Outsourcing makes good business sense.
Successful medical practices manage their relationship by continual face to face interactions with a competent billing service offering customizable services.
Achievable benefits with outsourced billing:
- Free up office space
- Reduce incoming phone calls
- Turn fixed expenses into variable
- Know your marketplace
- Access solid data analytics
- Know your accounts receivables
- Have a resource at payer offices
- Be prepared for a payer audit
In the traditional fee-for-service reimbursement model, healthcare providers are paid for the amount of services performed.
Value-based care has emerged as an alternative and potential replacement for fee-for-service reimbursement based on quality rather than quantity.
The Health Care Transformation Task Force inched closer to its goal of having 75 percent of business under value-based payment models by the end of 2020.
The shift away from fee-for-service to value-based payment has been a slow, but steady journey.
Assess financial health
Stay ahead of the curve
Charting and Billing practice reevaluation
Manage the revenue cycle
Make innovation profitable
Create a shared perspective
Improve patient services
Steps to Conducting an EHR Vendor Assessment
- Identify high-priority needs.
- Identify the most needed EHR features.
- Set specific, measurable, attainable, relevant and time bound EHR goals.
- List key decisions of potential deal-breakers.
- Decide where to store the EHR data: in-office, vendor server, or web-based.
- Narrow the field:
- Solicit the EHR experience of colleagues.
- Obtain EHR evaluaton tools and resources from medical societies.
- Utilize online information about different vendors.
- Further narrow the field using various metrics comparing vendors.
- Conduct 2-5 face-to-face vendor demonstrations.
- Compare core functionalities, look and feel, and practice management features.
- Personally preview each EHR on site, and contact references.
- Prepare lessons learned questions by your practice before, during, and after implementation.
Your patient is readmitted to the hospital with cellulitis at the incisional site during the postoperative global period after a transmetatarsal amputation.
You follow the patient for multiple daily visits. No surgery performed.
The only allowable coding option available refers to an "unrelated evaluation and management (E/M) service by the same physician or other qualified health care professional during a postoperative period."
Any diagnosis associated to the amputation will not qualify, only an "unrelated" one will.
Choosing the right Electronic Health Records (EHR) for your practice can be a daunting task.
There is enough research documenting improved productivity levels and efficiency gained by EHR Software implementation.
Large physician practices may have financial flexibility to implement an EHR with bells and whistles driving up the price point.
Small practices often lack this luxury.
Diagnosis codes must be reported based on the date of service (including, when applicable, the date of discharge) on the claim and not the date the claim is prepared or received.
When desiring to indicate a distinct procedural service the physician may need to indicate a procedure or service was distinct or independent from other services performed on the same day.
This may represent a different session or patient encounter, different procedure or surgery, different site, or organ system, separate incision/excision, or separate injury (or area of injury in extensive injuries).