In the current healthcare scenario, every patient encounter requires to be documented – both for future reference as well as for the facility to be reimbursed for the services performed. With the increase in healthcare services, the quantum of data has also increased manifold times. Along with increasing in sheer quantity, clinical data is also becoming increasingly complex.
According to the AMA’s health insurer report card, denial rates of claims for major private payers ranged between 0.54% and 2.64%. At the same time, denial rates for Medicare stood at close to 5%. Although the percentage does not sound like too much, given the fact that billions of dollars are claimed each year, the figures for denied claims suddenly assumes gigantic proportions.
The few picture frames on the wall showcase degrees and awards that have been bestowed a long time back. The magazines on the table are mostly journals – and old ones at that. Other than the soft humming of the air conditioner and the ticking of the seconds hand on the wall clock, the room is silent.
Your medical practice has never had it so good. The number of patients is increasing and you have enough left over after paying all your overhead expenses and bills. You even have enough left over to take that European holiday after paying off your mortgage and the household bills. Wow! You are doing well and your practice is earning money….or is it?
Globally, medical practices are facing tough financial times. The growing population coupled with the rise in new diseases is taking its toll on the healthcare system. Healthcare claims are coming under intense scrutiny, and the ever-increasing paperwork and frequently changing laws ensure compliance issues being faced by a medical practice. One of the critical challenges facing medical practices is claims denial.
Why outsource RCM
A highly challenging and demanding task, medical billing is one of the pillars on which your organization stands. Mistakes made in your medical billing can sink your practice faster than the Titanic. While there are definite advantages to having your own medical billing staff, the advantages of outsourcing your medical billing far outweigh them.
To provide the best possible healthcare to your patients, it is important that your healthcare providers are up to the task. But, how can you ensure that the healthcare providers you hire are competent and qualified for the job?
In the following article, I’m going to show you why Provider credentialing is the best way to compare,
Understanding net collection rates will help you to gain a better understanding of how much money that is owed to your practice is collected. Calculating your collection rate is quite simple, but it offers an excellent understanding of where your business stands and how you can improve it through medical billing operations.
Calculating your Net Collection Rate
The net collection rate holds a barometer to the health of your medical practice.
Revenue cycle management (RCM) refers to the financial process of keeping track of a patient’s expenses during their stay at the healthcare facility. The health care facility employs the use of advanced billing software to manage the entirety of the billing, right from the registration of a patient to the final payment, in an effective manner.
The process of physician credentialing is an important task that a health care institution has to undertake when hiring a new doctor. It is essentially a process that entails verifying a physician’s credibility, licensure and making extensive back ground checks for any criminal and financial misgivings in the past. This preventive measure will help eliminate any potential problems that might crop up in the future because of the new doctor,