How Telemedicine Increases Practice Revenue

How Telemedicine Increases Practice Revenue

As a business in the medical field, you have likely heard about telemedicine and may even implement some aspects of it into your practice. But what is telemedicine? According to the American Telemedicine Association, telemedicine, in a nutshell, is the use of medical information that is exchanged from one site to another through electronic communications in an effort to improve a patient’s clinical health status. It can be accomplished through any number of ways, from two-way video and email to smart phones and wireless tools.

Providers and healthcare systems are readily embracing telemedicine as an additional way to more quickly treat patients and efficiently receive reimbursement for those services. Perhaps you already know how this approach can engage patients and give them access to more and better care. But do you know how it can boost the bottom line for your practice? Luckily, there are many ways.

Reduce Late Cancellations
No-shows are likely the bane of your existence. People who don’t show up for appointments not only throw the whole day’s schedule off, they also take the place of another paying customer. The American Academy of Family Physicians says the average no-show rate is about 5.5 percent. While 65 percent of all practices  track those missed appointments and cancellations, only 46 have policies in place to address the issue. Look, we know there’s no way to predict or control who will show up and who won’t. That’s a given. There are parenting demands, traffic, late work nights, you name it. However, when you provide your patients with a more convenient method of receiving the care they need from home via telemedicine, your patients will be happier and you’ll likely see a reduction in your cancellation and no-show rates.

Boost Patient Flow

Telemedicine can keep the flow of your practice going, getting patients seen, evaluated and on their way without harming their satisfaction rates with you. Virtual check-ins and optimized appointment schedules can help you to achieve all this because patients are more at ease knowing they can ask quick questions without the hassle of coming into the office every time. Happy patients are more likely to book another appointment with you.

Increase Off-Hour and Same-Day Appointments
As a health care provider, you’re already spending many hours handling questions over the phone and returning patient calls without getting paid. Through Telemedicine you now have the option of transitioning those calls to billable units as after-hours telemedicine appointments by converting those patient requests into additional sources of revenue. Designating a separate time for telemedicine for example can increase flexibility during your regular workday to fit in those last-minute same-day appointments. And, by implementing an on-demand list to “see” patients or give them quick answers to questions, patients avoid the hassle of having to hang around your office all day just to get an answer.

Bring in New Patients
When word gets out that you’re offering telemedicine services, new patients will be attracted to your practice because patients want more options for convenient yet accessible healthcare. Just like you, your patients are trying to accomplish more with seemingly less time to do it in. Telemedicine is just the answer to that need.  Get in touch with Medical Healthcare Solutions today to learn more ways in which telemedicine can increase your practice revenue.

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The Importance of Revalidation & Credentialing for Groups & Providers

Medical providers must undergo revalidation and credentialing updates on a regular basis with their insurance carriers to stay current with the latest requirements regarding state and federal guidelines. This process also provides the insurance carriers with the latest information pertaining to their organization so that an active and accurate database of information can be kept on file. The insurance carriers require that all Medical groups and providers go through this process every few years in order to ensure that the correct information on file is maintained.

It is imperative that you do not ignore these requests because a lack of compliance will result in the deactivation of your billing numbers; and, without active provider numbers, a practice will not receive payment. Please note too, that if your number becomes deactivated it may take up to 90 days for reinstatement, impacting your bottom line even further.

Medical Healthcare Solutions, Inc. (MHS) offers complete provider insurance revalidation services as well as comprehensive provider enrollment and credentialing services for initial enrollment. It is crucial to work with a team backed by many years of experience in working with the major commercial carriers such as multi-state Medicare, Medicaid, and Blue Shield, among others. For instance, per, Medicare requires that all providers must revalidate every five years;  and submission of that application must occur within 45 days from the date on the revalidation notice.

Consistent Database

The main advantage of revalidation is to maintain an accurate and timely record of all provider and group information to speed up the process of claims and other medical billing tasks. Credentialing involves the review and validation of the professional qualifications of physicians who apply for participation in select insurance networks. This process is designed to ensure all participating providers meet their strict professional standards, thereby ensuring patients get the highest quality medical attention possible by qualified doctors and other providers.

Many medical billing companies provide complete credentialing services, which include assessment of the requirements by carrier, completion of the application(s), submittal to the carrier(s), and follow-up for processing by carrier(s). A database is then maintained by the billing company to keep track of those records across the board.

Switching hospitals or affiliations? Simply contact your medical billing company to prepare the right letters and forms for you to fill out. In addition, providers must submit credentialing change forms if there are any other changes to their enrollment information such as:

  • Legal business name
  • Practice location (change or addition)
  • Ownership
  • Authorized or delegated official
  • Changes in payment information
  • Legal actions

This is a crucial step in maintaining an accurate profile with your insurance carriers.

Insurance revalidation services work in much the same way. Your medical billing company will help you fill out the paperwork, submit the application and provide all necessary forms. MHS, your trusted provider of cooperative billing, has extensive experience working with a variety of software platforms with the ability to interface with all electronic medical records.

Contact Us

If you are sent a revalidation letter or credentialing request, contact Medical Healthcare Solutions, Inc. (MHS) right away to get going on your application. It’s important to get this information submitted as soon as possible to avoid payment interruptions.

Please contact us today to learn more information on how we can help with your revalidation and credentialing needs. We are proud to have decades of medical billing experience and service to the healthcare community under our belts and look forward to assisting you today!

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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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Telemedicine Medical Billing Company

Telemedicine and Your Future: How a Medical Billing Company Can Keep You Informed

  Telemedicine is technically nothing new, but modern technology has made it more viable than ever before. Accountable care organizations or ACOs can now use email, smartphone apps, two-way video and other forms of wireless communication to reach patients they might otherwise be unable to treat. And yet, it does leave some questions for medical professionals. Aside from the fact that telemedicine is far from traditional medical treatment, there is also the question of how to handle billing.

While there are generally clear guidelines when it comes to billing patients in a clinical setting, no such guidelines exist with telemedicine. Many insurance companies pay for telemedicine services, but the billing rules can vary greatly from one payer to the next.

Despite the hassle that can come with it, telemedicine should be embraced by ACOs. It really does allow doctors to treat more patients, and it allows doctors to keep up with the rest of the world as it continues to embrace wireless technology. It is simply a matter of evolving to stay relevant, and the good news is that ACOs don’t have to handle every aspect of it by themselves. Medical billing companies such as Medical Healthcare Solutions can take care of all the billing details for these services while keeping ACOs up to date on the many new developments in telemedicine.

Choosing the Right Telemedicine Solutions

As anybody could probably guess, there are several different telemedicine solutions out there. Some will be ideal for your ACO, while others won’t work for you at all. There is no wrong way to offer telemedicine services, but you need to know what is best for your ACO. A medical billing company will be able to help you decide whether you should have video conferencing services for example, or make use of smartphone apps to communicate with patients. So don’t hesitate to ask for advice before deciding what kinds of services you wish to offer.

Medicare and Regulations

Medicare has very specific regulations when it comes to billing patients for telemedicine services. You will obviously need to know about these regulations and what billing codes you need to use for the services you offer. Once again, a medical billing company can help you to navigate through those regulations and take care of at least some of the responsibilities.

Knowing What States Recognize Telemedicine

As ubiquitous as telemedicine is, only 29 states and the District of Columbia allow payers to reimburse for telemedicine services. Your ACO can still offer these services if it isn’t in one of these states, but insurance companies won’t be able to cover them. There is new legislation being introduced on a regular basis to allow companies to reimburse for telemedicine, but that is the case currently in only about half of the country. A medical billing company can of course help you to determine which insurance companies are reimbursing for these services, but they can also keep you abreast of all the changes with telemedicine as they happen.

Keeping Up with New Technology

Finally, a medical billing company can help you keep up with communication technology. There are constantly new smartphone apps, more software advancements and upgrades in communication technology that can make telemedicine services easier than ever to deliver. They can also extend the reach of your ACO and allow you to gain new patients.

Just as billing companies can help you to determine what services will be best for your practice, they can also teach you and your staff about the latest technology and how to integrate these elements into your practice. In many ways, telemedicine represents the direction of modern medicine, so it is always important to learn all you can so that you can keep up with the rest of the world.


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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



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

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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