Monday, April 1, 2013

Surgical Homes Led by Anesthesiologists May Reduce Costs and Improve

According to Adam Marcus over at Anesthesiology News, there’s pushback against the “forces now buffeting” anesthesiologists. These forces include ACOs and the burdensome and numerous quality-care initiatives being implemented. The pushback is a radically new care model known as the surgical home that’s being proposed by the American Society of Anesthesiologists (ASA).

“The society in recent years has pushed the surgical-home model, a coordination of perioperative care that improves efficiency, as a way for anesthesiologists to demonstrate their value within a healthcare institution,” Marcus writes. “Yet it has had little in the way of data to support the argument—until now.”

This data was relayed to attendees of the ASA’s 2012 annual meeting and was culled from several new studies. Although preliminary in nature, the studies support the idea that anesthesiologists should be more involved with the provision of care to surgery patients, both for reduced costs and better patient outcomes.

For example, the University of Southern California Keck Medical Center out of Los Angeles focused its surgical-home study on 30-day mortality. Basically, anesthesiologists were involved in every stage of care for surgery patients, even helping the surgeons map out the care plan. They and their residents were also present for each step of the plan.

“…The focus is on a good long-term outcome, not simply immediate success in the operating room,” Marcus explains. “The entire team is present for every induction, line placement, and critical event during the case.”
Early results indicated great success for the Keck model, with 30-day mortality rates down 47 percent from 2010 and 2011. Those behind the study expect the model will cut back on the average length of stay by half-a-day.

Beginning in 2010, Ochsner Medical Center out of New Orleans conducted the second study discussed at the ASA meeting. This study gave anesthesiologists the responsibility to “review medical records, order laboratory and other preoperative tests, and manage consultations for patients undergoing knee and hip replacements at the facility.” The goal here was to see if an “anesthesiology-directed perioperative triage can eliminate redundant testing…while boosting throughput and efficiency on the day of surgery.”

The finding was a savings of $18,000 in testing costs per 100 patients, along with care that “was more focused, more based on evidence and on clinical need.”

Finally, the University of Alabama at Birmingham (UAB) focused its study on total hip arthroplasty and how the preoperative anemia management program could affect the patients going through it.

“Under the program, called PAMP, anesthesiologists ensure that patients receive testing for anemia before surgery,” Marcus reports. “If their hemoglobin and iron levels are low, the anesthesiologist orders weekly doses of erythropoietin and IV iron.”

“Will this testing normalize a patient’s hemoglobin and cut back on needed blood transfusions?” the researchers wondered. If so, rehabilitation for these patients would go much more smoothly.

39 percent of the study’s participants were found to be anemic and needed 352 units of red blood cells during the surgery to the tune of $352,000. With anemia therapy, it would have only cost $245,000.
With these three studies, ASA is hoping to gain some leverage with the idea of an anesthesiologist-led surgical home and the potential benefits that such a model can bring to healthcare organizations.

What do you think? Do these studies prove anything? What is your opinion of the surgery-care model?

Majority of Medicare Providers Face Penalties under PQRS Standards

There’s developing news regarding the ongoing battles between physicians and Medicare, as The Hill reports that “more than 80 percent of Medicare providers will face penalties for failing to meet quality thresholds if current performance trends continue.”

This is based on a study conducted by the Harvey L. Neiman Health Policy Institute. According to the article, the study found “that fewer than one in five Medicare providers meet the program's Physician Quality Report System (PQRS) standards and are eligible for related bonus payments.”

Those bonuses become penalties this year under healthcare reform, and Institute CEO Richard Duszak believes that only “near-term improvements in documentation and reporting” will prevent “widespread physician penalties.” He stresses that physician compliance, while showing signs of improvement over the last few years, needs to happen now, because 2015’s penalties will be determined by 2013’s performance.

The Hill’s Elise Viebeck writes, “The requirements encourage doctors to improve patient care by following evidence-based clinical procedures, such as administering aspirin to someone suffering a heart attack or ordering a tuberculosis screening for rheumatoid arthritis patients.”

Performing the best in the Institute’s study were radiologists, “with nearly 24 percent of imaging docs eligible for PQRS incentives that year compared to 16 percent of others.” This translates into possible 2016 penalties of $100 million for radiologists, and over $1 billion for nonradiologists.

The AMA, among others, is fighting the government over PQRS penalties, requesting that they not be enacted in 2013 and instead be delayed until 2015.

As always, we’d like to get your perspective on this issue. What is your general opinion on these penalties? Should they be enacted this year? For those of you who are gainfully employed, what have you done to qualify under PQRS or what are you improving in order to qualify?

Thursday, February 14, 2013

Five Benefits Of Hiring Health-related Billing Companies

Community colleges, trade Software schools, and forprofit colleges supply various kinds of degrees and diplomas focused on the medical billing business. Because the sector lacks a universal certification, it may be hard to examine the varied offerings. When an educational background can demonstrate familiarity with the field, a diploma specific to medical billing may not necessarily be far more valuable than a additional common degree. As the medical billing market is fragmented, experience with one certain software program package and billing method does not translate to knowledge using a competing procedure.

The appropriate education will hopefully equip you with the correct knowledge and skills to be able to pass necessary examinations to enable you to earn certifications. A lot more potential students are looking into medical transcription educational programs, in addition to medical transcription editing programs due to the fact that it truly is becoming much more common for trained health-related transcriptionists to become able to telecommute from home. Skilled medical transcriptionists may possibly commonly use digital transcription systems to complete their job duties from home. You'll find many medical transcription organizations that offer you their services to medical clinics, health care facilities, hospitals, and physician groups. A medical language specialist may possibly also have the responsibility of editing voiceactivated transcription. Health-related Transcription Tutor provides information about healthcare transcription education, health-related billing and coding, healthcare assistant training and much more.

The next step in a medical billing or coding career is to assess your educational options. Look into your local accredited community colleges. Many colleges provide certificates or degrees in healthcare billing and coding and provide placement assistance for their graduates. Most correspondence courses are not accredited and are not recognized by most employers. Ask your local neighborhood college for names of past graduates that might be willing to speak with you and the names of practices where they have placed past graduates. If you are unable to fit college classes into your schedule, you'll find some reputable colleges that give distance education options. The American Health Data Management Association maintains a list of approved distance education courses.

Outsourcing to a health-related billing and coding company brings significant positive aspects to any healthcare organization. Regardless in the size/specialty of your health-related practice, healthcare billing and coding organizations give you complete and fully integrated healthcare billing and coding solutions. The outsourced solutions are available for almost all health-related specialties including chiropractic, cardiology, pediatrics, dentistry, radiology, dermatology, nuclear medicine, family practice, general surgery, oral and maxillofacial surgery, occupational therapy, pain management, and much more. In such a scenario, physicians would do well to entrust their support staff with only clinical functions, and outsource health-related billing, and Revenue Cycle Management (RCM) solutions from competent and credible sources. – being the largest consortium of medical billers and coders inside the U.S – is resourcerich in dispensing valuedadded services in healthcare billing and RCM. Its comprehensive suite of medical billing and RCM – comprising patient scheduling and reminders, patient enrollment, insurance enrollment, insurance verification, insurance authorizations, coding and audits, billing and reconciling of accounts, account analysis and denial management, A/R management, and financial management reporting – is ample proof of its competence.

Most data analysts possess a degree and background in computers, accounting/auditing or systems management. Analysts in fields such as finance and healthcare will have degrees in those subjects in addition to the technical degrees. So, if you enjoy creative problemsolving, technical analysis and presentation, then a career as a data analyst could be for you. The U.S. Bureau of Labor Statistics forecasts that job prospects are good having a 30% increase in data analysts and related computer jobs over the next decade. With average salaries range between 38,959 and 59,084 per year, becoming a data analyst is attractive.

Students longterm goals may possibly include acquiring the appropriate degrees, along with any required licenses or certifications to enable them to be qualified for their upcoming health care profession. To enter the workforce in a number of the popular healthcare careers such as medical coding, health-related billing, health-related assisting, nursing and healthcare transcription individuals need to obtain the proper training and education. Learn Health- related Transcription Online offers additional facts regarding healthcare transcription training, health-related billing and health-related coding.

Individuals with previous expertise as an executive secretary, who could have been laid off or are returning to the workforce after an absence, can find work with temporary employment solutions. In a slow economy it may be a way to find work when other doors are closed. In a recovering economy, office workers are are usually an occopuational group that is hired first. As a recession transitions into a recovery, businesses typically hire temporary workers first. As business improves they hire permanent workers. Working in a temporary job is a good way to bet back in to the workforce after some time away, regardless with the reason.

Role of Medical Billing Firms in Maximizing Medical Claim Reimbursement

Earlier, medical billing was something quite deterring to healthcare professionals with busy practices to run. Now, things have changed and medical billing has become smoother and swifter, thanks to billing services. Mainly, small / medium clinics and individual physicians are mostly benefited through billing services. However, large hospitals and healthcare centers are also benefited by the services of billing companies, as they provide cost-effective and hassle-free medical claim reimbursement services. This is why billing services are getting popular these days, among all healthcare entities. In this article we will look at the benefits of hiring a billing services provider.

100% Satisfying Claim Management with Medical Billing Outsourcing

The medical claims submitted to insurance payers have to be accurate in all respects if you are to receive correct reimbursement. Checking the insurance papers and getting the claim amount from the insurance companies through regular follow-ups can be time consuming, as well as budget intense. Mainly, small healthcare clinics may not have a separate accounts department, as it is cost consuming. On the other hand, handling the claims can be time-consuming as you need to follow-up with the insurance companies regularly for the claimed money disbursement.

From claim management to billing and coding, according to the laws of states, a billing company renders all the required services. Here are the services that you can avail of from a reliable billing company:

  • Checking the patient's insurance terms and conditions and investigating the validity of the insurance papers. This will lead to easy payment reimbursement from the insurance companies.

  • Following up with the insurance companies at a regular interval to make sure that there are no unnecessary delays in payment disbursement.

  • Handling the situation efficiently, when a claim has been denied. Competent providers of billing services follow up on denied as well as delayed claims, making the necessary modifications and providing valid information. They make sure that their clients receive maximum reimbursement.
Expand Your Business - Provide High-end Services

For a healthcare unit, seamless healthcare management and cutting edge services for the patients are the main objectives. This will help the clinic to become popular and thus, provide a chance for business expansion. With billing outsourcing, management teams of small healthcare clinics get more time and peace of mind to think about providing better services to their clients. They can focus more on quality services, without having any sort of anxiety regarding the payment.

Medical billing firms thus have an important role to play in helping their clients maximize claim reimbursement. Their value-added services will help healthcare entities eliminate those costly errors in billing and coding. Accurate claims will bring accurate reimbursement and help in maintaining a steady revenue cycle.

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5 Main Revenue Cycle Issues Spurred by Healthcare Reform

The third year of healthcare reform is only a couple months old, but there are five revenue cycle issues that will impact hospital executives throughout the remainder of 2013, according to a report from consulting firm Pyramid Healthcare Solutions.

1. Reimbursement and cash flow pressures. Healthcare reform will lead to decreased Medicare payments, more Medicaid patients and a larger percentage of high-deductible health plans, which will put more costs on commercially insured patients. These pressures lead many hospital executives to believe there will be a decline in patient revenue and days cash on hand, meaning revenue cycle teams will have to work harder to reduce days in accounts receivable and improve front-end collections, according to the report.

2. Business office operations. Consolidation among hospitals, physician practices, post-acute care and other providers will drive a consolidation of business office operations.

3. Innovative payment models. Accountable care organizations and bundled payments will impact existing patient accounting systems, most of which are not built to handle these types of new CMS-sponsored payment models.

4. ICD-10. This will be a big year for providers and ICD-10, as it is the final full year to formalize the transition. Revenue cycle teams will have to invest resources and time to master the new coding system, which will affect reimbursement trends and electronic health record implementation.

5. Outsourcing. As hospitals attempt to prioritize their various challenges, many are looking to outsource certain operations, including the revenue cycle, to handle and navigate the various deadlines.

New York Physicians' Monthly Collection Enhanced by 32% in the First Month by Medical Billing Services of!

Wilmington, 12th February, 2013

MBC by applying innovative medical billing solutions has successfully helped individual physicians, physician groups and hospitals across the State of New York - with its specialized team of billers and coders managing to enhance most of their physician’s monthly collections by 32% within the first month itself of taking up the account.

Recognizing New York Practitioner’s billing needs

Though the Medical billing requirements coincide in a certain way or another, each State’s billing needs are unique in their own way and MBC’s team endeavors to ascertain these State specific needs of all our clients. New York Physicians and especially Cardiologists find it tedious to balance patient care and admin needs mainly due to the large number of patients they need to cater to amidst time constraints.
MBC’s billing experts are aware about this crucial factor and New York practitioner’s requirement for both timely posting and follow up of claims to help maximize revenues. Additionally the health care reforms are likely to have considerable amount of impact on the New York’s Medical billing and hence physician’s revenue, for which the NY’s medical practitioners need to constantly update themselves.

Health Care Reform: will affect New Yorkers differently than other states

With the Federal health care reform there are to be changes to public and private health coverage in New York, including increased integration. Additionally advances in technology are likely to facilitate improved coverage and help streamline processes.

However with a number of prime consumer health insurance protections already in place in New York State it is likely to go through less transition than many states with respect to these reforms, never theless the number of insured will increase and MBC’s team is prepared to handle this situation for its clients and prevent them from struggling to balance these changes with patient care.

How we manage to collect more for you?

Running a medical practice in New York and maintaining an efficient medical billing department can be quite challenging. Generally denials can run up to 30% or more of a practice's billing; however MBC works towards a much lower denial rate and higher collection rate - with the principal of getting paid only when our clients get paid.

By and large the last 20-30% charges are not paid on first submission- requiring up to 10 times more effort to resolve, most practices or billings services have limited resources to do this work. MBC due to its large set-up can routinely and consistently apply collection efforts to these claims to generate higher and more consistent collections.

Guiding New York physicians towards better medical billing practices

MBC has been helping providers with all their medical billing needs located throughout New York, in major cities such as New York City, Rochester, Buffalo, Syracuse and Albany. MBC experts constantly update themselves about the health insurance systems, managed care systems, medico-legal and ethical responsibilities, confidentiality, drugs, and prescription records along with other industry changes – with an aim to achieve higher collections.

Get more information: New York City Medical Billing, Rochester Medical Billing, Buffalo Medical Billing, Syracuse Medical Billing, and Albany Medical Billing

Keeping in mind the large number of patients their New York practitioners attend to everyday have been working diligently and also have a dedicated department for our providers based solely in New York. Providing comprehensive medical billing and practice management services for over a decade; our professional billers know the ins and outs of medical billing practices, regularly updating themselves about the changing procedures and legislation that affect New York providers.

MBC invites all providers across New York to access our services depending on their needs – of professionals to handle the practice’s entire billing process or during a temporary staff shortage. Our well-informed billers are constantly applying new methods and trends are available to help you enhance your collections.

About is the largest 'Consortium of Medical Billers and Coders,' across the US. The portal brings together hundreds of billers, with experience in different specialties (anesthesiology medical billing, radiology medical billing, dermatology medical billing, oncology medical billing, Optometry medical billing, cardiology medical billing, ob/gyn medical billing, urology medical billing), on the same platform to service physicians in their local areas. This network of coders and billers is growing rapidly and is currently servicing over 40 specialty physicians, across the US with the most prominent being Cardiology Medical Billing and General Practice.
Prerna Gupta, Media Relations
108 West, 13th street,
Wilmington, DE 19801

Tel: +1-888-357-3226

Medical Billing Blog

Medical Center - Implementing The Most Up-to-Date System In Medical Billing Practice

The medical billing together with the coding course of action require supplies a large amount of assist to health care experts to supply timely and correct reimbursement from insurance agency. Experts in medical coding designate the correct codes for services and treatments, even though medical billing authorities bill these properly. By: medical centre

These positions have been completed with sufficient care given that faults may possibly result in denial of claims and badly affect the reimbursement observe. Due to this why most healthcare businesses outsource these services to a expert medical billing company. The medical coding and billing solutions presented by a dependable service service provider may also help conduct the coding and billing system efficiently, and ahead exact medical expenditures and claims in the intended cut-off date. 

Performing collectively with an expert medical billing specialist allows the medical services to streamline medical billing method, and advantage from effectively arranged coding and billing services which reduce declare denial and ensure of utmost refund. Medical coding and billing services are supplied to groups of physicians, clinics, medical centre, acute treatment services, free standing diagnostic centers, long term treatment services and many other individuals. 

The new medical billing system furnished may possibly start from cost entry, registering affected person information, recording, insurance verifications, payment publishing services, code evaluation and checking, claims/patient billing transmission, collection managements, authorization to appointment rescheduling and scheduling, AR follow-up. The medical middle coding workforce would have expertise in CPT coding, emergency home e-code assessment, DRG/ICD-9-CM and HCPS coding, medical coding audits, and a great deal additional. 

The medical middle be certain that they have effectively streamlining all the processes include from enrollment to insurance verification to AR collection. The new program has aided healthcare exercise to flourish its services and expand. It's got furnished the very best medical coding and billing services, advance billing software, progressive technologies, latest devices along with some others that are essential in executing medical billing service. 

The medical middle today have the most recent and freshest medical codes and standards, insurance and governmental regulatory benchmarks, and payer-specific coding desires. It is important to decide the medical middle that applies the most recent technologies in medical billing and coding to be capable to get your insurance reimbursement quickly and precise. An qualified medical billing and coding company can assist you deal with all sorts of medical billing difficulties simply. Make certain you get the job done with a trustworthy company which focuses on the action program, excellent assurance, full-time specialized enable, common reports and prompt service. By: western suburbs doctor brisbane