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Category Archives: Outsourcing

Culinary Medicine: Basics and Scope

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“The city has lost several of its grocery stores in recent years, leaving residents with few options when it comes to buying food. That’s where the relatively new discipline of culinary medicine comes in. Culinary medicine initiatives help to advance health equity by increasing access to healthy food and building awareness of the importance of nutrition.” reads an article in rapid growth media examining the health disparities in United States’s Michigan.

2018 was brimming with news of colleges and universities across the nation including a new curriculum in the field of medicine, i.e. culinary medicine to help people prepare food like a chef while thinking of the food’s nutritional value like a dietician.  

So, what exactly is culinary medicine?

It would be a mistake if you would think of going by its literal meaning as culinary medicine being a culinary art or food science. It is not merely about cooking and taking into consideration the micronutrients or macronutrients. It would also be ignorance to think of it as a branch that rejects the medical prescription.

Culinary medicine takes from both food and science and blends the art and certitude of food and science respectively to help enhance personal health and well being. When nutrition clubs with the scientific facts, such field in medicine is referred to as culinary medicine.

They say, we are what we eat, but have you ever given it enough thought that what you are eating is affecting your present health condition? This is  what culinary medicine is concerned with. It takes into consideration the actuality that the food is condition-specific and people should include different nutrition per their health condition. Culinary medicine aims to transform people’s eating behavior and help them understand that food being condition specific should be shopped for, stored and prepared in a particular manner.

What paved the way for this new clinical discipline?
  • Millennials and Gen Z are a highly aware generation who have the cognizance of this age produce severely lacking nutritional value, chemical involvement in artificially added flavors and nutrients. They only want the best for their body and are hence more inclined more towards the farms produce, local agriculture, organic food.
  • The escalating healthcare cost because of an increasing strain of diet-related health risk and diseases.
  • Increasing concern about weight management and unsuccessful attempts in managing chronic illnesses altogether.
How will it help the medical field?

To think that culinary medicine is just another clinical discipline would be a mistake since it goes way beyond physicians advising foods to patients. Culinary medicine is uncovering the lacking nutritional training given to the medical professionals in the medical schools. Physician despite being highly knowledgeable and experienced, might lack the precision to recommend diet as per the patient health condition. Culinary medicine, although fairly a new concept will help bridge this gap of knowledge and nutrition so that the physicians can dispense more precise treatment to the patient suffering from lifestyle diseases such as diabetes, obesity, hypertension and other health complications.

How will it help the patients?

This integrated healthcare field of medicine will help the patients eat right and keep their health complication under control. As mentioned before, food is person and condition-specific; hence culinary medicine will help people, healthy or suffering from an illness prepare meal to enhance their overall health and well being.

The medical community is divided on the benefits a new clinical discipline has to offer, with some arguing clinicians already advise patients to stick to a particular diet while specialty specific medical practitioners like a dietician, chiropractors are also trained to do so. Culinary medicine is here to change the way we think about our food habits and its future is filled with possibilities in improving the population’s health. What is needed to understand better this discipline is through research and results backed by evidence.

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Improve Medical Practice Management

Improve Medical Practice Management

Yes, setting up a medical practice is time and cost-extensive but that is not the end of it. How are you going to survive the health care competition without continuously working towards improving the practice management? It takes diligence and exceptional administration skills to operate a successful and efficient practice.

Take note of these strategies that will help you enhance your medical practice management as well as increase your healthcare practice’s revenue:

One of the critical aspects of enhancing your medical practice management is to improve the way your front desk operates. To improve productivity, you can start with pre-registering patients on online portals and intimate further via emails. Another cumbersome and time-consuming task is prescriptions refill, which should be automated, as in, the call should be directly connected with the concerned medical staff.

You know how they say, “it takes an army,” well so does enhance productivity and management of the medical practice. It is vital that you start with a bunch of talented, diligent healthcare staff who can streamline the practice per your requirement.

Practice productivity will be apparent if the patient flow is managed with an efficient schedule. Everybody is online, then why not leverage this to your practice’s advantages? A robust and secure scheduling system will not only affect your practice’s income but also enhance the patient inflow.

While incorporating effective strategies to increase the efficiency of your healthcare is essential and would be beneficial, a more sought-after alternative or complementary addition would be to outsource a revenue cycle management services like Medphine. Our team of billing and coding experts will make sure that all your revenue woes are carefully and profoundly resolved with our comprehensive yet efficacious approach. With Medphine by your side, you no longer have to worry about dealing with claim denials, employee training, compliances and other such vital elements that streamline medical practice management. You can trust upon Medphine’s approach in reducing your practice’s processing cost without compromising on the quality of service and cash-flow.

Why are an increasing number of medical practices opting for outsourcing revenue cycle management?

Medical practice focus should be on giving quality treatment to the patients coming to her facility, but to dispense these services, they need stable cash-flow. If medical practices only focus on being benevolent and treating patients without worrying about whether or not they would be able to continue this in the future, then they won’t survive long. Similarly being too focused on only the financial goal will deter them from their ambition, which is why investing in RCM is important. RCM professional like those at Medphine are proficient in identifying the problem areas, implementing potent techniques make the claim reimbursement as quickly as possible.

Medphine provides complete revenue cycle management services which go beyond getting the insurance money. Our team is dedicated to making your medical practice run as smoothly as possible, by continually monitoring every aspect of the revenue cycle, so that you and your healthcare staff can focus on providing the patients with the best possible treatment.

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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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Medical billing for behavioural healthcare

Medical billing for behavioural healthcare

How is mental health billing different from medical billing?

Psychiatrist unlike a general physician or any specific medical specialist serves it patients differently. While other healthcare professionals perform surgeries, a psychiatrist counsels the patients through therapy sessions. Hence, while undoubtedly insurance claim is a hassle for general health practitioner, but having to prove the time taken in the treatment to the insurance company is even more daunting for the mental health care service provider. Nature with which the patients of behavioural health problems are looked after and how these patients receive the insurance coverage is different from other healthcare services.

Why should behavioural healthcare provider choose speciality-specific medical billing and coding service provider?

Every healthcare sector has a different set of billing protocols. Instead of going for a general medical billing service provider, it would be advantageous to you if you hire a provider who has a profound knowledge of addiction and substance abuse laws and has demonstrable experience in these specific billing procedures

A speciality specific medical billing service will mitigate any hindrance to the growth and expansion of your behavioural health practice which can be intricate considering the fractional nature of services. Speciality-specific medical billing with boost productivity, patient engagement and reduces the administrative burden along with the cost of operation.

Since a speciality specific medical billing provider will have more experience sorting out the billing processes of the particular department, there is no possibility of staff-errors.

Experts who have been looking after billing and coding of behavioural health practices will help streamline and speed up the flow of revenue, while simultaneously providing analytics reports all the operations.

Behavioural health medical billing providers like Medphine provide billing and coding services that comply with the standard guidelines set by HIPAA ensuring supreme privacy from fraud and abuse.

Speciality-specific billing providers, with their expertise and proficiency, know how each second wasted in the collection, bill generation, documentation can impact the revenue cycle. They will provide integrated tools to optimise financial performance, reduce denial probability, to save more time and money.

Behavioural health service providers face a host of unique challenges that are unknown to other healthcare professionals.

It would be in your best interest if instead of trying to go about the account receivables, following up the denial claim and wasting time in billing and complex coding, you outsource a specialty-specific billing and coding services provider like Medphine. We understand how time is of the essence in heat care division and hence ensure timely adequate reimbursement so that you can give proper therapy sessions to all your patients.

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Improve denial management of your medical practice

Improve denial management of your medical practice

 

It is a task in itself to maintain the rapport of a medical practice by providing quality treatment and care to all the patients. What if amid trying to provide the best possible healthcare service, the provider is slapped with a notice of claim denial from the insurance company?

Yes, medical practices are for helping people with physical and mental distress, but every business requires money to continue operating their service smoothly. Apart from the upfront patient’s collection, claims are a significant contributory factor to a medical practice revenue cycle. But every year, a notable number of claims are denied which results in a massive financial loss for the practice. The reasons range from submitting incorrect information, filing a complaint after a considerable time has passed since the service has been provided, claiming under expired insurance coverage, etc. Hence it is imperative to have your denial management strategy aligned.

The standard ways to ensure effective denial management for maximum profit are:

Identifying the cause-
You should know what led to the denial, so that you can strategise further, accordingly. One of the most significant challenges faced by the medical practices with denial management is unable to prevent rejection of claims and the authorisation and pre-certification issues.

Other could be:
Did you file a claim after the expiration of date?

Are you claiming reimbursement for the service that is not included?

Did you not miss out on mentioning any vital information?

Do not pile up the denial claims-
Regularly monitor and review the account receivables to keep track of the requests. Piling up denials will lead to massive financial loss to the practice. Similarly, perform a periodic analysis to check the number of claims that have been denied. Correct them and duly submit them to ensure efficient workflow.

Utilize automation-
Automation helps to reduce the time wasted on extensive research of diagnostic codes and different insurance policies. The staff can use this time on verifying factors that are necessary to stay compliant.

Keep yourself and your staff updated-
Stay abreast with the latest development in medical standards, so that your claim is not rejected on the grounds of you being ignorant. Read newsletters, subscribe to essential channels.

Hold periodic training sessions-
Most of the claims get denied due to improperly and incorrectly filled forms. Educate and train your staff about the same. Train your staff to gather all the necessary information about the patients’ and their insurance coverage. Verify their eligibility and benefits. Encourage them to incorporate discipline in their request checking process, tracking denial rates, clearing out old denials to achieve better goals.

Never wait for the deadline-
File the claim for reimbursement immediately without waiting for the nearing deadline. Missing the deadline deprives you of the opportunity to get any amount back, as the money thus gone is lost forever.

Claims are a crucial part of medical practices. They involve extensive paperwork to stay compliant with the evolving insurance rules and regulations. It will be in your best interest if you consult a reputed medical billing and coding services to help devise an effective denial management strategy.

You concentrate on improving the lives of your patients and let a professional medical billing and coding company manage your account receivable and revenue cycle for you. A professional service provider will dig deep into sorting out the cause of the claim denial and provide end to end solutions for enhancing your revenue cycle with a rationalised approach.

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Insurance verification service for healthcare

Insurance verification service for healthcare

 

 

Imagine providing service on assurance that the payer is covered by insurance, but later realising they weren’t aware that their insurance has expired? Insurance verification, in every profession is imperative otherwise you might end up with an unpaid claim by the insurance company or worse, never being paid.

Keeping the nobility aside, medical practice, like every other profession runs on money. A consistent cash flow without any claim rejections is the ultimate objective of every healthcare service provider. Revenue cycle will function adequately only when there is successfully billing. Billing will be successful when there is proper health insurance verification.

It is necessary to perform a timely eligibility and benefits verification to establish the payer’s responsibility. Not doing an adequate eligibility and benefit verification check will make the doctor prone to not receiving any payment from the insurance claim.

Its imperative to determine the patient’s eligibility and benefits

Establishing whether or not the patient is eligible for the benefits of the insurance, gives healthcare provider a clear view on patient’s coverage, insurance information, benefits etc.

It also eliminates the possibility of claim denial, re-submission and categorical rejections.

Verify eligibility and benefits of the patient’s in advance

More often than not, patients are not aware about their insurance status; whether or not it has terminated or the policies have been modified, what all does it cover etc. Insurance protocols keep changing and not every person covered by the insurance would be aware of how much are the latest deductibles. Medical practices should train their in-house medical billing service or outsource one to perform a rigorous insurance verification check in advance, so that patients are well-informed on how much money they are supposed to pay, so that they can opt for payment plans accordingly and the whole billing procedure is transparent.

Better still, outsource an health insurance verification service provider.

Considering how busy the whole medical staff is in providing exceptional healthcare service to their patient’s, it would be in your best interest if you outsource a company providing health insurance verification service like Medphine. Medphine implements a straightforward approach to verify insurance cover status of the patient coming for treatment, promoting health revenue cycle by reducing denial claim rates to 40 %.

If you still want reasons for hiring a insurance verification service provider, keep reading:

The unmatched expertise of professional service provider

Claims processing and coding procedures should be performed by billing specialists and certified coders. An outsourced verification service provider will have certified experts that will ensure timely submission of error free medical bills and claims to cut down the likelihood of denial and ,maximise cash flow. They follow a consistent approach to streamline workflow. They are proficient with the changing rules and regulation of the insurance, codes, modifiers etc and will follow the right technology to ensure accurate verification.

No piled up claims and backlogs

A third party will keep a tab on the claims that are getting denied and will submit the rectified ones in time to avoid any piling up of claims. They will perform regular follow-ups for all the claims submitted during each phase, allowing medical practitioner to obtain maximum reimbursement.

Save money

Apart from proficiently manage claim denials that are stacked up escalating unnecessary financial burden, an outsourced verification service provider would also cut cost otherwise spent on maintaining the staff, technology, infrastructure, and necessary software can now be utilized in providing better healthcare service to the patients.

Save your precious hours and outsource an experienced agency to perform verification with a relatively higher accuracy and efficiency.

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How Outsourcing affects the RCM- Revenue Cycle Management

The rapid changes in the healthcare standards and its processes is amounting to a lot of stressful nights for anyone employed in the medical industry.
Due to these apparent changes, a lot of practices are even making their medical staff help out in the billing and paperwork process. While this might seem like a noble idea, it can have quite a backlash due to the inexperience of the staff in the billing procedures.

Outsourcing in World

Managing your revenue cycle lays the groundwork for every other operation involved in healthcare. Anything ranging from erroneous claims to late paperwork can deal a major blow to the whole revenue stream.
This is where outsourcing can help you. Medical practices can outsource their RCM to experts who have years of experience in dealing with medical billing. They can handle the management of all aspects of your revenue cycle so that you can devote your full attention towards providing the best medical care to your patients. Here are some reasons to convince you further:

 

Revenue

If you have an oncology specialist clinic, you won’t try to hire an orthopedic surgeon, will you? To become a successful enterprise, all of your work should be done by experts in that specific work field. Outsourcing your medical billing will save you a lot of money and time as you can cut down on all of your management expenditure. Medical Practices with outsourced RCM leads to a stress-free practice environment, increased revenue and a smooth working process. You can use this saved money for other revenue generation services like hosting promotional activities and patient engagement.

 

Workforce

Finding the perfect employee for medical billing and coding can be quite a difficult task. Due to the frequent changes, it’s very hard to find someone experienced enough to handle all manage all the process of billing cycle. Outsourcing companies have experienced billers and coders on their teams who can process all your claims without any errors, ensuring a constant revenue stream. Without an in-house billing staff, you can also save up on a lot of cost with no worries of employee health benefits, infrastructure, etc.

 

Reimbursement

According to MGMA, your healthcare practice isn’t sustainable if you have a denial rate of more than 4%. With the help of your outsourced experienced staff, there will be minimum errors in your coding, leading to a very low claims denial rate. The more claims get accepted, the more you get payment reimbursements. Proper submissions lead to improved efficiency and trouble-free system. Get paid faster – with no delays.   

 

Here at Medphine, we offer tailored services for each practice as we believe that every practice has different needs and requirements. Our process initiates in-depth review to identify your assets and liabilities, in order to provide the best services possible. Medphine is one of the premier organizations to offer total outsourcing of your management system that allows you to work stress free and achieve maximum profit.

Call us today at 732-419-2907 to know more or visit us at medphine.com now.

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