Top 5 Criteria To Select The Right Medical Billing Company

A medical billing service can improve the efficiency of your billing system, reduce denials, cut down operating costs, boost reimbursements and save valuable time that can be devoted to patient care. These services are better equipped to adapt to continuously changing billing codes and industry requirements.

But can a medical billing service deliver the promised results? Yes, it can. However, to find the right medical billing service for your practice you will need to undertake a comprehensive evaluation, one that transcends the regular performance track record metrics. The following five criteria will enable you to identify real expertise from market hype and find a reliable, long-term medical billing partner:

1. Quality of resources assigned to your account

The best criteria for selecting a medical billing service provider is evaluation of the number of employees assigned to the account, and their expertise. Before hiring a service provider, consider the following aspects:

* Number of employees who will support the account and their credentials.

* Length of experience of the employees.

* Experience in practices specialty. Many agents specialize in collecting a specific type of claim, such as nephrology, chemotherapy, radiology, cardiology, or vision care.

2. Commitment to regulatory compliance

As a medical practitioner, you are directly responsible for complying with legal regulations, whether or not you outsource collections to a medical billing service. For example if a billing service changes codes to increase collections, you will be held responsible for any regulatory incompliance.

To assess how well medical billing service providers’ follow regulations, ask them to give you a list of compliance policies and procedures used by their staff. Also, inquire about the training and methods that providers’ use to inform their staff about current state and federal rules, regulations and guidelines.

3. Dedication to maintain customer service standards

A medical billing service, which interacts directly with your patients, has a significant impact on the reputation of your practice and customer satisfaction. Therefore, the service should meet your customer service standards and project the right image of your practice on patients. A professional medical billing service will always have published customer service guidelines for its staff to follow and will review these guidelines with you before attending to your patients.

4. Performance and Accountability Metrics tracking and reporting

When you outsource billing responsibilities to a medical billing service, you should have comprehensive performance metrics to evaluate their performance. Ask potential providers about their standard performance benchmarks and productivity measures, and whether they regularly review employee performance. Professional medical billing services maintain their accountability by regular updates on performance and progress through monthly overview reports and account receivable reports. Additional reports must be made available to you when using a software-based or web-based billing service. Reports must be clear, easy to read and sort for different types of information. Get sample reports from service providers to determine if they meet your requirements.

5. Use of IT resources and billing software

Ask the medical billing service provider about the medical billing software and other technology resources. Evaluate their security features and ease of use. Additionally, if the service provider owns the medical billing software, ask about the frequency of updates.

Several medical billing services have now moved towards electronic claims submission. In this case, you must assess their technology solutions and automated systems, their security and how often the systems are updated to keep pace with industry changes.

Assess potential medical claims billing service providers on the above-mentioned criteria to identify the right medical billing partner for your practice and reap the rewards.

Outsourcing Medical Transcription Services – Save Money

Outsourcing medical transcription services reduces the workload and can help save money.

From the business point of view, outsourcing medical transcription services is believed to be very cost-effective. There are numerous medical facilities in the US which have recognized the benefits offered by the outsourcing companies and are pleased with their functioning.

Medical transcription is stressful and time consuming. The major disadvantage of employing in-house staff to carry out the transcription work is that it is not economical as the expenditure incurred (employee benefits, salary) is huge. Moreover, it proves impractical in the long run. Doctors, however, find it difficult to manage transcription work and treat patients. Excess work invariably results in stress and this could adversely affect the treatment of patients.

Outsourcing of medical transcription is therefore the most sought after service as it reduces the workload and substantially decreases client expenditure. Outsourcing of work can be either onshore or offshore. The cost of labor in countries like India, Philippines, and China is far less than that in developed countries like the US, UK and Canada.

Professional MT companies employ experienced transcriptionists who are trained in the field. The companies work round the clock and this makes the processing of work faster. The use of the latest technology and software also helps in speedy completion of the work. The work is constantly assessed and regular quality checks are conducted by proofreaders and analysts. This ensures that accuracy and standard of work is consistently maintained.

Outsourcing medical transcription services can help save money anywhere from 40% to 60%. A flexible and client-centric company handles all the aspects of transcription and provides unsolicited customer and technical support. Doctors find sufficient time to attend to their patients and focus on giving adequate treatment which they rightly deserve.

EMR Costs

The price of Electronic Medical Records (EMR) software is quite high, but the benefits of adopting EMR software can save you a lot of money in the long run. If you are a physician running your own private practice, then you should be weighing the pros and cons of adopting an EMR system. Those days are long over when practices had to keep a pile of files to properly archive the information related to the multitude of patients who walked into their medical facilities.

Our dependence on paper is gradually decreasing and tools like EMR software can easily hold all the important medical data in hard disks, which occupy less space compared to the traditional sources. Proper archiving and categorization of data becomes easier if practices decide to replace their old filing methods with modern technology. Automation of data collection and retrieval can dramatically increase the productivity and efficiency of practices.

The price of an EMR system can range from a thousand dollars to ten thousand dollars, and sometimes they cost even more. The sky is the limit for these products and EMR costs increase as the system becomes more feature-rich. If you own a very small medical facility where you are the sole practitioner, then a light version of good EMR software worth five thousand dollars will serve the purpose. Huge facilities can buy complete EMR systems that cost around forty thousand dollars.

How to get the best deal

EMR software offers a number of benefits but practices should perform a cost-benefit analysis before adopting this new technology. This will help them know if the system will serve their purpose. EMR costs can be prohibitive and a huge amount of money is at stake if you choose a system that does not meet the needs of your practice. Therefore, it is important to be completely sure of the product before you make the purchase decision. You devote time to find the product that meets all your requirements and can be scaled in future. There are some points to consider when you conduct the cost – benefit analysis for the EMR system that you intend to purchase.

Analyze what you need to get done:

First of all, practices need to take note of their current and future requirements. They should be able to collect relevant information such as the number of physicians in the medical facility, the staff to physician ratio, the patient capacity of the center and the average number of phone calls help desk attends every workday.

Training:

If you are purchasing a low cost, entry level EMR software, you will have to pay a certain amount of money to train your staff. Most of the expensive EMR software packages come with free training of staff members, so that they can get used to the interface and handle the workload from day one. There might be some initial hiccups while operating the new software. It is therefore important that the EMR vendor agree to offer on-site training to the staff for the first few months.

Implementation:

The software provider will also charge for the implementation expenses involved in installing and configuring the hardware according to customers’ preferences. An increase in working staff members usually means an increase in the implementation costs. So, it can become a substantial amount for a large practice. Once the EMR software is installed, practices also need to digitalize all the information they had in the files to make the system completely functional.

Hardware:

As soon as practices adopt the EMR system, they discover the need to buy a lot of new hardware to provide proper support o their infrastructure. The prices of computers, printers and server stations should also be considered while you do cost and benefit analysis to gain a clearer picture of the EMR costs. If you want to utilize the EMR product to its full potential, then you need hardware that perfectly complements the software. Make sure that you buy the computer hardware after much deliberation so that it does not go obsolete in a few months. Computer hardware with the newest configuration should always be bought from a reputed dealer so that you are assured of support and maintenance whenever anything goes wrong.

Support and maintenance:

After installing the EMR software, practices need to make provision for annual maintenance costs that become necessary for both the newly acquired software and hardware. The power consumption of a medical facility will increase significantly once you have installed a number of computers and other related hardware to run the new system. Practices may also need to rewire the entire electrical architecture so that the system can take the load of the various machines that will need to be connected.

Hiring:

EMR costs can rise drastically if practices don’t hire a networking professional to monitor and maintain the network in their facilities. A networking expert will ensure that the workstations remain connected to each other and seamlessly exchange data. If you want to keep your system up and running at all times, then you will also need to hire a few hardware maintenance experts to keep a watch on the entire system.

Update:

Your work is not finished once the purchasing and installation have been completed, as the EMR software will need to be updated from time to time. This means a certain amount of expenditure has to be made every year. In order to keep your system up-to-date, you will need to sign certain agreements with the vendor so that you can get access to all the updates as they are released.

Replacing your traditional systems with modern technology may costs quite a lot but it is definitely one of the smartest decisions a practice can ever take. The benefits far outweigh the costs incurred in investing in an EMR system.

It may seem that the initial investment or the EMR costs are a bit high, but you will save a lot of time and money that you would have otherwise spent on papers, filing, and storage space. The cost of filing all of your patients’ medical records and billing information can surmount over the years. Even if you have the best file management system in the world, your will still have to spend a fortune every year to keep the paper documents intact.

Look for government assistance to help finance your EMR software. There are various federal grants that could subsidize EMR costs to your health care facility. With all of this information considered, one has to be very patient while looking for the EMR software for your health facility. Consultation with an EMR expert will definitely increase the chances of procuring a system that is cost-effective for you.

Blumenthal: Meaningful use will focus on goals of care, not technology

National health IT coordinator Dr. David Blumenthal isn’t allowed to say what the final rules for meaningful use of EMRs will look like until HHS releases its formal proposal, but every time he gives a speech, he drops a new hint or two about what he’s thinking. Monday in San Francisco, Blumenthal largely gave attendees at the American Medical Informatics Association’s annual symposium what they wanted to hear by reiterating his philosophy that technology simply is an enabler of quality improvement, not a panacea for healthcare.

“The meaningful use framework will be about the goals of care, not the technology,” Blumenthal said. While he didn’t elaborate on that statement, he did state the position of the Obama administration–one largely held by the informatics community, if not the broaded healthcare industry–that the billions of dollars in federal subsidies aren’t simply meant to buy EMRs for providers. “It’s not the money that will turn out to be the most important,” Blumenthal said.

Instead, the net $19 billion investment is a way to demonstrate that EMRs should and will be accepted in the fairly near future as “symbolic of professionalism in medicine,” just as much as the stethoscope or examination table are today. “The idea that government should subsidize health IT will be as foreign an idea that the government should buy stethoscopes or exam tables for doctors,” Blumenthal explained.

“Information is really the lifeblood of medicine,” Blumenthal added. “Health information technology is its circulatory system.”

During the Q&A portion of the session, legendary medical informaticist Dr. Clement McDonald, the longtime director of the Regenstrief Institute for Health Care in Indianapolis and now the head of the Lister Hill National Center for Biomedical Communications of the National Library of Medicine, questioned this analogy. McDonald said HHS should approach health IT the way the Environmental Protection Agency regulates water quality. “Put a little onus on the polluters,” McDonald said, referring to providers of “dirty” data that’s useless. He drew a small round of applause.

First Look at ‘Meaningful Use’

The meaningful use workgroup of the HIT Policy Committee has released its initial recommendations for a definition of “meaningful use” of electronic health records. The definition is important because under the economic stimulus law, providers must “meaningfully use” EHRs to receive financial incentives from Medicare and Medicaid.

These initial recommendations do not include a formal definition of meaningful use. But they are the initial recommendation of the functionalities that will be required by 2011 when incentives start. “This is the beginning of a conversation that will continue for some time,” said David Blumenthal, M.D., the national coordinator for health information technology, during a meeting of the HIT Policy Committee, a public-private advisory group. Blumenthal added that “there is a long way to go” before a final definition of meaningful use is achieved.

The workgroup’s initial recommendations include 22 objectives–most covering inpatient and outpatient care–for EHRs in 2011. These include, among others:

• Use CPOE for all order types including medications;
• Implement drug-drug, drug-allergy and drug-formulary checks;
• Maintain an up-to-date problem list;
• Generate and transmit permissible prescriptions electronically;
• Maintain an active medication allergy list;
• Send reminders to patients per their preference for preventive and follow-up care;
• Document a progress note for each encounter;
• Provide patients with an electronic copy or electronic access to clinical information such as lab results, problem list, medication lists and allergies;
• Provide clinical summaries for patients for each encounter;
• Exchange key clinical information among providers of care;
• Perform medication reconciliation at relevant encounters;
• Submit electronic data to immunization registries where required and accepted;
• Provide electronic submissions of reportable lab results to public health agencies;
• Provide electronic surveillance data to public health agencies according to applicable law and practice; and

• Comply with federal and state privacy/security laws and the fair data sharing practices in HHS’ Nationwide Privacy and Security Framework, released in December 2008.

The HIT Policy Committee will make the final recommendations on meaningful use definitions to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services.

HHS is mandated to publish an interim final rule for standards, implementation specifications and certification criteria of EHRs that qualify for financial incentives by the end of 2009. CMS will develop the formal definition of meaningful use to support the incentive programs. CMS will go through the full administrative rules process with a proposed rule, public comment period and a final rule. A timetable was not given.

The recommendations from the meaningful use workgroup include a matrix of objectives for 2011, plus enhanced objectives for 2013 and 2015. The workgroup will refine the initial recommendations for 2011 and 2013 within three months.

The meaningful use workgroup also has laid out an “achievable vision” for benefits to be realized by 2015. These include reductions in heart attacks, medical errors, and preventable hospitalizations.

For more information, click here. Scroll down and click on “meaningful use preamble” and “meaningful use matrix.” Updates from certification/adoption and information exchange workgroups also are available.

Meaningful use rule ‘on target’ for end of year

The Centers for Medicare and Medicaid Services is still on target to publish by the end of the year a proposed rule on the meaningful use of electronic health records, despite growing fears from industry about the possible impact of the regulation.

Tony Trenkle, director of the Office of e-Health Standards and Services at CMS, said he had been spending a lot of time with health industry folks who have expressed “concerns and fears” about what will be in the regulation.

Those include how high the bar will be set for meeting meaningful use targets during the first year of implementation, and whether the industry will be able to meet them, he told a meeting today of National Committee on Vital and Health Statistics (NCVHS).

Other concerns include whether hospitals outpatient clinics would be eligible to receive separate payments, whether quality measures will disadvantage specialty health providers, and worries particularly by the states about whether CMS would be able to harmonize Medicare and Medicaid requirements.

Under the HITECH Act, a part of the American Recovery and Reinvestment Act, health care providers can receive payments from both the Medicare and Medicaid programs if they can demonstrate meaningful use of certified EHRs. Payments are due to begin in 2011.

One of the major outcomes of the Nov. 19-20 NCVHS meeting is expected be a letter setting out recommendations to the Secretary of the Health and Human Services for measures that can be applied to decide on just what meaningful use is.

They include commissioning a “fast track” study from the Institute of Medicine on a national strategy for quality measurement development, to begin a process to identify essential data elements, to require EHR vendors to use defined quality data elements, and to require that any certified EHR be able to add data elements that may be defined in the future.

The NCVHS expects to release the final version of the letter at the Nov. 20 conclusion of its meeting.

CMS encourages EHR use for Medicare quality reporting

Healthcare providers will have the option to use electronic health record systems to report Medicare quality and electronic prescribing measures to CMS in some of its pay-for-performance programs next year, according to an announcement by the Centers for Medicare and Medicaid Services.

The revisions are designed “to promote adoption and use of electronic health records and to provide both eligible professionals and CMS with experience on EHR-based reporting,” CMS said in the Oct. 30 announcement.

They run parallel to efforts by the Office of the National Coordinator for Health IT to set up additional incentives for providers to measure and submit data measuring the quality of their treatments.

According to CMS, providers could use EHRs to submit information for the CMS’s Physician Quality Reporting Initiative (PQRI) program, which pays an incentive to eligible physicians and other healthcare professionals who report on specific quality measures for care for Medicare patients.

Providers also will be able to report e-prescribing usage through qualified EHR systems or registries, according to CMS. Currently, providers’ reports about e-prescribing are based on patient medical claims.

Under the fee schedule rule, providers for the first time will be able to count quality data submitted through electronic health record systems toward their eligibility for a PQRI incentive payment, CMS said.

Next year, those payments will be equal to 2 percent of their total estimated allowed charges for the reporting periods, CMS said. The final rule will appear in the Nov. 25 Federal Register.

The rule also streamlines reporting of e-prescribing and focuses on the actual use of e-prescribing by the provider. In 2010, providers will use one code for e-prescribing, but they “need to report this code at least 25 times during the reporting period to be considered a successful electronic prescriber,” CMS said.

The Medicare fee schedule puts into practice provisions of the Medicare Improvement for Patients and Providers Act of 2008, which established a program for incentive payments for e-prescribing over five years. In 2012, CMS will impose penalties on providers who are not “successful e-prescribers.”

CMS to allow EHR reporting for PQRI, e-prescribing bonuses in 2010

The new Medicare Part B fee schedule for 2010 is encouraging doctors to adopt EHRs by, for the first time, allowing practices to use real clinical data from EHRs and e-prescribing systems to report quality measures for the Physician Quality Reporting Initiative (PQRI) and e-prescribing incentive programs. The change, according to CMS, is “to promote adoption and use of electronic health records and to provide both eligible professionals and CMS with experience on EHR-based reporting,” Government Health IT reports.

Whether the incentive payments are large enough to spur many practices to switch to EHRs ahead of the 2011 debut of the federal stimulus program is uncertain, however. PQRI participants can earn 2 percent on top of their total Medicare Part B fees for reporting quality data in 2010, and another 2 percent for writing electronic prescriptions. The e-prescribing bonus drops to 1 percent in 2011 and penalties for not e-prescribing begin in 2012. CMS is trying to simplify reporting of e-prescribing by requiring a single code to be eligible for the bonus next year.

Health IT panel to heed calls for simpler EHR standards

A panel advising the Office of the National Coordinator of Health IT (ONC) said it will heed the overwhelming consensus it has received in recent public comments to develop the simplest possible certification standards for accelerating health IT adoption.

The Health IT Standards Committee’s implementation workgroup reported today that it distilled the testimony of industry organizations within and outside healthcare, as well as contributors to its public blog. The participants provided details of their experiences with adopting standards.

On the blog, physicians and practices have reported that they have difficulty improving quality and productivity with their existing electronic health record systems. As a result, they are looking for the standards to provide a “pathway to success.” The blog will remain live until Dec. 1.

Under the health IT stimulus plan, health care providers will be entitled to receive federal incentive payments only if they purchase electronic health record certified to meet standards for interoperability and other features now being worked out by the committee.

Dr. David Blumenthal, the national health IT coordinator, emphasized that “experience in the field” embodied in the comments will inform how ONC will craft the health IT certification standards that ONC will release later this year.

ONC is expected to publish in late December an interim final rule on certification standards and a notice of proposed rulemaking for the certification process. The standards rule will detail standards for what constitutes a certified EHR.

Dr. John Halamka, vice chairman of the committee, said any  refinements to the standards would likely be applied to standards for 2013 and beyond than for 2011, the first year in which providers will be eligible to receive incentive payments under the stimulus plan. In 2011, providers must adopt standards to share medication lists, medical problems, allergies and laboratory reports.

“I think we have a basic set of requirements, and there may be some polish done to them based on the comments and principles. We’re just beginning the directional cycle for 2013 and 2015,” he said.

Physician and industry comments received by the panel overwhelmingly asked that the simplest standards be put forward to provide business value and rapid adoption.

“Our posts have led to conversations with committee members here who have taken them to their constituents,” said Aneesh Chopra, the administration’s chief technology officer and chairman of the committee’s implementation work group.

Among its guiding principles, the committee should concentrate on getting buy-in from physicians for standards required in 2011 to share medication lists, medical problems, allergies and labs before moving to more complex objectives, he said.

Halamka suggested that the committee continue to gather comments about 2011 information exchanges to determine if there are ways to improve testing platforms and implementation guidance.

Another guiding principle recommends that the committee separate content standards, such as those for continuity of care documents, from transmission standards, as well as separate the network layer standards from application layer standards.

Hospitals and EMRs: Stimulating a connection

Availability of government stimulus money, combined with hospitals being allowed to finance portions of physicians’ electronic medical record systems, could make EMR adoption a veritable bargain. Or the stimulus money could make hospital systems less eager to help pay for your EMR, figuring that government funds will instead.

Either way, the possibility of combining two avenues of EMR funding has added a twist to the economic picture for physicians deciding what, when and whether to buy.

Doctors can get a maximum of $44,000 in funds from the federal economic stimulus package for adopting a certified EMR system that meets the government’s “meaningful use” standards. How much physicians get in stimulus funds will be based on the percentage of their practice that is made up of Medicare or Medicaid patients. Hospitals can get their own share of stimulus funds, but the amount depends on how they’re connected with physicians.