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How Patient No-Show Affects RCM?

How Patient No-Show Affects RCM?

 

150 billion!

Yes, that is how much healthcare systems of the United State lose because of patient no-shows, in a year.

Setting up, operating and maintaining healthcare organization is expensive. What adds to the staggering expense and has an adverse impact on the revenue generated is the frustrating habit of the patient not showing without prior informing. Unless the fault was at the healthcare facility’s end or your part, there is no use of pestering patients for not showing up just because you are furious about the time that could have been profitably utilized.

The total cost of missed healthcare appointments in the United States every year is an astronomical $150 billion. Each open, unused time slot costs a physician 60 minutes and $200 on average. Now factor in that no-show rates are as high as 30% nationwide, and you can see how that $150 billion figure is reached. Despite these astounding numbers, healthcare facilities are not taking the necessary steps to monitor the patient’s behavior and minimize the adverse impact it has on the healthcare practices RCM, which is the need of the hour.

So let us talk about what exactly is referred to as a patient no-shows and what measure can a healthcare practice take to reduce it and the impact it has on the revenue cycle.

What is defined as a patient no-shows?

When a patient who has their appointment booked with a doctor, doesn’t show up for the check-up without informing the facility or canceling the appointment, this practice is a patient-no show. And although for the patient it might not be such a big issue, this habit affects healthcare organization’s revenue profoundly.

What is the reason for the patient not attending without informing the healthcare practice?

Superficially, it can be perceived as just negligence in patient part, but there are specific common reasons behind a patient’s inability to not attend the appointment, such as :

-APPOINTMENT ISSUE:
Patients tend to get irked if there is a considerable gap between the date the appointment was scheduled and the date the appointment is. The healthcare facilities have months that are prior booked, but since this cannot be explained to the patients, the long gaps lead to patients missing out on the appointments.

-LACK OF UNDERSTANDING:
This is one of the most common reasons for patients missing the scheduled appointment. They assume that them not attending the appointment will ultimately help the doctor’s office, which as per belief is always overbooked. They don’t understand that because of their missing out the appointment, the facility’s time and the financial cycle is disrupted.

-LACK OF EMPATHY OF FACILITY’S STAFF:
How does the healthcare organizations front desk engage in the conversation with the patient, what kind of atmosphere does your practice has and how they treat their patient plays a huge role not just in attracting patient but also in their retention? Service don’t just mean effective medicine or a nice private luxury room to the patient, but on how you and your clinical staff treat them.

-LAST MINUTE EMERGENCIES:
No one can predict what is going to happen the very next second, the patient who has their appointment schedule might not be able to attend it because of a family emergency or any other major conflict because of which they were unable to inform about their absence.

The no-shows and late cancellation have a profound impact as it leads to time wastage of the clinical staff, generating confusion with not enough staff when needed and too many in non-peak hours. This ultimately results in a dissatisfied patient who starts looking for treatment in other healthcare services. Patient no-shows, aside from wasting the time of the hospital and impacting the revenue of the healthcare practice on a greater scale, also delay the timely delivery of quality healthcare. By missing out on the scheduled appointment, patients slowly give the medical condition they have the freedom to thrive, and further, affect the immune system of the body.

To prevent your healthcare practice from a further loss in the revenue cycle and dispense adequate treatment to the patient, we have listed down some reliable strategies that will assure a significant reduction in no-shows rate, so that every patient coming at your healthcare facility get the treatment they need:

-FOLLOW-UP ON THE MISSED APPOINTMENT:
As mentioned before, not every missed appointment is intentional, which is why it would be a good practice if you drop text on their number or shoot an email. This will indirectly remind them of the hospital appointment, and they might try to reschedule one immediately.

-IMPLEMENT A NO-SHOW POLICY:
No show policy might seem like a tyrannical solution, but it doesn’t have to be that way. Instead of charging a fee for missing the appointment, you should modify the policy to removing the fee once they reschedule the appointment and attends it. Another strategy that could benefit your practice, in the long run, is rewarding the patient who showed up for their apportionment with gift cards.

-REDUCE THE WAIT TIME TO MINIMUM POSSIBLE:
If on their previous visit the patient had to wait for 20-30 minutes, chances are they are not going to come back for the follow-up. The waiting time will not only lead to not attending the appointment but also a loss of patients.

-HIRE AN APPOINTMENT REMINDER SERVICE:
We could suggest you automated appointment reminder for streamlining all the appointment making sure the no-shows rate is minimum, but what if we say, instead of a software, you can outsource a team of billing and coding experts like Medphine that understand the importance of these intricacies and will make sure the no call no show rates are decreased by being the communication channel between the provider and the patient. You can trust Medphine’s proficient appointment reminder in streamlining the scheduling process and improving your revenue cycle management.

-STRENGTHEN RELATIONSHIP WITH PATIENTS:
A healthcare practice’s relationship with the patient does not end on the day of last treatment process. Make your patient feel valued with updating them on the latest technology that you brought in your facility and how it can help with their medical condition.

Instead of burdening your in-house staff with the responsibility to make sure the appointment reminders strategy works appropriately, why not outsource to a billing and coding service like Medphine, that does the same job more efficiently with visible results?

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Rationalise your charge entry practice

Rationalise your charge entry practice

Of all the intricate processes that make up the medical billing and coding in the healthcare industry, be it Insurance verification, medical transcription, claim submission, payment posting, one process which holds utmost prominence, considering heightened intricacies of its own is charge entry practice.

Why, you ask?

Because charge entry process if overlooked will impact your eligibility for claiming the reimbursement of providing the service or impact the figure that you shall receive by the insurance company. The amount you will receive will depend on the accuracy of your charge entry.

What should all be covered under an accurate charged entry?

Diagnosis code
Service Location
The physician taking care of the case
Authorization
Date of the service being provided
Date and time of admission
Billing providers

One of the most common billing error which is also one of the most expensive ones is that of entering wrong information, which deprives healthcare service providers of their insurance money. Putting down incorrect information from the list mentioned above leads to immediate claim denial by the insurance companies. Furthermore, if the medical practice mentions inaccurate quantity like miscalculation in the number of days medical services were provided to the patient or in-facility prescriptions like Intravenous units etc., then they might not get the right compensation.

Some actions you can incorporate to optimize charge entry in your medical practice:

  • Encourage the habit of posting the charges the same day the service was rendered to the patients. With the passing days in delaying the posting of your charge, your reimbursement will be delayed.
  • If the code editor rejected the diagnosis code, implement practice and billing management system to quickly identify the error, giving the team the opportunity to fix the mistake.

How can a medical billing and coding service provide adequate entry service and help streamline the revenue cycle management?

Charge entry practice is the most crucial aspect of medical billing and coding as this establishes the amount that the insurance company shall pay a healthcare service provider. This is the reason why it is highly recommended that instead of burdening your pre-occupied in-house team with this intricate work, outsource a medical billing and coding solutions provider who specializes in charge entry practice like Medphine.

  • By outsourcing charge entry from Medphine, you can rest assured that there will a significant decrease in claim denials resulting from the improper filing of information. Our billing experts will make sure that every data is cross-checked twice to ensure 99% clerical accuracies.
  • Our team of specialists are adept with a wide range of billing software and have worked with several medical specialties. They stay abreast with the latest technological advancement in the standards and protocols of medical billing to ensure qualitative revenue cycle management.
  • Medicine billing expert will make sure that all the services are dispensed with 24-48 hours of turnaround time, so as not to delay the reimbursement process from insurance companies.
  • Our streamlined approach to billing processing will ensure smooth and quick claim management for your medical practice.

Accurate charge entry practice is necessary to minimize the number of claim denials, saving time otherwise spent on identifying and rectifying claiming errors and ensuring a healthy cash flow. All this can only be guaranteed by a team holding unparalleled expertise in medical billing and coding like Medphine.

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How Can Your Medical Practice Benefit From Payment Posting?

How Can Your Medical Practice Benefit From Payment Posting?

The following constitutes a healthy revenue cycle management:

  • Patient Pre-Authorization
  • Eligibility & Benefits Verification
  • Claims Submission
  • Payment Posting
  • Denial Management
  • Reporting

Of all these critical processes required for an effective revenue cycle management, payment posting is one of the most crucial ones. Although it seems like a simple process, payment posting if gone wrong can disarray the finance of the medical practice.

How can an error-free payment posting benefit your medical practice?

  • Correct payment posting affects the whole claim processing. If there is a mistake in initial posting, the secondary and tertiary payers will get billed incorrectly. Similarly, an accurate payment posting reduces the denial resolution time. Hence it is necessary to keep the staff updated with the latest billing/ coding, insurance payers instruction and other important correspondence to resolve the denial as soon as possible.
  • Accurate payment posting helps in to analyze the revenue cycle, helping it identify an area that needs improvement. It also helps in reducing the account receivable days, strengthening the revenue cycle management and improving its efficiency.

 

Abide by these healthy billing practices to optimize your payment posting:

 

Communicate better with patients

Patients, after all, are your consumers, what they are going to say the minute they step out of your practice is going to influence your revenue inflow at some level. Hence it is necessary that you communicate well with your patients. We’re not suggesting, you be busy on the phone solving their minor queries, but we are talking about your online presence via an electronic health record portal or software. This will help your medical practice in engaging more patients and motivating them to pay earlier.

 

Harness evolving payment technologies

It will help you if you make it a habit to send out an electronic statement regarding the payment to the patients as soon as they leave the healthcare center. For better convenience of the patient as well as the service provider, more and more organizations are including automatic payment. Utilizing technology will help in decreasing the operating costs from electronic transactions, lowering the number of write-offs. Automation like every sector will assist in enhancing productivity and efficiency, which will ultimately increase the cash flow and lead to better collections.

 

Diversify payment methods

With almost everybody using all three payment methods, every healthcare service provider must have the requisite machine to accept payment via any method: debit card, credit card or cash.

 

Collect payment on-site

If the medical service provider does not collect payment as soon as the patients check in or are getting the service done, the probability of receiving payment gets delayed to a significant level. You will have to inculcate this practice in your staff members by motivating them

 

Integrate your payment processing with healthcare workflow

To give your patients the freedom to pay your medical practice by web, by mail, by phone and via payment plans, it’s imperative that all subsystems of healthcare systems and payment processing are well-integrated. This will promote improved reporting, enhance operational efficiencies and benefit the overall financial performance.

 

It is necessary to optimize payment posting for streamlining medical billing to promote healthy revenue cycle management. Even better an option would be if you consult a medical billing and coding company for revenue cycle management. Outsourcing a proficient billing and coding service will lead to quicker and efficient revenue generation with reduced errors. They will effectively manage all the billing operations, so that time and money otherwise wasted on hiring and training staff members for in-house billing and collections services can be utilized on developing the practice to provide better service to the patients.

 

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Keys To Successful Implementation Of Any Healthcare Technology

Healthcare industry is undergoing massive change due to political and regulatory modifications. It is becoming increasingly difficult to operate a healthcare business because of its complexity and the profit margins are becoming narrower each day.

Keys To Successful Implementation Of Any Healthcare Technology

The modern healthcare flourishes on enhanced technology of health and management which helps these organizations in improving its efficiency. But these technologies don’t seem to be easily adaptable. Even if you are lucky enough to choose the right technology for your organization, the procedure of implementation is tricky in itself. Next you need to maintain the return on investment as well.

A successful implementation of technology demands the active engagement of people with the process of technology. Along with the right leadership, positive attitude and management of the organization can achieve the successful implementation of advanced technology.

The following strategies can help you in achieving the desired success through technology in your healthcare organization:

Plan It Ahead Of Time

If you are planning to get new technology onboard then you must analyze it thoroughly. Not every technology is apt for your business. Understand the technology and decide whether it improves your work or slows it down. Planning will prepare you for the expected (and unexpected) outcome and you would be able to meet the deadlines efficiently.

You can also take this time to train your team members so that they don’t get frustrated. It will eliminate inefficient usage of technology.

The Goal should Be Shared

The journey of a healthcare firm’s transformation is highly dependent on the contribution of the team. Before implementing a new technology, talk to your team members about the expectations from the modifications in the organizations.

If leaders have divided opinion about the change then nothing can make it successful. The staff will follow on their own only if the leaders are confident about the decision.

Create A Culture Of Growth

There are a lot of people in the company who might feel insecure because of the change. They might feel insecure about their job. It also can be one of the reason why they would not welcome the change.

Usually people are overworked in healthcare administration department. If you show them how technology makes their lives easy, they will acknowledge and adapt the change.

Follow up Is Important

No implementation can be successful unless you keep an eye on the improvements. It includes the data as well as the behaviour of the employees. If both of these elements aren’t producing positive results then the implementation cannot be considered successful. It is important to know what part is favourable for your business. You need to do a thorough analysis to ensure everything is working properly.

A successful implementation of technology in healthcare is a demanding decision but the results will be rewarding as well. If you do a proper research and good implementation then you will be able to get the most out of your resources. Cut down on your burden and head over to Medphine to get experts for your medical billing.

Keys To Successful Implementation Of Any Healthcare Technology

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Healthcare Technology Continuum & Care Environment

Healthcare providers are moving forward in a swift pace to improve everything from their services to the finances. The advanced technology has simplified their task to a great extent. It has changed the way of practice, diagnose and usage of equipments, which is truly revolutionary. Rapidly developing medical technology has changed the way healthcare is being delivered today. The advancement in healthcare technology is indispensable for society’s well being and it definitely brings a lot of money to the economy.

Healthcare Technology Continuum & Care Environment

Let us have a look at the the advancement in healthcare and its impact on patient revenue.

The Cost of Technology

As the technology is getting advanced and more effective, healthcare is also getting costlier than before. At the same time the demand for high-tech diagnostic and medical care is at an all time high. That is why the availability of such healthcare might come in conflict with the basic necessity, social justice and required cost effectiveness of healthcare.

Both the patients and providers suffer in the healthcare industry. Patients are much more at risk as the healthcare cost is skyrocketing. The providers are crushed for their money as their revenues are consistently declining. The entire medical payment system needs to be redesigned from the scratch to solve patient payment issues. This is the only way to control the staggering number of losses in healthcare industry.

Provider Friendly Technologies

Development in technology has emerged as a boon for the finances of healthcare. Providers can take a break from manual process to switch to a automated system and enjoy a quick and accurate process of medical billing. They can rely on a system that has all the health data, accurate medical records and advanced technology for telehealth. There are at least five kinds of medical innovations that have changed the face of healthcare and its revenue:

  1. Availability of data
  2. Advancement in communication
  3. Electronic Medical Records (EMR) & Electronic Health Records (EHR)
  4. Telemedicine
  5. Digital Application
Something for Everyone

The healthcare technology has made the medical costs quite clear. It gives an assurance to the patients that there are no hidden costs included. Even before visiting the doctor, the patient can be informed about the cost of the visit. The amount covered by insurance is also available on EHR for the consumption of medical billers. The technology has allowed varied payment options which is a major relief for both the parties involved. Patients also get a chance to give reviews which dramatically improves the healthcare services. It is proven that a satisfied patient is much likely to settle their finances at once. It directly impacts the medical organization which enjoys a better revenue system.

The growth in the healthcare technology is omnipresent. It definitely has far reaching consequences which affects both the patient and the provider. Despite the costs and complexity, the use of high-tech medical advancements is getting popular with each passing day. With all the simplicity and ease of payment, both patient and providers are immensely enjoying the benefits of this advancement.

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Express Gratitude To Your Doctor Today

30th March is observed as the National Doctors’ Day in United States. On this day we should make it a point to reach out to our doctors and thank them for their selfless contributions to the well-being of the society.

History

The National Doctors’ Day honours the date when Crawford W. Long used an ether as a surgical anaesthetic for the first time . Later in 1990, President George W. Bush formally designated the date as National Doctors’ Day. The day is traditionally celebrated by expressing gratitude to the physicians. Red carnations are also displayed as a symbolic flower for Doctors’ Day.

Express Gratitude To Your Doctor Today

When in the profession, doctors pledge themselves towards serving the community. Though a part of their job, along with the treatment and prescriptions, the selflessness and empathy we receive from them is what keeps us hopeful and going through tough times. Their profession demands a lot of sacrifices and stresses which we stand unaware of.

At Medphine, we constantly strive to give assistance to doctors and physician in order to make their lives easy. We try to take up their administrative responsibility so that they can focus on their duties towards their patients.

As a part of the community, it should be a collective aim to serve the people in need, and doctors have always played a crucial role in fulfilling this mission. We must express gratitude and appreciation towards these individuals who have taken care of us selflessly.

This day is important in the medical world, because it encourages us to acknowledge the hard work and dedication of the doctors towards keeping our society healthy. In honour of Doctor’s Day,  we at Medphine urge you to take a moment and express gratitude to your physician. Call them or simply drop a message/mail. They deserve to be accoladed for their dedication, compassion and care.

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Get Optimum Value From Electronic Health Records

Electronic health record (EHR) maintains the health information of a patient electronically. It provides higher quality accurate data along with safer care for the patient. EHR also enhances the quality of management for the health organisation (or provider) which results in better health care. The patient records become accessible and more coordinated. The patient data is also secure with EHR. Since all the information is at once place, providers benefit from effective patient diagnose reducing medical errors and providing safer prescription.

Get Optimum Value From Electronic Health Records

EHR has changed the face of medical billing. It has helped in improving the productivity of providers. It has provided them optimum work-life balance. Practitioners have admitted meeting their business goals efficiently after switching to EHR. It also streamlines coding and billing in the practice. The duplication of work is considerably reduced which enhances safety and improves health.

But the EHR has had its own share of issues in past. Many practitioners have reported that it has poor “usability”. A potential medication error can put the patient at risk. Another issue is that of increased time spent doing the documentation.

Let us have a look at how we can get optimum value from electronic health records:

Put efforts to get the precise data: EHR flourishes in a space where data is considered valuable. It thrives on data. If you want to get optimum value of EHR then you must start a culture that is data oriented. For the best EHR experience, each and every data has to be recorded regularly and accurately. The data makes it easier to precisely measure the quality, which in return helps in creating real and unambiguous electronic health record. As a provider put your efforts in getting the best data (accuracy, complete, quality research). It will increase the efficiency of EHR where the data is accessible and aggregated.
Extend the research benefits of EHR: EHRs have the ability to record the data of millions of people. So enormous collection of human health data cannot sit idle. The benefits of EHR can be extended by making a secondary use of this data. If it is used for further improvement in EHr, it can significantly reduce the costs related with clinical research.

Pay attention to the analytics in order to develop them and use them for extensions in the technology. It demands the involvement of the top members of health organization, along with the clinicians and statisticians. Until and unless there is alliance between all of these, one cannot transform it well in the EHR. A well developed data culture and program is adapted quickly by the practitioners across the country.

Improve the quality of EHR through Data evaluation: The data in EHR is complete in itself. It saves the cost of patient recruitment and data collection. Utilising this data for actual patient’s diverse medical care would be a huge breakthrough in itself. It will escalate the rate of new medical discoveries.

The data pertaining EHR is analyzed thoroughly before putting it to work. Before setting it for practice, the data is refined and tested. It sets the best practice for healthcare industry. The recommendations to improve the best practices are always welcomed. It is important to contribute the information to create a data driven culture. It helps the value of electronic health grow exponentially. Updated model which can be shared and implemented widely will help in improving the quality of healthcare.

Electronic health record has proved to be of utmost benefit for the medical practice. It has improved healthcare and decreased the otherwise escalating healthcare cost. A better EHR will impact the quality and safety of patients avoiding any sort of legal implications. The unintended complications can be improved to ensure patient safety and increase the quality of care.

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Why Medical Practitioners Must Record Inflow Monthly

Any business requires an ample amount of cash flow in order to maintain their budget, expenses and other investments. No matter what is the nature of business, one needs to know the approx amount of money that is going to come in terms of cash. Similarly, practitioners need to treat their medical practice as a business. No doctor ever prescribed a treatment without referring to the patient’s medical history, conducting tests and scrutinising through all the reports. But when it comes to managing the practice (or business), same practitioners are ignorant and do not pay much attention to the day to day financial operations. Just like the decisions for the treatment are highly data driven, the medical practice must be managed on the basis of recorded data as well. That is why practitioners need to manage the cash inflow in an organised way.

Why Medical Practitioners Must Record Inflow Monthly

The cash flow needs to be recorded on a regular interval so that you have an idea about the cash in hand. If you are not able to manage your cash flow efficiently then there are absolute chances of failure. Managing the inflow of cash is very simple if handled strategically. So let’s have a look at some points which will affirm that regular record of cash will smoothen your budget.

 

Note down the inflow of patients on daily basis

You get patients on daily basis. Right? Then why push the notes and documentation to the weekend? It is important that the documentation is done on the day patient comes in. it will give you more accurate account of the monthly inflow and keep the number of days out that you are going to be paid.

 

Send the claims out the same day the patient was seen

When you are receiving your patients everyday then why push the bills for claims at the end of the week or month. Not only it complicates the entire procedure, it also increases the chances of claim denials. It will barely take you a couple of minutes but sending out the claims on daily basis will ensure that you have a correct approximate of money in your practice.

 

Document money the same day they are received

To keep the medical practice running smoothly, you need an ample amount of money in hand. Accounts receivable (A/R) needs to be kept in check in order to claim the money on time. Keeping track of A/R will show you clear scenario of money management. Different health insurance companies pay anywhere between one week and a month. If A/R is increasing then it means that your bills are not being collected on time which is a threat to your practice.

As a practitioner, you cannot depend completely on the amount you might recover from the insurance companies. There is no assurance about an account receivable money. That is why you need to record your inflow on a regular interval. Keeping a regular cash inflow record makes the life easier for both the practitioner and the billing staff.   

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Questions To Ask Before Having A Medical Billing Company On Board

Many practitioners struggle with the question whether or not they should outsource their medical billing. On the surface it makes sense to hand it over this responsibility to an outsourced company since they are expert in it. But is it really that simple? Of course, not.

Questions To Ask Before Having A Medical Billing Company On Board

The medical billing is a lengthy, complicated procedure. Before outsourcing the job you might need to consider few factors that might affect your revenue. You need to be very clear whether outsourcing medical billing would be beneficial for you or not? Once you are sure about that, you can start hunting for the best medical billing company for you. Here you need to evaluate the company on following factors and see whether that company is right for you or not:

Cost

One of the prime advantages that billing companies provide is that they can help you save on your billing administration cost that includes salaries & benefits for billing staff and the investment on infrastructure need to run these functions. Often billing companies have more than one pricing models so you must check them all in detail and go for the one which provides optimal value for your ROI. Sometimes hiring a dedicated resource with a billing company at flat rate can be more beneficial then paying a percentage of your collection. So evaluate all the pricing options, check for any hidden costs for billing software, fax services, sending collection letters etc. If you do it right, you can save up to 40 percent on your monthly billing cost with improved performance of your reimbursables over the time.

Reference

If the medical billing company is new for you then you must ask for a reference. Do they understand your practice or the size of your business and speciality? Every practitioner is different and so is their medical billing process. That is why you need to see and understand whether they will be able to deliver a good job or not. Ask for testimonials and references to check if you can rely on the company’s capabilities or not.

Ask about the staff

Ultimately all the work will be done by the staff of the medical company. Ask the company about the kind of training they give to their staff. Is their staff updated about the current updates in the market?

Electronic services

Most of the medical billing services have become electronic now. Electronic process has improved the efficiency and accuracy. Ask for the software they use and what kind of payment option do they provide to the patients.

Transparency

Any part of business which includes financial transaction needs to have utter transparency. Ask them for a guaranteed transparency. The medical billing report and the process of medical billing should be shared with you on a regular basis. Ask how much involvement you will get once they get on board as a medical billing partner.

Outsourcing your medical billing to another company is a huge step. In a way you are giving too much financial control to another company. But the reason why this is successful is because the transparency and regularity they bring to a physician’s practice. So you should always research well and ask loads of questions before handing over your medical billing service to an outsourced company.

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