The increased use of electronic health record systems helped reduce costs in Canada's health care system by about 1.3 billion Canadian dollars -- or about $1.27 billion -- over six years, according to a new study by PricewaterhouseCoopers, EHR Intelligence reports (Bresnick, EHR Intelligence, 4/22).
With the growing costs of healthcare, patients are required to pay more out of their pockets than ever before! Medical insurance deductibles and co-payments are on the rise while fewer necessary procedures are covered in-full by many insurance companies. According to ACA International, 29 percent of adults reported medical debt or trouble paying medical bills, and 16 percent had been contacted by a collection agency for unpaid medical bills.
Like clockwork, once again, physicians would have faced a 26.5 percent reduction in the Medicare physician payment rate on January 1, 2013, as a result of the sustainable growth rate (SGR) formula. Congress has intervened 14 times since 2002 with a stopgap measure to prevent major cuts in physician Medicare reimbursement. Created as part of the Balanced Budget Act of 1997, the SGR formula and has never been corrected permanently by Congress.
As the business of healthcare IT continues to evolve, helping doctors provide access to their patients' continues to be at the forefront of the industry. Patients are constantly looking for new ways to manage their health while doctors look for new ways to advance patient engagement. With eClinicalWorks, providers and patients have the opportunity to fill the gap in improving health outcomes.
One of the most important aspects of a medical practice’s success is collecting the money that a patient owes them. This seems like a “no-brainer,” right? Well that does not necessarily make it an easy feat. Patient out-of-pocket fees account for 30 percent of a practice’s revenue, yet once a patient walks out the door, chances of collecting that money are practically cut in half.
Yesterday, the United States Congress approved legislation that prevents most taxpayers from experiencing a tax increase; prevents the scheduled 26.5% SGR related cut in physician fee schedule payments; and delays (until early March) the 2% across-the-board cut in Medicare payments due to sequestration.
The Affordable Care Act passed by Congress and signed into law on March 23, 2010 has made preventative care services free for 47 million women. The U.S. Department of Health and Human Services (HHS) released this information back in July of 2012 detailing eight new prevention-related services that must be covered by health plans allowing women to take control of their health. Insurance companies did not cover these services before under their health plans which made women responsible for the co-pays and deductibles for the care they need to stay healthy.
According to a recent study, GroupOne Health Source’s staff of medical billing experts, which includes certified coders and reimbursement specialists, has helped numerous medical practices of various specialties and sizes generate, on average, a 32% increase in monthly collections.
Recovery auditors (RACs), which had been primarily focused on the billing activities of hospitals, will expand their scrutiny to examine physician practices, reported American Medical News.
Electronic Funds Transfer (EFT) is a payment method utilizing electronic means (as contrasted with paper checks) to transfer monies between parties. EFT payments can be nearly instantaneous (avoiding postal delays) and reduce personnel costs associated with depositing payments. Many practices already use EFT to transfer employees’ wages electronically into each employee’s designated bank account, reducing administrative payroll expenses.
1. High volume centers. In some situations, it makes sense for high volume surgery centers to outsource billing services because you don't want to fall behind on collections. "If you are a high volume surgery center and you constantly have dirty claims and you aren't making headway on your accounts receivable, it's usually a direct effect of your staff," says Kelly Grier, vice president of business operations for ASD Management.
Michael Pankey, RN, administrator of Ambulatory Surgery Center of Spartanburg (S.C.), runs an outpatient surgery center where physicians have about 10,000 patient visits per year. "The larger a center gets, the more beneficial outsourcing becomes because the more people your vendor can put on your account," he says.
Effective July 1, 2012 only ASC X12 Version 5010 (Version 5010) or NCPDP Telecom D.0 (NCPDP D.0) formats will be accepted by Medicare Fee-For-Service (FFS). Providers that are still conducting one or more of the Version 4010 transactions electronically, such as submitting a claim or checking claim status, or rely on a software vendor, billing service or clearinghouse to do this on their behalf, are affected by this change. Now is the time to contact your software vendor, billing service or clearinghouse, when applicable, if you have not done so already to ensure you are ready. Transactions conducted by Medicare Administrative Contractor (MAC), fiscal intermediary (FI) or carrier telephone interactive voice response (IVR) systems, Direct Data Entry (DDE) and Internet Portals, for those contractors with Internet Portals, are not impacted.
Last November Physicians Interactive, which offer the popular Skyscape series of medical apps, began consolidating its many wares into one “destination” app, called Skyscape Medical Resources. The app is free to download but this week it topped Apple’s list of “Top Grossing” apps in the medical category. It’s the only top 10 grossing app on the list that’s free to download.
While the Skyscape Medical Resources app freely offers medical resources focused on drug information, medical calculators, and clinical information for more than 850 medical topics, the app also leverages Apple’s in-app purchasing functionality to offer users more than 600 premium resources that span 35 specialties. All in-app purchases are done through Apple’s AppStore but the new features are populated within the consolidated Skyscape Resources app. The company went from having hundreds of smartphone apps to just a few. Eventually, the strategy is to progress to just one app with in-app purchases, except for a few one-off apps PI develops with medical events partners and pharmaceutical companies.
According to the 2011 AMA Health Insurer Report Card, 1 in 5 claims are processed incorrectly. In addition to measuring overall claims processing accuracy, the report card examined how accurately insurers reported the correct contract fees to physicians. Contracted fees were correctly reported 62.08% on low side (Anthem BCBS) to 98.91% on high side (Medicare). For more information, read this.