All Posts in Category: Electronic Health Records

Medical Billing mistakes

The Cost Of Medical Billing Mistakes

The Cost of Medical Billing Mistakes

Medical billing errors are costing you money. Period. As a healthcare provider, you know the high cost of care and the competitive nature of the market. You can’t afford to lose an extra penny — especially due to a billing mistake that could easily be corrected. Sad thing is, you may not even realize how much your current medical billing system could be costing you. Some studies put the error rate for medical bills at a conservative 30 to 40 percent, with others put it closer to 80 or 90 percent, says The Huffington Post. Another study shows that medical billing errors cost about $20 billion, a number that has increased right alongside the increase in U.S. population.

A Look at the Numbers

Most of the costs associated with such billing errors involve expenses due to unnecessary inpatient and outpatient care, ancillary services and prescription drug services. But a surprisingly large portion of the mistakes is linked to the mortality rate and missed days from work. If you widen the lens and look at the costs as they pertain to quality of life and fatalities due to medical errors, the total costs jump to between $187 billion and $250 billion. Widen that lens even further to account for loss of productivity in patients who have experienced a decrease in quality of life and you’re looking at costs even into the trillions. Human error is one of the most common causes of medical billing mistakes, such as when a wrong billing code is entered.

Bottom line: medical billing errors are expensive. While you may be able to afford malpractice insurance (and let’s face it, this cost alone is probably eating into a lot of your profits), you certainly can’t take the blow to your reputation in event a major medical billing error costs someone their health or their life. So, ask yourself: do you have the in-house manpower necessary to make sure you are responsible for as few billing errors as possible? If the answer is no, you should probably think about outsourcing your medical billing.

Protecting Your Business and Your Patients

To protect your business and bottom line, it’s wise to examine your records for the past couple of years. What’s the total cost of your errors? How could they have been avoided? Remember, you’re in the healthcare business, caring for your patients from the time they step in your door until they walk out. You have a certain duty of care to uphold for them. It’s critical to ensure your patients don’t fall victim to easily-avoided medical billing errors. In the process, you’ll save your business’ budget and reputation.

Contact Medical Healthcare Solutions

If you are ready to improve your office processes, cut administrative overhead and boost patient satisfaction within your practice, rely on the seamless medical billing provided by Medical Healthcare Solutions. We can help you put an end to those costly mistakes that are leeching your profits and taxing your resources. Call us today to learn more at 800-762-9800.

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ALLSCRIPTS

Top 3 Reasons Allscripts is the Best Inpatient EHR Vendor

A market leader in its own right, Allscripts Sunrise is a top choice as inpatient EHR vendor across the board — and the recognition is there to prove it. In fact, Black Book Market Research recently named Allscripts as the top overall inpatient electronic health record (EHR) for large hospitals and academic medical centers for the third year in a row. Not only did Allscripts take the cake for overall honors, it was named top vendor in the patient health data management and administrative processing, as well as the top vendor in the communications and connectivity categories, according to The Business Journals. Other honors included vendor overall preference/vertical industry recommendations for Meaningful Use Stage 1 and Stage 2, and best of breed technology and process improvement for Meaningful Use Stage 3.

Receiving these accolades has pushed Allscripts to the top of the heap when it comes to inpatient EHR vendors. Let’s take a look at three reasons why they’re considered the best.

  1. Integrated Solution Suite: One of the most important aspects of an in-patient EHR vendor is the ability to provide one repository for acute, post-acute, ambulatory, revenue cycle and emergency health care providers. By offering one EHR for emergency, inpatient and ambulatory care along with an easily-accessible patient portal, you’re getting everything you need in one spot without the need for other software, programs or solutions. With Allscripts Sunrise, medical staff are also allowed access to integrated patient information across all platforms, with its use occurring through several of the top  hospitals and health systems on the planet. Clinical decision support is made easier as a result.
  2. A Proven History: Allscripts has already proven its abilities within the ambulatory systems industry, so it stands to reason the transition into the hospital arena just six years ago due to a merger with Eclipsys would go smoothly. Today, its product line can go toe-to-toe with other giants of industry, including Meditech and Cerner. The effect is far-reaching: Allscripts has products installed in 50,000 physician practices, 1,500 hospitals, and 10,000 post-acute care facilities, according to InformationWeek Healthcare.
  3. Accolades Recognizing Allscripts’ Work: In addition to the above distinction by Black Book, other organizations it seems are also happy with Allscripts’ approach of in-patient EHR vendor management. In 2014, LAS Research named Allscripts Sunrise Clinical Manager Best in KLAS Global (Non-US) Acute EMR and Category Leader, Global Acute EMR – Northern America (Canada) in the 2014 Best in KLAS: Global Software (Non-US) report. Also this year, King’s College Hospital NHS Foundation Trust in the UK named Allscripts Sunrise platform as its top Electronic Patient Record (“EPR”) system. University Hospital of South Manchester NHS Foundation Trust and Baptist Health Care Corporation also selected Allscripts as its chosen platform late last year.

It seems Allscripts is here to stay as a major player in the global EHR marketplace.

Want to know more? Get in touch with Medical Healthcare Solutions, a trusted provider of comprehensive medical billing, electronic health records and practice management services for healthcare professionals. Contact us at 800-762-9800 or e-mail sjbrighton@mhs-inc.com.

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Little-Known Advantages to Using a Medical Billing Service

Little-Known Advantages to Using a Medical Billing Service

From time savings to money savings, outsourcing your medical billing to a professional who specializes in this industry can be very beneficial to your company. Particularly if you are a small medical practice, billing can be a demanding and challenging job that takes up a lot of your time and productivity. Using an outside medical billing service to handle these tasks for you is the solution. You may already know that a medical biller can be convenient, saving you from those mundane tasks; however, there are many lesser known benefits to using this type of service.

Reduce Billing Errors

When you entrust your medical billing tasks to an experienced, professional team with training in this area, you get peace of mind knowing your claims are being processed accurately, efficiently, and timely. Handling this on your own or farming this task out to someone within your company who is already taxed with their own duties can lead to mistakes, and those mistakes can be costly. When you choose an independent medical billing service, those professionals focus solely on this service, day in and day out. They have the software, resources, time and extensive training to submit medical claims so that the number of denied claims due to billing errors is reduced.

Save $$$

Outsourcing your medical billing can put more money in your pocket annually, as you could realistically be saving thousands of dollars when it comes to yearly salaries and benefits for an in-house employee. You also save on:

  • Office supplies and furniture
  • Upgrades
  • Billing software
  • Computer equipment

Most medical billing services charge a flat rate or percentage of each claim they handle, but those fees are significantly less than what you would shell out on a full-time employee with insurance and benefits.

Focus on Customer Care

When you don’t have to worry about the stress of technical tasks like medical billing, you can spend more energy and time focusing on what matters most: ensuring your patients get the attention they deserve. It simply isn’t possible for physicians, especially in small practices, to provide superior patient care if they’re pulled in other directions when it comes to the office finances. On the other side of the coin, patient satisfaction in response to that extra attention is increased. Your satisfaction rates will increase, referrals will ideally increase and you can add to your practice one patient at a time.

Boost in Cash Flow

No office is immune to the effects when an employee calls in sick or leaves on vacation. You have to scramble to find coverage for the day or week, while piggybacking those tasks onto someone else’s shoulders within your office that may not have the experience to deal with it. This inconvenience is compounded when your in-house medical biller can’t come in to work and you’re left with a pile of unpaid and unprocessed claims. You may be able to manage for a day, but what if this goes on for days or weeks? As you well know, interruptions in billing processes will delay payments and ultimately hit your bottom line in the form of less cash flow. To keep this cash flow steady, invest in an outsourced medical billing service for seamless operation.

For More Information

Would you like to know more about how outsourcing your medical billing can benefit your company? We would be happy to help. Contact Medical Healthcare Solutions, Inc. (MHS) in Andover today at 800-762-9800 or fill out our convenient online form. Bringing decades of medical billing experience and service to the healthcare community, we are your trusted full-practice Revenue Cycle Management company with customized, confidential solutions.

 

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5 reasons to start using a medical billing company today

5 Reasons to Start Using A Medical Billing Company Today

One of the most important decisions you will have when opening a medical practice is whether to handle your medical billing in-house or outsourcing it to a good medical billing company. While some medical professionals might prefer a more hands-on approach that comes with in-house billing, there are just too many good reasons to use a medical billing company. Here are just five reasons to consider.

1. It Saves You Time and Money

Since you’ll be outsourcing your billing to a medical billing company, you will have more time to focus on treating patients and performing other tasks associated with a medical practice. Accurate medical billing and coding can take a lot of time and effort, so the seemingly simple task of hiring a company to take care of it for you will make operating your medical practice that much easier. A medical practice that uses a medical billing company can also forego hiring and training staff members for in-house billing. This saves money that can be spent elsewhere to run a more efficient clinic.

2. You Get Your Money Faster

All businesses require a steady cash flow in order to be successful, and private medical practices are no different. While you will still receive payments if you decide to go with an in-house medical billing solution, you will receive payments much faster if you outsource your billing to a company that specializes in it. This is very important for a new practice that has yet to be established and is still working on building a cash flow.

3. It Reduces Rejected Claims

Medical billing is changing constantly, and it’s hard to stay on top of all of those changes. One error can mean a rejected claim, which can be a major headache for any practice. Since medical billing companies specialize in billing compliance, they will be less likely to make mistakes than an in-house billing department, which will lead to fewer rejected insurance claims.

4. You Can Learn How to Make More Money

Medical practices do need to make money to stay afloat, but doctors and nurses need to focus on treating their patients instead of increasing a clinic’s revenue. On the other hand, a medical billing company focuses entirely on improving the finances of its clients. A good medical billing company will keep you informed of changes in health insurance and medical coding, and they will be able to teach you about the changes you can make to your own practice to reduce overhead costs and other expenses that could hurt you in the long run.

5. It Provides Added Security

Finally, medical billing services provide much-needed security to private practices. Any information that is given to a medical billing company is perfectly secure, yet the services offered by such companies are transparent enough that you can access any billing information you may need.

These are just some of the reasons a medical practice should consider using a medical billing service as opposed to an in-house billing department. Most of them come down to outsourcing the work to a company that specializes in billing, coding and finances while your staff can focus on treating patients, and that makes a big difference for any medical practice. Whether your practice has been around for years or it is just starting out, you can definitely benefit from a great medical billing company.

 

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Avoid PQRS Penalties Starting Today

The PQRS Penalties for Not Participating In the PQRS Initiative

The Physician Quality Reporting System (PQRS) is the beginning of CMS’s goal to pay for performance and quality care instead paying fee for service.

Penalties for Not Participating in or Following the Guidelines of PQRS are the Following:

If you did not participate in or follow the guidelines of PQRS in 2014 there is a 2% penalty on each of your claims for 2016

If you did not participate in or follow the guidelines of PQRS 2015 there will be a 2% penalty on each of your claims for 2017

If you do not participate in or follow the guidelines of PQRS in 2016 there will be a 2% penalty on each of your claims for 2018*

*If you are an individual provider and do not participate in PQRS in 2016, the penalty will be 4% on each claim in 2018

 

Plus

Medicare already deducts 2% per claim for sequestration.

PQRS Facts

Within each measure is a group of codes:

  • The PQRS guidelines state that an EP must use nine measures on 50 % of the claims that the EP submits to Medicare within the year 2016.
  • The codes that are submitted must fall into three of the following six domains. Each code has its own designated domain.
  • The six domains are the following:
    1. Personal Caregiver Centered Experience and Outcomes
    2. Patient Safety
    3. Communication and Care Co-ordination
    4. Community Population Health
    5. Efficiency and Cost Reductions
    6. Effective Clinical Care

One of the measures to satisfy the requirements of PQRS participation must be a “cross-cutting” measure.  The list of “cross-cutting” measures may be found at www.cms.gov/pqrs.

If Medicare is the secondary insurance, the provider still is obligated to submit the PQRS codes.

When using any of the PQRS codes, the documentation in your notes must match the PQRS code (s) that you submit

Methods of Reporting if you are an Individual Practice

  • Claims reporting
    • Electronic Reporting Using CEHRT (Certified HER Technology) or on paper claims
  • Registry reporting
    • Qualified Clinical Data Registry (QCDR)

Methods of Reporting if you are a Group Practice

  • Registry Reporting and/or Electronic Reporting Using CEHRT (Certified HER Technology)
  • Group Practice Reporting Option (GPRO) via Web Interface (only available for groups of 25+ EPs)
  • CAHPS (Consumer Assistance of Healthcare Providers and Systems) for PQRS via claims survey vendor (for group practices of 2+) to supplement PQRS group practice reporting

Medical Healthcare Solutions is collaborating with Ruth Dolby of Dolby Healthcare Consultants to help practices avoid PQRS penalities in 2016.  Ms. Dolby has in-depth expertise to help providers decide:

  • How the practice will report the PQRS measures
  • Which PQRS codes the practice will be reporting if the practice is reporting the codes on claims

 

If the practice is reporting the codes on claims, once the PQRS codes are established, Ms. Dolby will advise the practice concerning the guidelines for each code, including for example

  • How often the PQRS code has to be submitted within the reporting period
  • The diagnosis associated with each code, if a diagnosis is applicable, and
  • The age requirements for the code
  • The CPT codes that are mapped to the PQRS codes to be submitted

 

Please reach out to Medical Healthcare Solutions today to help your practice avoid PQRS Penalties

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