GeBBS Healthcare Blog

CMS Chronic Care Management (CCM) Initiative Can Help Improve Bottom Line for Physicians

Posted on Fri, Mar 18, 2016 @ 05:00 AM

In today’s healthcare delivery environment, physicians are constantly looking for new ways to earn and increase their bottom lines. For example, the 2015 Medicare Physician Fee Schedule (PFS) will pay for non-face-to-face services for CPT code 99490 -- Chronic Care Management (CCM), which reimburses practices on an average of $42 per patient, per month. Of all the governmental mandates that have come along -- this is a good one. It incentivizes physicians to extend their care management and care coordination services to their patients who need it the most, and it will improve outcomes for critically-ill patients.

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The good news is that chronic care management, as well as the medical coding for these services, can be fulfilled by professional outsourced companies. This is a critical element of the CMS initiative.

Traditionally, physicians have not had the staff bandwidth to support intensive Chronic Care Management; however, this initiative allows doctors to outsource much of the hands-on, daily care coordination to healthcare organizations who are staffed with experienced care management and medical coding professionals. These outsourced coding companies can work hand in hand with a medical practice’s CCM to provide end-to-end professional services. 

It’s not a coincidence that more than 80% of practices who want to offer CCM services to their patients ultimately end up outsourcing their CCM service and their medical coding. 

The billing physicians are still responsible for creating their critically-ill patients’ care plans and directing the efforts of their professional outsourced staff. 

CMS allows physicians who bill for the 99490 code to delegate this non-face-to-face time, and provide only general supervision on the CCM work they do. This critical change allows physicians with smaller professional staffs to extend the medical coding and care management of chronic diseases to their patients who need it the most and at the same time create a new revenue stream.

Tags: Business Process Outsourcing (BPO), Offshore Medical Billing, Offshore Medical Coding, Outsource Coding, outsourced medical coding, outsourced medical billing, Offshore Revenue Cycle Management, coding outsourcing, Medical Coding Outsourcing, Remote Medical Coding, Medical Coding BPO

Medical Coding Outsourcing is More Than Staffing

Posted on Thu, Feb 18, 2016 @ 06:00 AM

Outsourced medical coding's traditional approach has been staff augmentation. It has been typically used to meet short-term gap needs due to turnover, extended absences, or electronic medical record (EMR) changes. In other words, it has been used when a healthcare provider needed temporary additional resources to supplement its existing resources. However, from our experience, this traditional staff augmentation model is not keeping up with the rapidly changing needs in the healthcare industry.

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There is a growing demand for healthcare services to meet the needs of an aging population and the burgeoning impact from newly-insured patients resulting from the Affordable Care Act. The effect is a trickle down that has increased staffing needs all along the revenue cycle from coding to accounts receivables to collections. With the industry’s transition to ICD-10 with its new codes and processes, and computer-assisted coding (CAC), providers have been challenged to keep up with this evolution.  There is a need for coders -- not just new coders, but also current coders who have been trained to work in today's new coding world.

As a result, there are some healthcare providers who have spread their outsourcing needs across multiple vendors to meet this demand. Invariable, the quality can suffer with inconsistencies among different vendor processes and management. Further, the vendor has limited economic incentive to make meaningful investments to ensure success due to the limited or unknown contract length. Short-term traditional approach engagements face ramp-up challenges, since even experienced coders may need 45 or more days to reach full efficiency. Coders working in these environments may not capitalize on the values of synergy in processes and technology that using outsourcing professionals from a single vendor offers.  

GeBBS, which was recently selected to this year's IAOP Global 100 Outsourcing List, has seen this trend with its long-term investment and delivery of end-to-end revenue cycle management (RCM) solutions. These solutions provide not only coders, but also HIM technology platforms for coding and audits to improve coding efficiency, accuracy and control. This combination of coders and a comprehensive audit and management capability creates transparency for higher coding performance that meets client standards. The byproduct from higher coding performance is the reduced number of claim denials, which ultimately improves the provider’s revenue flow.  This long-term investment is just as true with accounts receivable and patient access, where the strength of GeBBS’ outsourced RCM is not just outsourcing staffing, but also the infrastructure backbone supporting the staffing. The net impact that healthcare providers are seeing include cohesive outsourcing benefits across all of the elements of people, processes and technology.  So when you think of outsourcing, realize the important value that outsourcing can provide is not only people, but also the processes and technology to support those people.

Tags: Business Process Outsourcing (BPO), Offshore Medical Billing, Offshore Medical Coding, Outsource Coding, outsourced medical coding, outsourced medical billing, Offshore Revenue Cycle Management, coding outsourcing, Medical Coding Outsourcing, Remote Medical Coding, Medical Coding BPO, Coding Accuracy

New Year's Resolutions Can Be Achieved If You Have a Plan

Posted on Thu, Jan 14, 2016 @ 07:00 AM

A new year presents a fresh opportunity to set annual goals and create a plan to achieve them.  Many people make New Year’s resolutions where they strive to do better than they have in the past.  Often the most successfully attained resolutions are the ones that are documented and backed-up with a plan to achieve them. 

NewYearsRes-600x400.jpgNew Year’s resolutions are not limited to self-improvement in your personal life, but can also impact your business life.  What are the New Year resolutions for your job?  They can range from simply being more efficient, or to being more resourceful and proactive by planning ahead instead of always working in a crisis mode.

If the foregoing resolutions seem viable to you, what steps can you take to achieve them?  If it is about being more efficient -- are you being more technology savvy?  Are you working smarter and using your time more efficiently? Are you planning to add more internal resources, or do you plan to outsource some of your workload and have best practices available to you immediately? Maybe you are planning to use a combination of all three. 

For healthcare providers, 2016 goals may include becoming fully ICD-10 compliant. This resolution can be achieved immediately by outsourcing this work to a professional firm who can extend their expertise and best practices to your workflow, while simultaneously improving your patient satisfaction with higher quality service.  For example, your practice may be dealing with paper EOBs, but that doesn’t mean you cannot be more efficient by using an outsource service to transfer paper documents to an electronic format that will expedite your charge entries.

It’s not too late to make 2016 the year where your goals are set and actually achieved.

Tags: Business Process Outsourcing (BPO), Explanations Of Benefits (EOBs), Offshore Medical Billing, Offshore Medical Coding, Outsource Coding, Offshore Revenue Cycle Management, Medical Coding Outsourcing

Survey Shows About 80 Percent of Hospital CFO's Consider Outsourcing RCM to be the Best Stop-Gap Measure

Posted on Mon, Oct 19, 2015 @ 08:00 AM

By Nitin Thakor, GeBBS President & CEO

offshore medical codingAccording to a recent survey reported in Healthcare Finance, 83 percent of hospitals now outsource some accounts receivable and collections, 58 percent of hospitals outsource some contract management, 55 percent of hospitals outsource some denials management and 68 percent of physician groups with more than 10 practitioners now outsource some combination of collections and claims management.

The expected impact of ICD-10 on the revenue cycle will prompt providers to outsource even more of their revenue cycle functions the article states. Larger health systems are even more bullish on the trend. The survey found 93 percent of larger hospitals (more than 200 beds) anticipate supplementing their existing revenue cycle software with outsourcing services in the first quarter of 2016 as fallout from ICD-10 likely affects cash flow and more value-based reimbursement opportunities are presented.

Outsourcing RCM: Onshore and Offshore Medical Coding and Billing

This trend is nothing new to GeBBS Healthcare Solutions. We have always promoted outsourcing as a means to cut through the complexity of revenue cycle management with proven expertise, operational excellence, and a sophisticated approach to business processes. Outsourcing providers have experienced, ready-to-deploy remote medical coding, denial management, and medical billing resources available immediately to ameliorate the effects of ICD-10.

Tags: Business Process Outsourcing (BPO), Revenue Cycle Management (RCM), Healthcare Revenue Billing, Medical Coding, Knowledge Process Outsourcing (KPO), Offshore Medical Billing, Offshore Medical Coding, Outsource Coding, Offshore Revenue Cycle Management, Healthcare BPO Companies, Medical Coding Outsourcing, Remote Medical Coding