. New practitioners have to overcome a large learning curve when it comes to the dos and don'ts of starting their own business for the first time.   

In addition to all of this, it is common for health care professionals to make mistakes when it comes to their medical billing process.

Unfortunately, these mistakes can cost their practice dearly when it comes to revenue and their bottom line. To assist practitioners in avoiding these costly errors, we have compiled a list of some of the most common medical billing mistakes.

By taking note of this list, your practice can improve its chances of increasing revenues and building a solid foundation for success.   

Unbundling Codes 

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Often times, there is one code that can successfully capture payment for multiple parts of a medical procedure. Sometimes health care professionals incorrectly use multiple CPT codes for various parts of a single procedure, when it is this single code that should be used for everything.   

Medical practices that unbundle their codes can do so out of a lack of understanding or in an attempt to increase their bill on purpose and fraudulently. To learn more about unbundling and how to avoid it, contact a medical billing service provider.    

Upcoding   

When health care professionals incorrectly change billing codes so they show a more serious diagnosis or service, "upcoding" occurs. Upcoding is highly illegal and falsely inflates patient bills. For example, if a practice meets with a patient for only 15 minutes but charges them for a full 45-minute session, this would be upcoding.   

Other frequent upcoding violations include things like listing a name brand medication when a generic brand was actually the one used or stating a normal office visit was a more specialized one.   

Consequences of upcoding can be quite serious, as practitioners can be fined hundreds of thousands of dollars or even be excluded from participating in various medical programs.   

Billing Multiple Times for the Same Service  

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Double or triple billing can occur when different members of a practice charge a patient for the same thing. For example, medication could be billed at both the time of prescription either on purpose or unintentionally. Sometimes hospitals also bill patients for the first few days of their stay, multiple times.   

This happens because the first few days of a hospital visit often cost more than days later in the visit. Multiple billing is one of the biggest reasons behind high medical bills.  

Be sure to keep an eye out for potential situations within your practice that could be vulnerable to multiple billing. Setting some safeguards to prevent this from happening can make a big difference.   

Mistakes in Patient Information  

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If your practice makes any mistakes in listing a patient's information, insurance companies can easily reject your claim. Errors in medical billing are pretty common thanks to the fact that medical bills come under contact with so many different people at a time.  

Mistakes can fall through people's fingers and be passed down to the next individual in charge. Enforcing safeguards when processing patient information is key to avoiding additional mistakes that could affect your claims.   

There just a few of the most common billing mistakes healthcare providers make. By becoming familiar with these frequently occurring errors, medical practitioners can get their new businesses off to a strong start.  

Take the time to set some safeguards so your practice doesn't get sued or fined by different medical organizations. It only takes a few mistakes to lose the trust of your patient base or get fined so much money that your practice has to shut down.   

To learn more about how you can prevent medical billing mistakes, contact us by clicking here

The Future of Medical Billing - Trends & Integrations

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By now it's clear that populations around the world will continue to spend more money on health care as years go by. Unfortunately, many healthcare organizations will see their operational costs rise along with this increased spending within their industry.  

Medical billing complexities are no help to these providers, as coding continues to grow more intricate. Thousands of unique codes exist for different medical systems, procedures, and situations. These codes will always change and evolve with the industry.   

Thankfully, the medical billing and coding industry is moving towards increased efficiency and effectiveness. Here are some of the latest innovations and trends helping move the industry in the right direction:  

Blockchain Technology

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Blockchain technology has been showing really interesting possibilities for the future of Electronic Health Records (EHR). The innovative ways in which blockchain functions has pushed it as an increasingly common way to improve the security and standardization of healthcare data.    Many have touted blockchain as the next big innovation in healthcare technology.

In fact, blockchain technology could potentially transform the very nature of EHRs.   Here are a few reasons EHRs should consider implementing blockchain data storage:

  • Much better privacy protections
  • To make information exchange easier and more efficient
  • To increase patient control over their data

There is also tremendous potential for how blockchain could potentially improve revenue cycle management and claims processing for healthcare providers across the world.  Blockchain would give providers the ability to record tests, results, medical billing, and payments in an unchangeable register. 

This change alone could help practitioners reduce fraud and potentially save money by reducing the amount of time, energy, and money currently used to track this type of information through different systems.   

Computer Assisted Coding (CAC)

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Computer-assisted coding is currently growing rapidly, especially when it comes to coding inpatient claims. In fact, reports indicate the global market for CAC software could reach $4.75 billion by 2022. Some healthcare professionals are concerned that this new technology could take jobs and replace many industry workers within the next ten years.

However, it is important to realize that computer-assisted coding software works best as an aid to human workers.    According to a recent study, CAC helped increase coder productivity by over 20% and lowered coding time by 22% relative to those who didn’t use CAC, all without reducing accuracy. On the other hand, CAC software is actually less accurate when used without the help of a professional human coder.   

Aligning EHR 

Unfortunately, inaccuracies in record keeping can lead to a mountain of problems when it comes to getting reimbursed. Most medical practices spend a tremendous amount of time searching for the right diagnostic codes instead of getting to know their patients better. Thankfully there are ways to improve the effectiveness of your record keeping activities.

Finding ways to integrate technologies can be a great way to do so. For example, there are so many benefits to aligning your EHR and medical billing software. Furthermore, if your medical billing offers CAC, the process can go even faster.  These integrations can make it possible for automated coding suggestions to pop up at the point of documentation, helping make codes more accurate right from the beginning.

Your practice could also auto-populate patient data into billing documents, helping save your staff valuable time and potential errors.  Integrations such as these can helphealthcaree providers reduce errors, save time and provide more in depth reports than traditional EHR and billing methods of the past. 

 

For more information on medical billing & coding innovations, please contact us by clicking here!