All posts by medicalhealthcaresolutions

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MHS Featured in CIO

Medical Healthcare Solutions Featured in CIO Review Magazine

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We are proud to share that Medical Healthcare Solutions has been selected as one of the 50 Most Promising Healthcare Solution Providers in the CIO Review magazine. The CIO Review is a leading print magazine and online portal that bridges the gap between enterprise IT vendors & buyers. As a knowledge network, CIOReview offers a range of in-depth CIO/CXO articles, white papers, latest Enterprise Technology News to help CIOs & IT leaders make the right decisions.

It is a great honor to be listed among 49 other top healthcare solution providers in this series.

Our very own Stephen Brighton took part in an interview feature for CIO Review and was quoted saying, “MHS’ service-oriented approach and utilization of cutting edge technology allows us to provide healthcare professionals with medical billing, electronic health records, and practice management solutions.”

The article provides an in-depth overview of the services MHS offers such as medical billing, healthcare informatics, and practice management consulting services to name a few. Additionally, the article highlights the effectiveness of third-party billing and how it can ‘take precedence in determining the sustainability of a practice.’  A streamlined medical billing service only scratches the surface of what MHS has to offer and why MHS is listed in CIO Review as one of the 50 most promising healthcare solution providers. Brighton is also quoted in the article saying, “MHS’ services allow enhanced insights into medical practice performance with an outcome that achieves higher profitability and provides more time for staff to focus on patient care and increases referrals, especially in small practices.” Most importantly MHS can help practices, hospitals, and universities ‘experience immediate improvement in day-to-day collections, boosted cash flow, and reduced costs.’

We thank CIO Review for featuring MHS in their TOP 50 Most Promising Medical Healthcare Solution Providers of 2018 series. We invite you to check out the article. Click here to go to the article and turn to page 63.

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student health billing

Increase Focus on Student Care with Third Party Billing

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As a student care provider, you no doubt want to center your efforts on the quality of care that your students are receiving. Whether you manage a boarding high school, a small college or a university, you are likely experiencing some difficulties in terms of billing, particularly if you’re trying to handle it all in-house. This taxes your existing staff, increases chances for costly mistakes, and can be detrimental to your bottom line as accounts receivables are not enforced like they should be.

Your students need quality care, that’s a given. It’s also a fact that they have to be billed for those services. Generally, health care services are not covered under tuition costs. This is a precarious situation because many students are still included on their parents’ health plan. But what works in terms of billing for the parents may not necessarily work well on the student end. Students, especially young ones who may only be 14 starting out their first year at a boarding school, need extra TLC. They are in a new environment, they have questions that Mom or Dad can’t answer and they need help. That’s where you come in.

As such, it’s important that you streamline your medical billing efforts to bring an increased focus to student care.

According to the National Center for Education Statistics, more than 20 million students were enrolled at American colleges and universities in 2015, an increase of nearly five million since 2000. All of those students require quality care.

How Third Party Billing Helps

When it comes to student health billing, consider a third party provider to handle all this. You may currently divide billing among your staff, or perhaps you have an in-house employee that takes care of this. Either way, you could be losing money. Not only that, you could be devoting so much time on billing tasks and chasing down payments that you are failing in your most integral role: caregiver.

So, why should you outsource to a billing service? The main reason is to establish a new revenue stream through the reduction of self-pay billable line items. Those streams that you may have believed uncollectible now have the ability to be recouped, presenting a whole new possibility for revenue and growth potential. This is a good thing, especially in an economic climate where the recovery rate for non-hospitals is 21 percent for healthcare debt and collections, says ACA International.

Medical billing is demanding, draining, time-consuming and challenging. Taxing your staff with these challenges absolutely takes away time and resources better spent with your young patients. In addition to increased focus on student care, you can experience these benefits from hiring a third party biller:

  • Reduce billing errors
  • Save thousands of dollars annually on salaries and benefits, office supplies, furniture, billing software maintenance and computer equipment
  • Reduce billing interruptions due to employee absence
  • Improve patient satisfaction
  • Ensure billing compliance
  • Increase revenue

Sound like an asset to your school? Contact Medical Healthcare Solutions to learn how to make this a reality.

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How the 2016 Election Could Impact Your Practice

How the 2016 Election Could Impact Your Practice

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Sure, you may have a personal opinion on who should win the upcoming 2016 presidential election, but take a minute to think of the professional ramifications of the candidate who wins next week. A lot rides on the winner of the election, particularly when it comes to healthcare and how it affects your practice, whether you’re in the dental, surgical or medical industry. Healthcare is a hot-button issue with both candidates, and how they approach our national healthcare system will have far-reaching effects over the next four years and beyond.

Affordable Care Act: What Now?

The Affordable Care Act, implemented by current president Obama, and what happens to it after this election, lies uniquely in the hands of each candidate. If Hillary Clinton takes over, the act will stay largely intact, utilized as a basis for continuing the program. She wants to expand program coverage through the use of tax credits and reductions in out-of-pocket costs, plus she wants to include uninsured families no matter what their immigration status may be. Should Donald Trump be elected, he will ask Congress to repeal the Affordable Care Act, replacing it with new proposals that focus on free-market competition to keep costs down. He wants to get rid of governmental mandates that say every person must purchase health insurance or face fees. He also wants to allow inter-state competition among health insurance companies, provided their plans comply with each state’s regulations.

Impacts on Medicaid

This is another area of concern for many people across the country. Hillary Clinton wants to continue to allow states that request Medicaid expansion to get a total match for the first three years. Expanding Medicaid, in her view, would bring about full coverage for the ones who need it most. Donald Trump wants to enlist block-grant funding for Medicaid, meaning appropriate funding would be doled out to each state, with each state then deciding how best to spend that amount based on the needs of their residents. The aim is to cut down on federal involvement, boosting the power of each state instead and thus reducing corruption of the system.

Pharmaceutical Prices

With the cost of prescription drugs constantly on the rise, many people simply cannot afford the drugs they need to get well and stay well. Clinton wants to crack down on pharmaceutical companies for hiking up their rising prices, instead rewarding them for research investment, promising to lower the cost of prescription drugs for middle-class families and senior citizens. Trump plans to reduce pharmaceutical costs through a free-market approach by removing barriers to entry into free markets and giving people better and easier access to lower-cost imported drugs from overseas.

Medical professionals know all too well how fast the industry is changing. It practically takes a PhD just to keep up with them all! The vote you cast on November 8 will impact your healthcare practice now and in the future, so vote wisely. Take the time to research each candidate’s position, making a bullet list of each factor that you feel would most impact your practice. Good luck and get out and vote next week!

Contact Medical Healthcare Solutions

For more information on what we offer to make your healthcare practice easier to operate, contact us today or fill out our convenient online form. We apply the latest medical billing technology in order to meet and exceed even your most challenging medical billing needs, from electronic health records and practice management services to ASC Revenue Cycle Management services. If you have questions on further ways the 2016 election will impact your practice, give us a call.

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What You Need to Know About Value Based Reimbursements: A Guide From MHS

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There’s no doubt the healthcare landscape is changing — and changing quickly. In order to keep up with these changes, many organizations are moving from volume-based care (fee-for-service) to a value-based reimbursement structure (fee-for-value). This population health approach provides benefits to all involved: the patient, the healthcare provider and the payer, prompting healthcare providers to offer the best care at the lowest cost to patients. Better care with better value is the name of the game here.

So how does reimbursement happen with this type of approach? What must be done in order to transition to a value-based reimbursement model? Here are some key points:

  • Changing from the traditional care model to a network care model
  • Increased need for acquiring, aggregating and analyzing data across networks
  • Integrated platform for standardized view
  • Reorganization of structure to account for value-based payments in an effort to cut operating costs and increase efficiency
  • Align common goals with physician engagement along with a structure of incentive to achieve those goals
  • Creation of new clinical and operational processes that encourage ongoing behavioral changes

It’s no secret that patient populations are changing. Their needs are evolving, their health care needs must be met, and the current structure can’t support those needs. Value-based reimbursement can assist healthcare providers in preparing for:

  • Increased care access
  • A higher number of chronic diseases for treatment
  • An aging population
  • Sicker patients with several chronic conditions
  • Patients who want more access and insight into their care, backed by more value for their money
  • An Increase in market share that offers people more choices

Where Does MIPS Come In?

First off, MIPS stands for Merit-Based Payment Incentive System. This is a big piece of the Value Based Reimbursement puzzle. In a nutshell, MIPS is the new Medicare physician reimbursement program slated to begin in 2019.Formerly, approach was to set base payment rates; that is being replaced with automatic increases for all doctors between 2015 through 2019. There will be no automatic increases for six years after that, and instead doctors’ rates will be changed based on their performance under a Merit-Based Payment Incentive System (MIPS).

MIPS combines three existing pay-for-performance programs plus one more. While the new incentive structure would be budget neutral, current penalties under these programs will be repealed. There are four categories or metrics of assessment:

Those doctors with the lowest performances will see their payments reduced by up to nine percent. Congress will be the ones in charge, setting the payments for the years 2026 and beyond. Doctors will have to participate in Advance Payment Models (APMs), where their pay increases will be determined. Basically, their composite performance scores (CPS) in a given performance year determine MIPS payment adjustments in the second calendar year. In addition, doctors’ annual CPS performance will be made available to the public.

Why Value-Based Reimbursements?

As the healthcare industry shifts from fee-for-care to value-based reimbursements, it’s important to understand WHY this is happening. With the overall Medicare margin on a downward spiral starting in 2000, those margins are understandably being challenged — a no-brainer since Medicare represents 30 to 40 percent of healthcare business. When that number goes into the negative, things get dicey and the consensus is that things must change in order to reverse that trend.

Thus, value-based reimbursement is moving to the doctor community, with physicians not only required to meet quality cost standards but report them as well. Commercial payers are also affected, with a majority of hospitals already making the shift to a mix of value-based reimbursement and fee-for-service. Experts believe that in the next five years, fee-for-service will decrease from 56 percent to 32 percent to enable a greater shift towards Value Based Reimbursements.

Contact Medical Healthcare Solutions

We can help you prepare for changes occurring as part of Value Based Reimbursements and MIPS. Call Medical Healthcare Solutions at 800-762-9800 Or email Stephen J. Brighton at [email protected] for more information. Backed by decades of medical billing experience, we provide the most efficient, effective, and professional service possible as we work with our clients to ensure effective and rapidly evolving services available to the practice.

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