Healthcare RCM

  Covid-19 in 2020 became an unprecedented disruption to all aspects of the healthcare sector in a short period. However, the planet is now, luckily, recovering from the damage. We’re both hoping for better days ahead with the New Year and the Covid-19 vaccine. While the healthcare industry has been slow to adopt digital tools in the past, innovation is now critical to recovering from the losses suffered during the pandemic. During the pandemic, as we were all trapped in our households, digital media played a vital role in keeping the world together.  Healthcare trends  and digital solutions had a much broader impact than we might have expected. There are many ways of using digital means to overcome a crisis during these difficult times. During the pandemic, the prominence of telehealth solutions would reshape a variety of facets of our healthcare system. SIX Healthcare Digital Transformation Trends to look for in 2021 1. Major advancement in Telehealth Telehealth has bee...

  Imagine putting all your money in a bag with a hole! Most of us would wince at such indiscretion, wouldn’t we? But denials, the proverbial holes in the coffers of healthcare businesses are mostly left unmanaged. An average hospital faces a loss of around $5 million in denials every year. And surprisingly, nearly 65% of those denied claims are not resubmitted again! Why do hospitals and healthcare services choose to close their eyes to this gaping drain in their revenues? Well, studies and interviews reveal that most health organizations are deterred by the time, labor, and cost that denial management calls for! So the question that naturally follows is how hospitals can manage their denials without stretching their resources? The recourse we feel lies in a thorough and holistic approach that looks at denial management from every facet and works at it from the base to the top. We need to devise strategies that address the root causes and work at eliminating them. Here are some hel...

Crisis begets change. True to the saying, the Covid-19 crisis we face today has ushered in many changes in the US healthcare system. It has changed the way we see and it has definitely changed the way we do things. For instance, it has transformed the way we deliver healthcare. One of the positive changes that the pandemic has brought about is the acceleration of Telehealth’s foray into mainstream medicine. Telehealth is not by any means new to US healthcare. It was already touted as the fastest-growing medical care service by an AMA study conducted in 2019, pegging the growth rate at a striking rate of 53% with more than 76% of hospitals in the country offering the service. This year the pandemic is slowly yet forcefully pushing this number closer to 100. From big multispecialty hospitals to small single physician practices, every player in the healthcare business is now looking at telehealth as a viable way to continue serving the community with quality healthcare. But...

You have set up your independent medical practice and you’re slowly climbing up the first leg of growth. Then comes the big challenge – the increasing complexity of medical billing. The one question that looms large over your sky at this point is this: ‘To outsource or not to outsource?’ Before arriving at an answer let us look at some facts Nearly 80% of all medical bills have errors and in around one-fourth of these bills, the errors involved a significant amount of money. The average cost to file an initial claim is $ 6.75 while the average cost to rework a denied claim is around 25 $ In the last seven years, there has been a 70% increase in data breaches in the healthcare industry So what do these data tell us? They tell us that precision and attentiveness are absolute musts to reach a satisfactory level of efficiency in medical billing. And we know that efficiency improves when any task is handled with more specialized knowledge and expertise. Medical billing compa...

Healthcare service calls for a high degree of compassion and selflessness. But ultimately, a hospital or a doctor’s office is a business too. It has to generate enough revenues to pay the staff, maintain the infrastructure and grow. But thanks to the complexities inherent in the US healthcare system, maintaining a smooth flow of revenues is a challenge for many healthcare practices. In recent years there has been an added twist to the problems that healthcare providers face. The reimbursement model for  healthcare services  has seen a shift towards more patient responsibility. Patient copays now make up 20 % of a practice’s revenue. This shift poses a big challenge for healthcare providers because collecting from patients is more difficult than collecting from insurance companies. That is perhaps why only 60 % of patient copays make it to the practitioner’s accounts. These losses when accumulated make a big dent in the provider’s revenue. According to the American Hos...

Before we get to the reasons why  outsourcing medical billing services  is good, here are some facts to mull over An American Hospitals Association 2019 report has pegged the value of uncompensated hospital care since 2000 at more than $620 billion. A Mckinsey article has reported that out of medical bills exceeding 3000$, a startling 99 % were not paid in full. According to Bloomberg, bankruptcies in the health care sector have more than tripled in 2017. In the first 3  quarters of 2018, 8 hospitals have filed for bankruptcy and 9 hospitals have closed down.  Healthcare providers lose $300 billion a year due to failures in claims processing, payments, billing, and collection of bad debt. These facts call attention to the major problem that US healthcare providers face today – revenue erosion. A lot of factors contribute to this issue. Three major ones are the fragmented nature of the US healthcare system, the complexity of regulations and inefficiencie...

Billing in any other industry is fairly simple. A small bunch of employees or a department can handle the task. But medical billing is an altogether different story. It is a complicated process thanks to the fragmented healthcare system and the complexity of regulations. To get medical billing right you need specialized knowledge, special technology and a whole lot of effort. That’s why most healthcare providers today outsource billing to professional Medical Billing Companies. Tips for Picking The Right Medical Billing Company But again, choosing a medical billing partner is no simple feat too. There are more than 1500  medical billing companies  in the US offering services differentiated by extent, scale, quality, cost and a lot of other factors. How can you as a healthcare provider narrow down the choice to one? We have put together 12 practical tips to help you pick out the perfect medical billing partner who will care for your financial health as diligently as...

Most of us would have heard this famous line popularly attributed to Management Guru, Peter Drucker, “What gets measured, gets managed!”. This saying fits healthcare finance more snugly than it fits any other domain. Most healthcare practitioners or hospitals do not pay enough attention to the financial health of their healthcare business. And so, they do not detect deterioration or seek a cure for it until it is too late! Maybe that’s why in the past few years, bankruptcies in the healthcare sector have doubled. The only solution is for healthcare practices and hospitals to keep close tabs on their key financial metrics. Why do these Metrics Matter? As healthcare professionals, we are not strangers to numbers. Every day we rely on counts and rates to diagnose health problems in our patients and monitor their health. A patient’s critical health parameters are measured and compared against reference values to help us understand what is wrong with the patient and plan the course of...