Why is the Trend of Outsourcing Medical Billing Services Increasing by the Day?

In any organization, the finance department is of prime importance as it involves revenues. However, in this race of survival of the fittest, leading organizations are so busy in their core business concerns that they are not left with any time to look after their revenue cycle. In today’s world, as the service industry is growing more than any other industry, companies are more interested in satisfying their customers. However, it needs to be realized that if revenues are not managed properly, businesses won’t be having enough funds to continue their operations at full capacity. Same is the scenario in the health industry where physicians are fully occupied with their routine work that it becomes extremely difficult to maintain revenue cycle in a regular manner.

Therefore, in order to channelize the revenue cycle, care providers have started outsourcing their Medical Billing Service to external billing specialist companies.  Revenue cycle management is an intricate process that involves the verification of insurance eligibility, medical coding, Medical Billing, claims denial management, and ensuring timely inflows. In order to gain most from it, specialists are required to execute this complex process. The basic aim of efficient revenue cycle management is to waste as little time as possible and maximize practice revenues.

Business Process Outsourcing (BPO) is turning out to be a leading management fashion. Of course, the increasing popularity of outsourcing Medical Billing is linked to innumerable advantages it holds. By outsourcing billing to an external partner, healthcare providers enjoy streamlined revenue cycle, specialist services, low costs, reduced hassle, and faster revenue collection. In addition to this, as compared to in-house billing, there are low infrastructure costs, employee costs and lesser overheads.

Due to the aforementioned advantages, the trend of outsourcing Medical Billing Service is expected to increase in the future. However, before outsourcing such an important department, healthcare providers must check the skills and knowledge of the employees of that billing company.


Patient Portal – The Vendors Need it too

While providers and patients are considered to be the major beneficiaries of the health IT applications such as Electronic Medical Records (EMR) and patient portal, today, even the product vendors are reaping extravagant profits through them. Although the existence of more than 700 vendors in the market has made the industry quite competitive, not every vendors enjoys the same position as the established vendors do. This case is quite evident when it comes to patient portals, especially.

Many health IT consultants think that EMRs were sufficient to help vendors sustain the existing market share, the ever increasing pressure of competition requires new developments. Although patient engagement and secure patient-physician interaction the major reason behind introducing patient portals, vendors also believe that this could help them attract more clients and make a mark in the market. Interestingly, only a few established vendors are making patient portals and various other applications. This is what gives them an edge over a lot of competitors.

“To keep themselves in the market, vendors should always keep on experimenting with their product and also come up with new ideas that would help them sustain the competition. With such an intense competition, vendors should not risk their position by merely relying on their conventional products”, says a North Dakota based health IT consultant.

One cannot even disagree that patient portals have come a long way from merely being a platform facilitate communication. Established vendors have incorporated various features that allow patients to not only interact with their physicians whenever needed but also perform several administrative tasks without having to visit the physician in person. This means reduced costs associated with making redundant telephonic calls and spending money on fares.

Considering that time is of essence, the finest patient portals allow patients to schedule their appointments online and keep a follow up by making a few clicks. Patients are at complete liberty to access their health records online and even download them if needed. Imagine the ease of staying connected within the care continuum through a simple internet connection. Where patients and physicians are making the most of patient portals, the increasing rate of implementation is definitely helping vendors make profits too.


EMR Interoperability – An in-depth Analysis

Even since the introduction of EMR the health IT industry has been making considerable changes to the technology. With each passing day, we witness a new feature or a systematic change made within EMR applications, such as the introduction of Cloud EMRs. One can identify a plethora of advantages that cloud EMRs have brought to the healthcare system. No doubt, EMR vendors have taken and are still taking the increasing competition seriously. It did not take them much time to realize that they key to capture market share is to meet the demands of healthcare professionals.

Although healthcare providers have their own concerns related to the usability of the EMR solution, the government’s meaningful use requirement did not back out from increasing the physicians’ demands either. It is the issue of EMR interoperability that I am talking about. Being part of the health IT industry, today, almost everyone is aware of the significance that interoperability has attached to it. Physicians who have been implementing EMRs for a long time now, have started taking the matter of EMR interoperability seriously. After all, interoperability is considered to change the dynamics of the healthcare industry. Imagine the ease with which health information would be easily exchanged with healthcare providers both within and outside single premises. Definitely, the extent of care coordination is likely to augment.

“Although vendors are responsible for keeping their EMRs updated, physicians should not sit back and risk their meaningful use financial incentive funds. It is high time when physicians start making the vendors realize the importance of meeting their demands and requirements. And this applies to both the existing and potential clients. I am sure vendors would not want to take the matter easily as well”, says a New Jersey based health IT consultant.

While is it not absurd to believe that it is the vendor’s responsibility to ensure that their product accommodates interoperability, physicians and healthcare institutions should not sit back without raising their mounting concern in front of the vendors. The rationale is simple; where complying with the meaningful use objectives would help physicians get their hands on thousands of dollars, straying away would not only lead to losing the incentive funds but also result in financial penalties – coming in terms of reduced reimbursements.

As covered in a leading health IT related magazine, emphasizing on the importance of EMR interoperability, Farzad Mostashari, MD of the ONC, said that physicians should report to the ONC if their vendors fail to comply with the interoperability issues, and their issue would be paid due importance.

After introducing cloud EMR technology, vendors now try to innovate the solution with every passing day. Where the issue of EMR interoperability is of vital importance for physicians, it is surely an attention paying issue for EMR vendors too.


EMR – What’s the race all about?

One of the most interesting things about health IT applications, especially Electronic Medical Records (EMR) is that ever since its inception there seems to be an upward trend in the product demand. Overtime healthcare providers have realized the potential advantages that EMR technology has provided and are likely to provide to the healthcare industry. Every now and then you would come across physicians discussing specialty focused EMRs, free EMR, and especially certified EMR.

More interestingly, given this increasing popularity of the certified EMRs, the product vendors have started experiencing cut throat competition. No wonder why over the past few years, health IT has been considered to be one of the most rapidly growing industry across the US. The availability of more than 700 vendors, intensively trying to capture the market share, is clear support for the aforementioned statement. While there are thousands of reasons behind the increasing competition, the government’s financial incentive program could be attributed as one of the vital ones.

Being part of the health IT industry, we are all aware that the government requires meaningful use of certified EMR on part of physicians to consider them eligible for the program. No doubt, this is one of the essential criteria to qualify for the incentive funds. Realizing that certification was becoming a crucial requirement for physicians, be it the one who charged a monthly subscription fee for its EMR or provided free EMR, the vendors made sure that their software fulfilled the certification criterion. The logic was simple; keeping pace with the industry requirements would help them influence the client’s choice.

“Be it any industry, competition amongst the vendors can never end. In fact, new regulations and opportunities are likely to increase the existing competition. This is what is happening in the EMR industry. While the existing renowned vendors are trying their best to retain their clientele and attract more potential clients, novice vendors are enthusiastically trying to keep up with the pace”, says a San Francisco based health IT consultant.

It would not be absurd to say that besides helping physicians with clinical procedures, EMRs are also becoming a marketing tool for the vendors. The reason is, if the EMR conforms to a physician’s requirements, even if it’s not a free EMR, the physician is likely to refer it to another colleague – eventually creating a chain of references. Of course, at the end of the day, it is the vendors whose product is being promoted. However, such a situation increases the burden on the vendor to maintain the reputation in the market.

Read more: Choosing an EMR Vendor


Practice Management Software – A New Office Manager

In the healthcare industry, increased cost associated with the operations of medical practice is one of the issues that one would possibly hear physicians, especially the solo providers, whining about. Every now and then you would come across healthcare professionals complaining about the very fact that efficient management of both the administrative and financial operations is, but a delayed, result of enormous monetary costs. Hiring additional dedicated resources to control the administrative and financial side of the practice is one of the reasons behind the increasing operational costs. Fortunately, health IT has a remedy to this problem as well.  Applications like practice management are available to help physicians streamline the business operations on their own,  without having them spend hefty amount of money.

“Why do physicians even have to be spendthrift when they have practice management available to them? Today, established vendors even provide all-in-one, affordable solutions that could help physicians address both their clinical as well as administrative needs by merely paying a minimal monthly subscription fee”, says a San Francisco based health IT consultant.

Certainly, I tend to agree with the aforementioned statement. With practice management software in place physicians can perform all the non-clinical tasks by themselves. Practice management helps them optimize all the business workflows within seconds – thereby saving valuable time and money. From scheduling appointments to noting patient demographics to sending electronic messages, the built-in practice management modules help physicians streamline all these administrative tasks. The software also ensures that there exists seamless workflow transition between the front and back office so that no barriers hamper the billing operations once the clinical actions are completed.

Furthermore, cloud based practice management software has also helped in curbing the costs associated with traditional hosted servers. This means that after spending an affordable amount on implementing practice management, physicians do not have to waste more money on software upgrades and maintenance.

Considering the financial slump and appalling conditions of the economy, physicians cannot afford to spend a good deal of money on first hiring additional resources and then training them to manage the business operations of the practice. Instead they could simply implement practice management software and eliminate the need of an office manager. While adversaries would proclaim that this might end up hampering physicians’ productivity – making them less attentive towards their core responsibilities, the advocates would not back out on supporting practice management software and helping physicians realize the potential benefits this technology can bring to them.

Practice Management Software – What Physicians are Missing Out on?

Although the availability of internet and media has played a vital role in creating the awareness about health IT applications like Electronic Medical Records (EMR) and Practice Management. However, some physicians even today seem to have limited or no knowledge about such solutions. While one can expect physicians being familiar with EMRs, generalizing the fact about practice management software would not be appropriate.

“Although the technology has been out there for quite some time now, not every physician is fully knowledgeable about practice management software. There are various reasons to it. Nevertheless, the increasing trend of practice management adoption illustrates that physicians are taking the matter seriously”, says a New York based health IT consultant.

Increasing number of patient visits is obviously a sign of augmenting profitability for a practice. However, this is only possible if the productivity and efficiency of the physician is not questioned. Practice management helps physicians address the aforementioned issues by automating the administrative and financial workflows of the practice. Physicians who once spent a lot of time staying engulfed in huge piles of paper, can now do it all with just a few clicks. Some physicians fail to understand that the time they spend in managing paper records and getting into the hassle of billing efficiencies could be easily saved by implementing practice management. The time saved could then be used to ensure better patient engagement and better care quality. Besides various other advantages, fewer patient complaints and increasing profitability would surely be the two most evident benefits.

Since we’re on the subject of billing issues, it reminds me that one of the major problems for physicians is never ending account receivables. Since they are not running charities, being paid for the services provided and that too in a timely manner is obviously going to be a preference. Practice management software helps physicians streamline the billing operations in a jiffy. It also helps physicians recover the outstanding receivables, which may have occurred because of human errors in real time.

One of the plausible reasons why some physicians do not take the matter seriously is the misconception that practice management software requires one to be equipped with extensive IT related knowledge. However, renowned EMR vendors understand that IT is not the area of expertise for physicians. This is why, while offering practice management software, they keep usability their top priority; not to forget, affordability too.


EMR – The word on the Street – Part 2

Continuing from where I left off 3 weeks ago, EMR – The Word on Street – Part 1, most patients tend to have very unique perspectives about the EMR technology. Still not accustomed to the change like most physicians, patients are more intrigued and fascinated by the drift towards automated healthcare. While I have not had the chance to reconnect with the group, I had not quite finished the account of our detailed discussion on health IT and the wondrous world of electronic medical records.

I was able to establish that the patients in the group did not have any inhibitions towards the electronic medical records technology. Even when invoking the subject of privacy and health information exchange, most of the group members felt secure, citing that they ‘trusted their doctors’. Despite being an ‘awww’ moment, I was surprised at this response. One member quoted, “If my doctor is using an EMR, I expect he has gone through all the hurdles to make sure that my information is safe and secure. They are professionals and they know how to do their job.” That statement summaries what most patient feel about health IT adoption, instead of being personally concerned about the security of their health data, patients expect physicians to play that role for them, as professionals.

While providers plan for such risks and unauthorized disclosures, electronic medical records change the job description significantly. Digitized data is more susceptible to theft. Not only is data exposed in its physical environment but also vulnerable to cyber theft. However, the problem is that most providers tend to rely on basic firewalls and commercial encryption software available at economical rates, while others simply leave the security up to their hosting parties and EMR vendor. Given the amount of recent breaches, such methods are no longer acceptable. Ensuring patient safety and maintaining confidentiality should be one of the top priorities for physicians. With health information exchange (HIE) in sight, physicians should look to train their staff to work within such an environment whilst planning for contingencies.

However, despite their trust in provider professionalism, the group did not take lightly to the possibility of physicians selling their patient’s personal health information to disease control bodies, etc. even when de-identified. I had to assure one of the group members that it would be a HIPAA violation and against the ‘rules’ to sell patient information without prior consent. One patient joked about reading the fine print of every medical document from  henceforth.