In today’s healthcare environment of shrinking reimbursements, due to governmental mandates and Medicare policy changes, the importance of maintaining a healthy revenue cycle is second only to providing the best patient care possible. Without an adequate margin there can be no medical mission.Read More
GeBBS Healthcare Blog
Tags: Business Process Outsourcing (BPO), Revenue Cycle Management (RCM), Medical Coding, Affordable Care Act, Insurance Billing Solutions, Offshore Medical Billing, Offshore Medical Coding, Medical Billing BPO, Offshore Revenue Cycle Management, Remote Medical Coding, Medical Coding BPO
It is no secret that the healthcare industry is burdened with costly administrative processes. A good example of this are paper explanation of benefits (EOB) forms that have been estimated to cost nearly $18,600 per physician per year in administrative fees.Read More
Business pressures are forcing healthcare financial managers to re-evaluate their present revenue cycle management solutions, and look to the next generation of solutions for answers to their financial woes. Shifting payment models, new regulations and healthcare reform are forcing healthcare leaders to redirect previously launched budgets, priorities and strategic plans to assess if new solutions can rescue them from imminent financial catastrophes.
Business pressures are forcing healthcare financial managers to re-evaluate their present revenue cycle management solutions, and look to the next generation of solutions for answers to their financial woes.Shifting payment models, new regulations and healthcare reform are forcing healthcare leaders to redirect previously launched budgets, priorities and strategic plans to assess if new solutions can rescue them from imminent financial catastrophes.
In an earlier blog, we admonished healthcare providers not to let their revenue cycles be swamped by the rising number of new self-pay patients entering the healthcare delivery stream. Under the Affordable Care Act (ACA), the self-pay portion of a healthcare provider’s receivables is going to increase significantly. According to a recent Healthcare Financial Management Association (HFMA) study, the current self-pay average is 20 percent of a healthcare provider’s receivables, but that is only going to increase over the next few years. How to manage the accounts of patients who must pay a significant percentage of their bill out of pocket will be a key strategy to achieve or maintain profitability during the new rollout of federal reform mandates.
The good news about the Affordable Care Act (ACA) is that more patients should have insurance coverage and seek care from physicians. The bad news is that some practices may need to turn away patients due to the fact that they are "closed" to new patients or patients will have long waits for initial appointments. The Medscape Multispecialty e-Newsletter recently offered some good advice to physicians who may be swamped with these new patients -- who will have very high deductible insurance plans. They suggest physicians:
Hospital Revenue Cycle Management is about to be challenged by an unintended consequence of the Affordable Care Act (ACA). Even as hospitals are set to see an influx of newly insured patients, industry watchers warn that bad debt may become an even larger problem under theACA, putting more pressure on already thin margins.
Becoming an accountable care organization (ACO) requires that your facility adopt a completely new point of view when it comes to revenue cycle management. The goal of an ACO is to reduce costs by improving the quality of care provided to patients. Providers are encouraged to and boost preventative efforts that may ultimately reduce the future need for high-cost medical services such as hospital stays. As a reward for the collaborative efforts of the ACO, participating insurers such as Medicare will generally offer financial rewards for lowering costs and meeting quality care goals for their patients. On the down side, this also means that ACO providers are accountable to Medicare and may risk losing money if their costs run higher than expected. Costs will no longer just affect overall profitability; for example, they will be evaluated in conjunction with efficiency to determine reimbursement parameters. Healthcare organizations need to be able to collect the correct financial and quality data, compile accurate reports and run predictive analytics in order to meet ACO objectives of better care at lower costs.
Tags: Business Process Outsourcing (BPO), Revenue Cycle Management (RCM), Evaluation and Management (E&M) Requirements, GeBBS Healthcare Solutions, Healthcare Revenue Billing, Medical Coding, Knowledge Process Outsourcing (KPO), Accountable Care Organizations (ACOs), Affordable Care Act
In the face of today’s uncertain healthcare financial environment brought on by the effects of the American Recovery Reinvestment Act (ARRA Public Law 111-5) and Health Information Technology for Economic and Clinical Health Act (HITECH) and the House and Senate’s versions of the Affordable Healthcare Act for America, how can your healthcare organization deal with the shortage of certified medical coders needed for billing and audit functions?
The federal government spends around $1 trillion a year on health care programs. Different communities — the elderly, the disabled, military and civilian federal employees, low-income individuals and their families, and others — benefit from these programs. The two largest programs are Medicare and Medicaid.