5 Must Follow Steps for Accelerating Revenue Cycles



Revenue cycle management (RCM) is the process which includes billing services, accounts receivable management, practice management & follow up services to optimize your practice revenue. Partner with ascent business solutions for highly efficient RCM. Visit for more information about Healthcare Revenue cycle management company.


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5 Hidden Costs to Account for When Budgeting Your EHR Implementation

One of the biggest problems practice owners and provider organizations are running into when implementing EHR systems is unanticipated costs. Learn how and why to budget for this problem by reading on.

First ICD-10, Now This? Getting Your Budget Ready for EHR Implementation

As if the ICD-10 transition was not enough, many practices and providers are being strongly encouraged to also transition to electronic health records (EHRs).

Like ICD-10, EHR implementation promises strong gains in an effort to modernize medicine. For one, the government will provide incentives in the form of increased reimbursements. For another, patient care promises to become more consistent and thorough, particularly when moving from provider to provider.

Regardless of the benefits, the here-and-now of EHR implementation promises to be a challenge. Looking exclusively at the problem of hidden expenses, providers are going to have to budget extra money and time in order to cope with unexpected costs.

Because of the likelihood of this problem, the HealthIT.gov website recommends adding to your budget with emergency provisions and anticipatory funds. How much? Several years ago in 2012, the Modern Medicine Network recommended squirreling away an additional 50 percent on top of your current expected EHR implementation budget.

That number may not be precise, but providers are going to have to set aside quite a large chunk of change in order to meet budget bloat head on. Here are just some of the things they will need to account for:

EHR Software

Hardware Costs

EHR software needs something to run on, and your organization’s current systems and hardware may not be up to snuff. At the very least, you are likely to invest in a few extra workstations and an increase to your networking capabilities, including an internet bandwidth upgrade.

For many providers, a full-scale replacement of computing systems may be in order. That means new, faster computers and a full suite of networking and application hosting servers, as well as all the wiring and installation costs that come with it.

All said and done, some providers are going to be saddled with a huge bill before they can even run their Best EHR Software. Plenty of others are lucky enough to get away with minimal hardware upgrades, but you have no way of knowing which category you fall into until your software is finally running as it should be.

Estimated added baseline cost: $5,900 on average

IT Staff and Outside Support

Most vendor service contracts include some amount of system support and troubleshooting, especially during the initial installation phase. Even with this help, your organization is likely to need some IT support of their own once the training wheels are removed.

Also consider that some support services are not provided by vendors, or that the support may not be available at all hours. These factors in addition to the inevitable IT staffing upgrade that will occur during full EHR implementation can increase providers’ tech payrolls into the foreseeable future.

Estimated added baseline cost: $3,094 on average


Training the entire staff will be necessary, with separate training goals based on their role within the EHR system. Physicians alone needed two weeks of training before they were able to satisfy the Meaningful Use requirements, according to one study.

On top of that, front-house staff will need to know how to use EHR systems for things like billing and patient registration. You will also need an IT department with many staff members who know the EHR system backwards and forwards. All of these training hours add to lost productivity and overtime wages, the single-most anticipated expense when it comes to labor.

Decreased Patient Loads and Increased Staffing Needs

Every moment spent troubleshooting or learning the EHR system is a moment taken away from patient care. Once implementation is complete, these bumps are expected to smooth out, but full EHR implementation for some organizations could take one to two years.

To make up for the lost productivity, new staff may be needed just to handle the leftover administrative and patient-end responsibilities. The combination in decreased patient loads and increased labor costs is predicted to be the most variable and unpredictable for providers implementing EHR.

Network Security

With more sensitive patient data traveling through their networks, providers are going to have to invest in robust network security solutions and IT expertise so that all that data will be protected. Anyone who fails to do so and who could be found negligent could potentially face HIPAA violation fines.

Conclusion: Form a Contingency Plan, Allocate Extra Budgets, Prepare for the Worst

The purpose of outlining all of these potential costs is not to deepen your despair. Instead, you should take this information to heart and plan positively and proactively by preparing a contingency plan.

Set aside extra budgetary funds that provide for a significant cushion when unexpected costs arise. If you feel like you cannot come up with such a budget, request help from your local Regional Extension Center (REC), which is designed to provide advisory knowledge and support for EHR implementers.

Finally, develop a strategic plan that accounts for setbacks like lost productivity for two or more years into the future. Keep in mind that you may need to upgrade your systems by that point as well.

With all these elements in place, your provider organization should have a substantial safety net to prevent you from falling on your face should you stumble. Remember that everything should get smoother as adoption increases and systems are refined. Many providers and government organizations even expect for EHRs to provide some ROI in the not-too-distant-future. So spend now and be grateful later that you did.

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Why and how must you immediately begin preparations for the ICD-9 to ICD-10 conversion?

Last year, the much debated ICD-9 to ICD-10 conversion deadline was delayed another year and set to October 1, 2015. However, numerous provider groups and stakeholders have been pushing for another delay, which would be the third in total, stating that the conversion will result in unmanageable financial pressure on the already challenged practices.

This article summarizes how ICD-10 differs from ICD-9, what the Congress had to say about the deadline, and in what way must you prepare for the conversion.

CureMD ICD-9 Into ICD-10

The new codes

The first question that most providers have is about the specific changes in the code sets. Here’s a summary:

* 68,000 diagnosis codes as opposed to just 13,000 in ICD-9

* A maximum 7 alphanumeric characters per code as opposed to 3-5 in ICD-9

* Very specific, more complex, and more flexible codes

* Lateral codes as well (different codes for right and left)

* 87,000 procedure codes as opposed to 3,000 in ICD-9

* 7 alphanumeric procedure code characters in contrast to 3-4 numbers in ICD-9

* With detailed methodology descriptions, procedure approach mechanisms, more detail, and flexibility

The Meeting

Last week, the Energy and Commerce Committee’s Subcommittee on Health held a public forum to discuss the ICD-10 deadline. The meeting panel comprised of experts and stakeholders from across the industry, and included doctors and EHR vendors.

The Response

Despite opposition from a few stakeholders who held the view that small practices wouldn’t be able to manage the new codes, the majority voted in support of the October 1 deadline.

The way forward

The response by the congress via the meeting is clearly tilted towards ensuring that the deadline holds. If you were anticipating a delay, and haven’t yet started working on the conversion; you can still manage. Here’s how:

  1. Contact your EMR and Practice Management vendor and enquire your system’s readiness for the conversion. Ensure that their software possesses the necessary updates and ICD-9 to ICD-10 conversion mapping tools to make certain that your system is ready for, and will facilitate the conversion.
  2. In the case that your vendor is not ready, immediately begin looking for a new system. This is because from October 1, your claims will not be processed on ICD-9 codes.
  3. Delegate an ICD-10 expert (from you staff, or hire a professional) to train your staff, and to devise and execute plan for the conversion in line with your practice workflows.
  4. Consider Outsourcing Medical Billing if your ICD-10 expert (and yourself) feel that your current staff will not be able to manage claims processing on the new code set.
  5. Get in touch with payers and clearinghouses to determine their readiness.

The target for completing these steps (apart from staff training which could be ongoing) should ideally be March 15.

  1. Next, you must begin internal testing of the new codes between March and April, to check how well your staff will manage the new codes. Ideally you should be done by this till the end of June at maximum; and make the necessary workflow adjustments to fix errors in which the process proceeds.
  2. After internal testing in June, you need to begin external testing with clearinghouses and payers to determine how well your test claims (with ICD-10 codes) will do once out of your practice.

It is imperative to identify and correct any slow or disruptive processes in every stage of your conversion process. Doing so will enhance the efficiency of your practice, and help make certain that you are ready and equipped for the ICD-9 to ICD-10 conversion by October 1.


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5 Ways Affordable Care Act Affects Reimbursement

The Affordable Care Act (ACA) enters the mature phase of its implementation, which is going to impact physician revenue in different ways – some favorable, others not much. Therefore, it is time for physicians to prepare for challenges ahead.  Here are 5 ways that the ACA will impact your income in the years to come.

Extra services covered in insurance

According to the ACA, more services will be covered by insurances that were not covered previously. This step has gained immense support because “patients who have insurance and access to primary care have better health outcomes,” said Jeffrey Cain, MD, President of the American Academy of Family Physicians (AAFP).

Now patients won’t have to pay from their pockets for medical services like blood pressure checkup, mammography, childhood and autism screenings, and contraception.

CureMD- Affordable Care Act

Increase in patient volume

More and more Americans will be insured in the years ahead and looking for primary and eventually specialty care. This means primary care practitioners can now enroll new patients bringing more money. However, most of these patients will come from low-income families, who will be insured on subsidized rates and pay out of pocket.

Increase in out-of-pocket payment patients

Practitioners will be forced to rethink their patient payment policies because of changes in the ACA that will increase the trend of out-of-pocket charges. Kaiser Family Foundation found out in a survey that 72% of employees had a deductible for single coverage, which was 20% more from 2006. It further reported that annual deductible for 72% of employees was $1,097 in 2012, which was 88% higher since 2006.

Rise in penalties will impact reimbursements

CMS incentive programs, Meaningful Use and Physician Quality Reporting System (PQRS), will reduce or stop payments from 2015. Meanwhile, physicians who haven’t complied with the programs will bear financial penalties.

From fee-for-service to pay-for-performance model

Accountable Care Organizations (ACOs) are a breath of fresh air for the physicians trying to decrease cost without compromising quality. This new payment model, pay-for-performance, was introduced to maximize the benefits for patients to improve quality of care while reducing costs. However, as the Model matures, physicians will be required to report their performance to CMS in order to participate in the shared savings.

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Telemedicine: Paving Way for Cost Effective Medical Services for Primary Care

According to an article published in the Herald Journal, the history of telemedicine can be traced back to the 1920s, when patients on ships at sea would connect with physicians on shore through radios. With innovation in technology, telemedicine services were provided through interactive television in the 1970s and via video conferencing in the age of digital technology.

Telemedicine: Paving Way for Cost Effective Medical Services for Primary Care

However, the evolution of telemedicine has been curtailed in every period of time – lack of technology in the early 20th century to government regulations in the 21st century – which has added to the skepticism of physicians.

Barriers to adopt Telemedicine healthcare

Under the government’s Affordable Care Act, focus has shifted to cost-effective, quality patient care that has given rise to different approaches of healthcare delivery such as Accountable Care Organizations and telemedicine. However, there are certain barriers to adopting telemedicine at a practice:

1.      Barrier to establish patient-physician relationship

This is the major concern for primary care and specialist physicians, who haven’t introduced telemedicine at their practices. Initially, they hesitate that the use of telemedicine will hinder them from developing effective patient-physician relationship, which will affect outcomes.

2.      Barrier to prevalent practice workflow

Another barrier that most physicians face is disruption to prevailing workflows. Physicians have adapted to changes in the health IT industry by implementing EHRs technology at their practices and designing new workflows accordingly.

However, they are hesitant to adopt telehealth, fearing that it will not be possible to incorporate this approach with the current workflow that is suitable for the new technology they have spent heavily on.

3.      Barrier to medical practice beyond state borders

State and federal laws regarding physicians’ license and reimbursement procedures create a barrier to telemedicine adoption. According to the law, physicians should be licensed to provide medical services in the state they have physical presence in and where they provide telehealth services.

Moreover, changes to reimbursements – shift from value to volume – make it harder for practices to collect from patients via telemedicine.

Benefits of Telehealth services

Despite an air of skepticism among providers, telemedicine is growing by leaps and bounds. Medical Economics, quoting statistics from an IMS research, said over 300,000 patients were monitored via telehealth services for various health problems including cardiac, mental health and diabetes in 2012. The report further said that the number is expected to increase to 1.8 million by 2017.

Assisting home care patients

Telemedicine has made a difference in lives of home care patients by providing telehealth services. Its effectiveness can be measured from the success of a healthcare program introduced by the Veterans Health Administration (VHA) Department that aimed to provide telehealth services to home care patients with chronic diseases.

The services were provided via vital sign monitors, videophones, digital cameras – specifically for wounded patients and those having skin-related issues. Within four years of starting the program, 30,000 patients enrolled to receive telehealth services bringing down hospital visits by 19% which helped in saving costs.

Assisting patients in rural areas

Telemedicine has been particularly helpful in providing efficient and quality health service to patients living in rural and remote areas. Rural primary care physicians have used telehealth approach to facilitate their practice and patients by:

  • Providing quality healthcare within the community
  • Saving cost and time on travelling to city
  • Making medical care available round the clock
  • Providing emergency care to patient prior to transporting them to hospital
  • Making initial diagnosis prior to specialist consultation
  • Consulting with specialist

Assisting primary care physicians

Primary care practices have faced setback because of increase in specialist practices and changes in the health IT sector. According to a study, Primary Care: Current Problems and Proposed Solutions, a shortage of over 40,000 primary care physicians is expected by 2025.

Telemedicine has played a role in primary care health as it has proven to be a successful approach to provide cost and time effective healthcare to patients, resulting in patient retention.

  • Primary physicians can team up with specialists to provide healthcare
  • Facilitate hospitals in providing post-surgery general medical care according to specialist instructions
  • Providing cost effective care in nursing homes
  • Giving privacy to patients suffering from diseases that are still stigmatized in closed communities, like HIV and mental health issues

 Solutions to Barriers for Telehealth

Dr. Adam Darkins, chief consultant for telehealth services at the U.S. Department of Veteran Affairs (VA) has emphasized on the importance of relationship between patients and their physicians for telemedicine system to function effectively.

Dr. Jason Mitchell, director of AAFP’s Center for Health IT clarified that telemedicine is not different from regular medicine practice. He explained that only difference is the mode of interaction between the doctor and the patient.

However, the government needs to make certain provisions in order to remove barriers that hinder success of telemedicine.

  • Flexibility in practice license for telehealth physicians: Telemedicine providers should be given relaxation to practice medicine in states other than their own. This way government can cover the shortage of primary care physicians and facilitate them to recruit patients to meet their costs.
  • Modify reimbursement policies: With changes in insurance policies, patient payments have become a major part of collections. This will create further problems for practices to collect payments from patients who have received consultation via telemedicine.

Changes under the Affordable Care Act are all about providing cost effective, quality healthcare services to patients that can be achieved through telemedicine system. This system is particularly beneficial for small to medium practices that can provide services to more patients, while saving time and money.

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