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#Medical Billing Services in NewYork
neomdincblog · 2 years
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NEO MD - ICD CODING SERVICES
Is your practice facing denials because of incorrect deployment of ICD Codes? Or your current staff is unable to precisely interpret ICD Codes for rendered services?  Outsource your practice coding Services to NEO MD CPC Certified Coders and enjoy the on-time reimbursement by reducing the denials ratio.
Get us at! ([email protected]) or (929) 502-3636). https://neomdinc.com/
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credensemb · 1 year
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Credence Medical Billing Company brings you skilled manpower to provide the most comprehensive medical billing services for healthcare practices. We assist healthcare facilities to improve their bottom line while ensuring better patient care outcomes. We have a skilled team of billers and coders we provide top-quality medical billing for all our clients.
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nycannabistimes · 2 years
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#Repost @m4mmunited ・・・ We predicted this would come several years ago. Thank you #newyork for treating cannabis like the medicine that it is. Welcome to the future of cannabis. Repost from @thenewyorkcannabistimes • @ssenv2022 ・・・ FYI, link in story 💨💨✌️. New York lawmakers have approved a bill that would require public health insurance providers in the state to include medical marijuana as a covered prescription drug and authorize private insurers to do the same. The Assembly Health Committee passed the legislation from Majority Leader Crystal Peoples-Stokes (D) in an 18-7 vote on Tuesday. It now heads to the Ways & Means Committee before potentially advancing to the floor. The measure would amend state statute to define cannabis as a “prescription drug,” “covered drug” or “health care service” for health insurance purposes. Medical marijuana would need to be covered by public insurance entities “regardless of federal financial participation” in their services. State Medicaid, Child Health Plus, workers compensation and EPIC programs would be required to treat cannabis from certified dispensaries the same as other conventional pharmaceuticals for the purposes of coverage. Private health insurers, on the other hand, wouldn’t be forced to provide coverage for medical marijuana, but the bill clarifies that they can if they choose to. #newyork #ny #nyc #legislation (at Martina's Resort & Event Center) https://www.instagram.com/p/CqIaAPJsmi0/?igshid=NGJjMDIxMWI=
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jennyvergeese · 4 years
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Best Medical Billing Service Providers
Are you spending much time between billing your patient and giving him the best healthcare service? If so, then you should search for the Medical Billing Service Provider, that knows how to use the decoders and modifiers and can do all the administrative and financial work for you. So, you can focus more on providing the best healthcare services to your society.
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For all the practitioners and healthcare providers, here are some of the top medical billing service providers you can ever find.
●      24/7 Medical Billing Services - A HIPAA certified multi-specialty expertise in medical billing service providers. From ensuring a high level of data security to transparency in procedure and charges. 24/7 Medical Billing Services offer services that smoothly and efficiently runs the office operation from patient appointments to account receivable follow-ups. As per its customers feedback, around 50% operation cost is deflated and 15% revenue is inflated. It has the best coders and modifiers and is also most suitable for insurance credentialing.
●      AdvancedMD - Software that unites the business and clinical aspect of the company. It enables three different aspects of the work i.e. health records, patient management and practice management to be maintained in order automatically. They have the best EHR software’s to let you have access to all its patients' healthcare information. AdvancedMD software runs on the MAC and Windows Operating System in Desktop and iOS and Android Mobile Phone.
●      CureMD - It is an all-in-one solution for the healthcare providers. In usage of the cloud technology, it integrates and disperse the information among multiple platforms. CureMD streamline the business operation in line with the ensured industry standard and practices. In a highly competitive scenario today, it makes sure to be ahead in terms of revenue and services with its flexible approach.
●      Kareo - A web-based medical billing service provider across the United States. More suitable for small establishments in scheduling patients to make payments to customized records. It has an additional built-in messaging feature to let you reach billers, patients and your employees whenever you want. It is an ICD-10 Medical Compliant Solution software that is used in Chiropractic, Pediatrics and many more medical specialties.
●      NueMD - It offers cloud-based software’s for all medical practitioners. Apart from the practice management to the electronic health recording, it also consists of additional features that made it to the top 5 medical billing service providers. Credit-card processing and one-click away paper claim. You can also opt for a monthly subscription to start with.
Now you have the best medical billing service providers in front of you to choose from. Choose wisely, otherwise your bottom line will get affected.
 About 24/7 Medical Billing Services
24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%.
Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.
 Media Contact:
Hari Sudan, Media Relations,
24/7 Medical Billing Services,
16192 Coastal Hwy,
Lewes, DE – 19958
Tel: + 1 -888-502-0537
Website – www.247medicalbillingservices.com
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#1yrago New York hospitals illegally billed rape survivors for their rape kits, then sent debt-collectors after them
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New York State Attorney General Barbara Underwood has concluded that seven New York hospitals illegally billed rape survivors for their rape kits, at least 200 times, for sums ranging from $46 to $3,000, and then sent collections agents after survivors who could not pay.
New York law requires hospitals to bill the state's Office of Victim Services for rape kits; in addition to ensuring that rape kits are available regardless of ability to pay, the rule clears an impediment to reporting rape: women who bill their insurance for rape kits may fear stigma from their employers or families.
The seven hospitals did not comply with the law, nor did they inform the survivors of their rights -- another legal obligation.
The hospitals involved are Brookdale University Hospital Medical Center, Columbia University, Montefiore Nyack Hospital, NewYork-Presbyterian Brooklyn Methodist Hospital, New York-Presbyterian Columbia University Irving Medical Center, Richmond University Medical Center, and St. Barnabas Hospital. The hospitals have not admitted culpability, but have agreed to refund the rape survivors and establish policies to ensure future compliance.
In case you were wondering, there is another way to address this: universal, free health care, AKA Medicare for All. Because hospitals you don't have to pay to use don't have billing departments, don't contract with debt collectors, and don't have to deal with private insurers.
https://boingboing.net/2018/11/30/insult-to-injury.html
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chloeharper2187 · 3 years
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Top 5 Challenges Every Medical Practice Goes Through
Technology has moved its sides faster than we even thought. These technologies are creating a serious impact on our lives.
Since the healthcare industry adopted new technologies in the early stages, they came with both advantages and disadvantages. Technology connected the healthcare practices in every possible way, say, emotionally, mentally, physically, and financially.
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The disadvantages brought challenges for the healthcare industry and we are trying to highlight the top 5 sectors in the industry with burning challenges today.
1. Staffing
Many industries predicted a shortage of doctors and medical staff by approximately 100,000 by 2030.
Recruiting capable staff members is something important but what more important is retaining them. To discover candidates that are the best fit for your practice, fulfil expectations more smoothly, match the job description, be available to references from internal staff, get input from existing staff, and respect your culture.
So staffing is one of the most frustrating challenges faced by the medical industry.
2. Software costs
Software is a major part of technologies. Even the top software applications are changing a lot. Most of the software now come with an advanced Appointment Management System, Laboratory Information Management System, and Patient Administration System that are powered by advanced technologies like AI and machine learning. The increasing software costs are another challenge faced by medical practices today!
3. Payment collections
Medical practices are trying to be more proactive while collecting patient payments.
Timely payment collection can be achieved by informing patients about the policies and processes in time. Payment plan options can also help in receiving timely payments.
Accurate medical coding and documentation are two main factors that cause a challenge in payment collections.
4. Insurance follow-ups
The cost disaster in medical services isn’t new. Numerous partners play a vital part in deciding the cost of medical services, going from medical device manufacturers to clinical medication production companies and payers to insurance policy companies.
Proactively checking with insurance agencies for co-pays and deductibles before the patient visits your facility one of the best practices to bring ease to patient pay collections.
5. Ethical dilemmas
Medical practices also must confront ethical challenges on the field today, as they deal with life-and-death situations, sometimes they can be pulled in different directions.
For example, how can a practice balance patient need with their ability to pay? Or decide on expensive end-of-life treatment that only delays the inevitable?
Following all the guidelines from Government authorities along with central & local ones can be hectic and thus it is another challenge faced by medical practices today.
Now some good news.
Although so many challenges are taking a toll on medical practices today, many better solutions are also arising to let these practices focus more on their work rather than these challenges.
Medical practices need to consider these challenges that arise with new technology and change the processes. To overcome these challenges in medical care, it is important they map the requirements and preferences of their clients and based on that make a concrete plan.
24/7 Medical Billing Services can help you find your ideal practice process across the entire United States. CONTACT our professional team of experts to get started.
 About 24/7 Medical Billing Services:
 We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses. Contact:  24/7 Medical Billing Services Tel: +1 888-502-0537 Email: [email protected]
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burningpainterface · 3 years
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NewYork Home Health Care Services
New York home health care services are a great way for you to provide for the needs of your elderly family member. These providers are available around the clock to help you and your loved one get the medical care you need. Many of these services are free of charge, and the services are available for anyone in need of assistance. Using the A Place for Mom's home health care service directory, you'll be able to easily identify the best in-home health care service for your loved one.
The best home care service in New York is the one that assesses the specific needs of your loved one and matches them with a caregiver. These professionals can provide a single caregiver or a team of caregivers. Additionally, they are supervised and offer back-up services if necessary. The goal of these services is to keep your loved one comfortable and safe while in the comfort of their own home. There is no reason to sacrifice your quality of life or the dignity of your family member.
There are several different types of home health care in New York. Often, Medicaid will provide the service, which may be difficult to navigate for a consumer who is unfamiliar with the process. There are many different types of providers involved in the home health care process and it's easy to get confused. To help you navigate the home healthcare process, consider the following tips. You'll be glad you found this information.
Alliance Homecare is a home care agency based in Bronx, NY. Their team of compassionate caregivers provide hourly and live-in care. Depending on the level of support needed, they may provide one caregiver or a team of caregivers. In addition, they offer back-up services and can even offer free in-home assessments. There are many benefits to hiring an agency that provides home care.
Alliance Homecare is a renowned provider of NewYork home health care services. The agency is certified by the Joint Commission to provide high-quality care for seniors. Its caregivers will always provide hands-on care without compromising their clients' dignity. The agency offers affordable and reliable home health care services for all ages and ethnic groups. This is a great way to protect your loved one's dignity.
Select Care is another NewYork home health care service provider. They have been in the community for over 30 years, and pride themselves on providing exceptional personal care. As a matter of fact, the company provides complementary health assessments, monthly checkups by registered nurses, and help with insurance billing. These companies have many years of experience in serving senior citizens and their families, and they're committed to excellence. dispozitie
Home health care in NewYork can be provided by a professional. OnCallCare is one of the top home health care service providers in NewYork. They offer a wide range of services. The agency's staff is licensed and has trained caregivers that can provide individualized care. The agency's team aims to provide support to clients without compromising their dignity. This is one of the reasons why the company has a reputation for excellence in NewYork home health care.
As an independent agency, we strive to provide the best care possible for our clients. We believe in delivering quality service and providing the highest level of customer satisfaction. By partnering with the best home health care provider in NYC, we ensure the safety and well-being of our clients. This is our number one priority. When we are evaluating the needs of our clients, we also consider the type of care required. Our NewYork home health care services can vary from one person to the next, depending on the needs of our clients.
A good home health care agency will assess the needs of your loved one and match them with the right kind of caregiver for their unique situation. Whether you need a single caregiver or more, a home health care agency will provide a personal caregiver. And when you have a family member who needs a nanny, they will be able to help you with the day-to-day needs of your loved one.
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gordonwilliamsweb · 3 years
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Covid Testing Has Turned Into a Financial Windfall for Hospitals and Other Providers
Pamela Valfer needed multiple covid tests after repeatedly visiting the hospital last fall to see her mother, who was being treated for cancer. Beds there were filling with covid patients. Valfer heard the tests would be free.
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This story also ran on Fortune. It can be republished for free.
So, she was surprised when the testing company billed her insurer $250 for each swab. She feared she might receive a bill herself. And that amount is toward the low end of what some hospitals and doctors have collected.
Hospitals are charging up to $650 for a simple, molecular covid test that costs $50 or less to run, according to Medicare claims analyzed for KHN by Hospital Pricing Specialists (HPS). Charges by large health systems range from $20 to $1,419 per test, a new national survey by KFF shows. And some free-standing emergency rooms are charging more than $1,000 per test.
Authorities were saying “get tested, no one’s going to be charged, and it turns out that’s not true,” said Valfer, a professor of visual arts who lives in Pasadena, California. “Now on the back end it’s being passed onto the consumer” through high charges to insurers, she said. The insurance company passes on its higher costs to consumers in higher premiums.
As the pandemic enters its second year, no procedure has been more frequent than tests for the virus causing it. Gargantuan volume — 400 million tests and counting, for one type — combined with loose rules on prices have made the service a bonanza for hospitals and clinics, new data shows.
Lab companies have been booking record profits by charging $100 per test. Even in-network prices negotiated and paid by insurance companies often run much more than that and, according to one measure, have been rising on average in recent months.
Insurers and other payers “have no bargaining power in this game” because there is no price cap in some situations, said Ge Bai, an associate professor at Johns Hopkins Bloomberg School of Public Health who has studied test economics. When charges run far beyond the cost of the tests “it’s predatory,” she said. “It’s price gouging.”
The data shows that covid tests continue to generate high charges from hospitals and clinics despite alarms raised by insurers, anecdotal reports of high prices and pushback from state regulators.
The listed charge for a basic PCR covid test at Cedars-Sinai Medical Center in Los Angeles is $480. NewYork-Presbyterian Hospital lists $440 as the gross charge as well as the cash price. Those amounts are far above the $159 national average for the diagnostic test, which predominated during the first year of the pandemic, at more than 3,000 hospitals checked by HPS.
<![CDATA[ window.addEventListener('message', function(event) { if (typeof event.data['datawrapper-height'] !== 'undefined') { var iframes = document.querySelectorAll('iframe'); for (var chartId in event.data['datawrapper-height']) { for (var i=0; i
That’s the amount billed to insurance companies, not what patients pay, Cedars spokesperson Cara Martinez said in an email.
“Patients themselves do not face any costs” for the tests, she said. “The amounts we charge [insurers] for medical care are set to cover our operating costs,” capital needs and other items, she said.
Likewise at NewYork-Presbyterian, charges not covered by insurance “are not passed along to patients,” the hospital said.
Many hospitals and labs follow the Medicare reimbursement rate, $100 for results within two days from high-volume tests. But there are outliers. Insurers oftentimes negotiate lower prices within their networks, although not for labs and testing options outside their purview.
Billing by hospitals and clinics from outside insurance company networks can be especially lucrative because the government requires insurers to pay their posted covid-test price with no limit. Regulation for out-of-network vaccine charges, by contrast, is stricter. Charges for vaccines must be “reasonable,” according to federal regulations, with relatively low Medicare prices as a possible guideline.
“There’s a problem with the federal law” on test prices, said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University. “The CARES Act requires insurers to pay the full billed charge to the provider. Unless they’ve negotiated, their hands are tied.”
But even in-network payments can be highly profitable.
Optim Medical Center in Tattnall, Georgia, part of a chain of orthopedic practices and medical centers, collects $308 per covid test from two insurers, its price list shows. Yale New Haven Hospital collects $182 from one insurer and $173 from another.
Yale New Haven’s prices resulted from existing insurer agreements addressing unspecified new procedures such as the covid test, said Patrick McCabe, senior vice president of finance for Yale New Haven Health.
“We didn’t negotiate” specifically on covid tests, he said. “We’re not trying to take advantage of a crisis here.”
Officials from Optim Medical Center did not respond to queries from KHN.
Castlight Health, which provides benefits and health care guidance to more than 60 Fortune 500 companies, analyzed for KHN the costs of 1.1 million covid tests billed to insurers from March 2020 through this February. The analysis found an average charge of $90, with less than 1% of bills passing any cost along to the patient. Since last March, the average cost has gone up from $63 to as high as $97 per test in December before declining to $89 in February, the most recent results available.
In some cases, hospitals and clinics have supplemented revenue from covid tests with extra charges that go far beyond those for a simple swab.
Warren Goldstein was surprised when Austin Emergency Center, in Texas, charged him and his wife $494 upfront for two covid tests. He was shocked when the center billed insurance $1,978 for his test, which he expected would cost $100. His insurer paid $325 for “emergency services” for him, even though there was no emergency.
“It seemed like highway robbery,” said Goldstein, a New York professor who was visiting his daughter and grandchild in Texas at the time.
Austin Emergency Center has been the subject of previous reports of high covid-test prices.
The center provides “high-quality health care emergency services” and “our charges are set at the price that we believe reflects this quality of care,” said Heather Neale, AEC’s chief operating officer. The law requires the center to examine every patient “to determine whether or not an emergency medical condition exists,” she said.
Curative, the lab company that billed $250 for Valfer’s PCR tests, said through a spokesperson that its operating costs are higher than those of other providers and that consumers will never be billed for charges insurance doesn’t cover. Valfer’s insurer paid $125 for each test, claims documents show.
Even at relatively low prices, testing companies are reaping high profits. Covid PCR tests sold for $100 apiece helped Quest Diagnostics increase revenue by 49% in the first quarter of 2021 and quadruple its profits compared with the same period a year ago.
“We are expecting … to still do quite well in terms of reimbursement in the near term,” Quest CFO Mark Guinan said during a recent earnings call.
Hospitals and clinics do pay tens of thousands of dollars upfront when purchasing analyzer machines, plus costs for chemical reagents, swabs and other collection materials, maintenance, and training and compensating staff members. But the more tests completed, the more cost-effective they are, said Marlene Sautter, director of laboratory services at Premier Inc., a group purchasing organization that works with 4,000 U.S. hospitals and health systems.
A World Health Organization cost assessment of running 5,000 covid tests on Roche and Abbott analyzers — not including that initial equipment price, labor or shipping costs — came to $17 and $21 per test, respectively.
Unlike earlier in the pandemic, lab-based PCR tests no longer dominate the market. Cheaper, rapid options can now be purchased online or in stores. In mid-April, some CVS, Walmart and Walgreens stores began selling a two-pack of Abbott Laboratories’ BinaxNOW antigen test for $23.99.
Regulations require insurers to cover covid testing administered or referred by a health care provider at no cost to the patient. But exceptions are made for public health surveillance and work- or school-related testing.
Claire Lemcke, who works for a Flagstaff, Arizona, nonprofit, was tested at a mall in January and received a statement from an out-of-state lab company saying that the price was $737, that it was performed out-of-network and that she would be responsible for paying. She’s working with her insurer, which has already paid $400, to try to get it settled.
Sticker shock from covid tests has gotten bad enough that Medicare set up a hotline for insurance companies to report bad actors, and states across the country are taking action.
Free-standing emergency centers across Texas, like the one Goldstein visited, have charged particularly exorbitant prices, propelling the Texas Association of Health Plans to write a formal complaint in late January. The 19-page letter details how many of these operations violate state disclosure requirements, charge over $1,000 per covid test and add thousands more in facility fees associated with the visit.
These free-standing ERs are “among the worst offenders when it comes to price gouging, egregious billing, and providing unnecessary care and tests,” the letter says.
In December, the Kansas Insurance Department investigated a lab whose cash price was listed at nearly $1,000. State legislatures in both Minnesota and Connecticut have introduced bills to crack down on price gouging since the pandemic began.
"If these astronomical costs charged by unscrupulous providers are borne by the health plans and insurers without recompense, consumers will ultimately pay more for their health care as health insurance costs will rise,” Justin McFarland, Kansas Insurance Department’s general counsel, wrote in a Dec. 16 letter.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
USE OUR CONTENT
This story can be republished for free (details).
Covid Testing Has Turned Into a Financial Windfall for Hospitals and Other Providers published first on https://nootropicspowdersupplier.tumblr.com/
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stephenmccull · 3 years
Text
Covid Testing Has Turned Into a Financial Windfall for Hospitals and Other Providers
Pamela Valfer needed multiple covid tests after repeatedly visiting the hospital last fall to see her mother, who was being treated for cancer. Beds there were filling with covid patients. Valfer heard the tests would be free.
Tumblr media
This story also ran on Fortune. It can be republished for free.
So, she was surprised when the testing company billed her insurer $250 for each swab. She feared she might receive a bill herself. And that amount is toward the low end of what some hospitals and doctors have collected.
Hospitals are charging up to $650 for a simple, molecular covid test that costs $50 or less to run, according to Medicare claims analyzed for KHN by Hospital Pricing Specialists (HPS). Charges by large health systems range from $20 to $1,419 per test, a new national survey by KFF shows. And some free-standing emergency rooms are charging more than $1,000 per test.
Authorities were saying “get tested, no one’s going to be charged, and it turns out that’s not true,” said Valfer, a professor of visual arts who lives in Pasadena, California. “Now on the back end it’s being passed onto the consumer” through high charges to insurers, she said. The insurance company passes on its higher costs to consumers in higher premiums.
As the pandemic enters its second year, no procedure has been more frequent than tests for the virus causing it. Gargantuan volume — 400 million tests and counting, for one type — combined with loose rules on prices have made the service a bonanza for hospitals and clinics, new data shows.
Lab companies have been booking record profits by charging $100 per test. Even in-network prices negotiated and paid by insurance companies often run much more than that and, according to one measure, have been rising on average in recent months.
Insurers and other payers “have no bargaining power in this game” because there is no price cap in some situations, said Ge Bai, an associate professor at Johns Hopkins Bloomberg School of Public Health who has studied test economics. When charges run far beyond the cost of the tests “it’s predatory,” she said. “It’s price gouging.”
The data shows that covid tests continue to generate high charges from hospitals and clinics despite alarms raised by insurers, anecdotal reports of high prices and pushback from state regulators.
The listed charge for a basic PCR covid test at Cedars-Sinai Medical Center in Los Angeles is $480. NewYork-Presbyterian Hospital lists $440 as the gross charge as well as the cash price. Those amounts are far above the $159 national average for the diagnostic test, which predominated during the first year of the pandemic, at more than 3,000 hospitals checked by HPS.
<![CDATA[ window.addEventListener('message', function(event) { if (typeof event.data['datawrapper-height'] !== 'undefined') { var iframes = document.querySelectorAll('iframe'); for (var chartId in event.data['datawrapper-height']) { for (var i=0; i
That’s the amount billed to insurance companies, not what patients pay, Cedars spokesperson Cara Martinez said in an email.
“Patients themselves do not face any costs” for the tests, she said. “The amounts we charge [insurers] for medical care are set to cover our operating costs,” capital needs and other items, she said.
Likewise at NewYork-Presbyterian, charges not covered by insurance “are not passed along to patients,” the hospital said.
Many hospitals and labs follow the Medicare reimbursement rate, $100 for results within two days from high-volume tests. But there are outliers. Insurers oftentimes negotiate lower prices within their networks, although not for labs and testing options outside their purview.
Billing by hospitals and clinics from outside insurance company networks can be especially lucrative because the government requires insurers to pay their posted covid-test price with no limit. Regulation for out-of-network vaccine charges, by contrast, is stricter. Charges for vaccines must be “reasonable,” according to federal regulations, with relatively low Medicare prices as a possible guideline.
“There’s a problem with the federal law” on test prices, said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University. “The CARES Act requires insurers to pay the full billed charge to the provider. Unless they’ve negotiated, their hands are tied.”
But even in-network payments can be highly profitable.
Optim Medical Center in Tattnall, Georgia, part of a chain of orthopedic practices and medical centers, collects $308 per covid test from two insurers, its price list shows. Yale New Haven Hospital collects $182 from one insurer and $173 from another.
Yale New Haven’s prices resulted from existing insurer agreements addressing unspecified new procedures such as the covid test, said Patrick McCabe, senior vice president of finance for Yale New Haven Health.
“We didn’t negotiate” specifically on covid tests, he said. “We’re not trying to take advantage of a crisis here.”
Officials from Optim Medical Center did not respond to queries from KHN.
Castlight Health, which provides benefits and health care guidance to more than 60 Fortune 500 companies, analyzed for KHN the costs of 1.1 million covid tests billed to insurers from March 2020 through this February. The analysis found an average charge of $90, with less than 1% of bills passing any cost along to the patient. Since last March, the average cost has gone up from $63 to as high as $97 per test in December before declining to $89 in February, the most recent results available.
In some cases, hospitals and clinics have supplemented revenue from covid tests with extra charges that go far beyond those for a simple swab.
Warren Goldstein was surprised when Austin Emergency Center, in Texas, charged him and his wife $494 upfront for two covid tests. He was shocked when the center billed insurance $1,978 for his test, which he expected would cost $100. His insurer paid $325 for “emergency services” for him, even though there was no emergency.
“It seemed like highway robbery,” said Goldstein, a New York professor who was visiting his daughter and grandchild in Texas at the time.
Austin Emergency Center has been the subject of previous reports of high covid-test prices.
The center provides “high-quality health care emergency services” and “our charges are set at the price that we believe reflects this quality of care,” said Heather Neale, AEC’s chief operating officer. The law requires the center to examine every patient “to determine whether or not an emergency medical condition exists,” she said.
Curative, the lab company that billed $250 for Valfer’s PCR tests, said through a spokesperson that its operating costs are higher than those of other providers and that consumers will never be billed for charges insurance doesn’t cover. Valfer’s insurer paid $125 for each test, claims documents show.
Even at relatively low prices, testing companies are reaping high profits. Covid PCR tests sold for $100 apiece helped Quest Diagnostics increase revenue by 49% in the first quarter of 2021 and quadruple its profits compared with the same period a year ago.
“We are expecting … to still do quite well in terms of reimbursement in the near term,” Quest CFO Mark Guinan said during a recent earnings call.
Hospitals and clinics do pay tens of thousands of dollars upfront when purchasing analyzer machines, plus costs for chemical reagents, swabs and other collection materials, maintenance, and training and compensating staff members. But the more tests completed, the more cost-effective they are, said Marlene Sautter, director of laboratory services at Premier Inc., a group purchasing organization that works with 4,000 U.S. hospitals and health systems.
A World Health Organization cost assessment of running 5,000 covid tests on Roche and Abbott analyzers — not including that initial equipment price, labor or shipping costs — came to $17 and $21 per test, respectively.
Unlike earlier in the pandemic, lab-based PCR tests no longer dominate the market. Cheaper, rapid options can now be purchased online or in stores. In mid-April, some CVS, Walmart and Walgreens stores began selling a two-pack of Abbott Laboratories’ BinaxNOW antigen test for $23.99.
Regulations require insurers to cover covid testing administered or referred by a health care provider at no cost to the patient. But exceptions are made for public health surveillance and work- or school-related testing.
Claire Lemcke, who works for a Flagstaff, Arizona, nonprofit, was tested at a mall in January and received a statement from an out-of-state lab company saying that the price was $737, that it was performed out-of-network and that she would be responsible for paying. She’s working with her insurer, which has already paid $400, to try to get it settled.
Sticker shock from covid tests has gotten bad enough that Medicare set up a hotline for insurance companies to report bad actors, and states across the country are taking action.
Free-standing emergency centers across Texas, like the one Goldstein visited, have charged particularly exorbitant prices, propelling the Texas Association of Health Plans to write a formal complaint in late January. The 19-page letter details how many of these operations violate state disclosure requirements, charge over $1,000 per covid test and add thousands more in facility fees associated with the visit.
These free-standing ERs are “among the worst offenders when it comes to price gouging, egregious billing, and providing unnecessary care and tests,” the letter says.
In December, the Kansas Insurance Department investigated a lab whose cash price was listed at nearly $1,000. State legislatures in both Minnesota and Connecticut have introduced bills to crack down on price gouging since the pandemic began.
"If these astronomical costs charged by unscrupulous providers are borne by the health plans and insurers without recompense, consumers will ultimately pay more for their health care as health insurance costs will rise,” Justin McFarland, Kansas Insurance Department’s general counsel, wrote in a Dec. 16 letter.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
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This story can be republished for free (details).
Covid Testing Has Turned Into a Financial Windfall for Hospitals and Other Providers published first on https://smartdrinkingweb.weebly.com/
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neomdincblog · 2 years
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NEO MD - PRECISE CLAIM SCRUBBING SERVICES
Incorrect claim submission is the prime source of delayed reimbursement for practices. NEO MD Experts have years of experience in scrubbing the claim before submitting clean claims to insurance. Due to our Scrubbing accuracy, we ensured the first-level claim acceptance ratio of (95-98%).
Get us at! ([email protected]) or (929) 502-3636). https://neomdinc.com/
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nycannabistimes · 2 years
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@ssenv2022 ・・・ FYI, link in story 💨💨✌️. New York lawmakers have approved a bill that would require public health insurance providers in the state to include medical marijuana as a covered prescription drug and authorize private insurers to do the same. The Assembly Health Committee passed the legislation from Majority Leader Crystal Peoples-Stokes (D) in an 18-7 vote on Tuesday. It now heads to the Ways & Means Committee before potentially advancing to the floor. The measure would amend state statute to define cannabis as a “prescription drug,” “covered drug” or “health care service” for health insurance purposes. Medical marijuana would need to be covered by public insurance entities “regardless of federal financial participation” in their services. State Medicaid, Child Health Plus, workers compensation and EPIC programs would be required to treat cannabis from certified dispensaries the same as other conventional pharmaceuticals for the purposes of coverage. Private health insurers, on the other hand, wouldn’t be forced to provide coverage for medical marijuana, but the bill clarifies that they can if they choose to. #newyork #ny #nyc #legislation (at Washington Heights) https://www.instagram.com/p/CqE7lLqM5oN/?igshid=NGJjMDIxMWI=
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norabliss · 4 years
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Advantages Of Auditing Your Medical Billing Expenses
In any business across industries, auditing plays an important role. It acts as an excellent tool for ensuring proper revenue management cycle, adhering to regulations and laws, to identify the scope of improvement in the internal processes. This is definitely true when it comes to physicians, particularly with medical claims.
Medical audits cater to two ways to enhance operations at a medical practice. The primary auditing begins with the claims administrator. The second one is self-audit of operations within your own practice to identify the areas of mistakes and how improving from those mistakes can bring a difference.
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Dealing with medical claims is quite complicated and costly if not well-managed. Some factors that medical claims may require audits are finding errors in medical billing, finding methods for improving recovery opportunities, and ensuring a medical practice is adhering to the recent compliance regulations governing medical claims.
Before we look into the benefits of auditing in medical billing, let us know the types of audits performed in medical billing.
Medical Billing
Types of medical claim audits
Medical claims and medical billing audits can be conducted no matter what the size of your organization is. Performing regular audits can keep your medical billing system streamlined and with sufficient cash inflow.
The following are the types of audits performed in medical practice:
Random Sample audit
In this audit, claims are picked according to the insurance money covering both large and small claims are audited. It throws more focus on the dollar amounts rather than the number of claims involved. A random audit does not get you money refunds from insurers directly but can help to move to a comprehensive auditing review.
Comprehensive audit
This audit has a more immense scope and looks at a group of audited clams prior, both electronically and manually. It gets you to claim refunds from claims administrators, which is the comprehensive audit’s ultimate objective.
Hybrid audit
A hybrid audit is the combination of random sample audits and comprehensive review audits that achieves the results of both factors, such as the recovery of money and compliance to regulations. Moreover, it focuses on the quick recovery of over payments.
Benefits of a Medical claims audit
A self-audit is not officially incorporated by the federal government but only encouraged by the CMS.
So, according to CMS, a medical practice can experience the following benefits due to medical claims audits:
#1: Reducing and preventing improper payments
Audits can have a check on your regular and irregular payments and can guide you on how to make a move for further transactions with your claims partner. It helps identify the reason behind delays in claims reimbursements/medical billing systems and gives you a clear picture of improvements and best practices. This definitely helps you with reduced payment issues and prevents insufficient funds inflow in your medical practice.
#2: Ensuring claims are submitted accurately
Since audits help check every nuke and corner of medical billing and claims submission, your future claims get progressed without any rejections from the insurer. When claims are submitted accurately, your revenue is also enhanced, resulting in patient satisfaction.
#3: Enhancing patient care
Regular audits support you in receiving quick reimbursements and improved focus on patient care who visits your medical practice. When there is no hassle in medical billing and claims processing workflow, you can run your operations more efficiently with spending more time for your patients.
#4: Reducing the chances of external audit
If your internal medical audits are sufficient to provide the scope for improvement and point out messed-up areas, there is no need for you to spend time and money, allowing external audits.
#5: Instant feedback on staff performance
Internal medical audits give an opportunity for you to identify the good/poor performance of the staff and instruct them on their areas of improvement instantly. It also provides accountability of errors to your staff so that they work more responsibly.
#6: Cost-benefit and compliance
Audits help your practice figure out the areas where you can pull your pending or slowed-down money from and introduce new policies and procedures to avoid the mistakes made previously by your staff. Thus audits offer benefits both cost and compliance-wise.
#7: Training on weakened areas
Since internal audits help you understand how efficient your staff is in terms of medical billing and claims services, they can be provided proper training on areas where they find it difficult.
Conclusion:
All your internal audits can be made easy by partnering with 24/7 Medical Billing Services, one of the leading medical billing and coding outsourcing partners. You need not break your head on documentation and other audits related work, since we handle your patients’ data highly secured.
About 24/7 Medical Billing Services:
24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 42 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.
 Contact us -
24/7 Medical Billing Services,
16192 Coastal Hwy,
Lewes, DE – 19958
Tel: + 1 -888-502-0537
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jennyvergeese · 4 years
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Outsourcing Medical Billing Services Saves Your Practice Time and Money
As per Medliminal Healthcare Solutions (MHS), at least four in five medical bills have mistaken, which cost USD 68 billion annually in unnecessary healthcare expenditure by doctors and patients alike. A lot of medical practitioners are thus choosing to outsource their billing needs to a medical billing company rather than going for an in-house team. However, both in-house and outsourcing have their benefits and complications.
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There are a few challenges involved in outsourcing billing services rather than keeping it in-house. One of the major concerns is patient's data security. There have been cases of data breach where personal medical data has been made public. However, a good medical billing company understands its significance and invests a considerable amount in maintaining strict data security. Another common problem with outsourcing is the lack of accessibility as compared to getting billing errors rectified with an in-house team. Third most common challenge medical practitioners’ face is of hidden costs. Medical billing agencies often charge extra fees for some additional services. However, in dealing with a reputed billing service provider, there is no need to worry about hidden charges because everything is mentioned beforehand in the contract.
Why should practices choose to outsource?
·         Outsourcing is lighter on your pocket. Maintaining an in-house medical billing department will cost you around 10-12% of your annual income. Whereas, medical billing service providers charge you around 4-8%. It saves you from additional expenditure involved in the set up of in-house department, and hiring and training of staff.
·         Coding errors are one of the common causes of claim denials. Codes increased from 13000 in ICD-9 to almost 68000 in ICD-10. This significantly increased the chances of error, especially with newly trained staff. Outsourcing gives you access to professional coders who are constantly updated with coding changes and requirements.
·         In-house billing requires regular monitoring. You will have to dedicate considerable amount of time for its proper functioning. This robs you of valuable time that can be invested in patient care, and other vital administrative tasks. Outsourcing lets you focus on your core responsibilities, which in turn improves engagement with patients, and increases their satisfaction level.
·         Working with a reputed medical billing firm can boost your cash flow. With their latest technology, and automated claim submission software, claims are reimbursed faster. Quick and error-free claims submission means quick payments.
About 24/7 Medical Billing Services:
We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses. Contact:  24/7 Medical Billing Services Tel: +1 888-502-0537 Email: [email protected]
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kristinsimmons · 5 years
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Low Value Testing and Unmet Cascades
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By ANISH KOKA, MD
Mr. Smith has a problem. 
He can’t see. 
Even this cardiologist knows why.  The not so subtle evidence lies in the cloudy lens in front of his pupils.  He is afflicted with cataracts that obstruct his vision to the point he can’t really do his job refurbishing antique furniture safely.  His other problem is that he hates doctors. He hasn’t had reason to see one for more than a decade.  He’s 68, takes no medications, smokes a pack of cigarettes a day, and is a master of one word answers. He’s in my office because he needs a medical evaluation prior to his cataract procedure. Someone needs to attest to medical safety. I’m it.
He just wants to get out of here.
His annoyance of being in the office is justified.  Cataract surgery is very low risk.  Unless he’s having an acute medical problem, there is little to do.  The problem is that in an age of high volume, super specialized care, the eye doctor can’t attest to this, and the anesthesiologists have little interest in finding out the morning of his procedure that Mr. Smith has been having more frequent episodes of chest pain over the last two weeks.  Perhaps the chest pain is just acid reflux, or maybe it’s because of a pulmonary embolism related to the tobacco induced lung malignancy no one knows about. It’s possible, and highly likely, Mr. Smith will survive his cataract surgery even if he has a pulmonary embolism.  Cataract surgery really is pretty low risk.
But the doctor’s ethos has never been to ‘clear a patient for a cataract’, it is to commit to the health of the patient.  Mr. Smith deserves the opportunity to receive good medical care that isn’t made threadbare just because of the cataract surgery on the horizon.
An ample body of literature has arisen on just what to do with Mr. Smith driven largely by the question of the yield of preoperative testing performed prior to low risk procedures.  The outcome of interest to researchers is the impact of preoperative medical testing on the safety of surgery.  But this outcome completely misses the point of a medical evaluation.  Of course there won’t be any evidence to make never events rarer.  It would be a lot more fun to do a chicken dance in front of Mr. Smith than spend time discussing smoking cessation, and I can guarantee that the randomized controlled trial with surgery safety as an outcome will show that the chicken dance is equivalent to actual medical care.
But never events in low risk scenarios are the perfect place to beat the low value testing drum.
Identifying ‘Low Value Testing’ is the holy grail of the health policy community because a more perfect health economy awaits the surgical excision of these warts from medical practice.
A recent paper now featured in a Washington Post OpEd attempts to use preoperative cataract evaluations to show us the ills of low value testing in a cohort study of 110,000 Medicare Fee-for-service beneficiaries.  Patients were 66 years or older without any known heart disease. 
Researchers compared patients who did receive an ECG preoperatively with those that didn’t.  They discovered that a small number, 11% (12,408) of patients, who had no prior cardiac disease received an ECG prior to a cataract surgery.  Of this group, 15% (1,978) had at least one test done in follow up.  Termed cascade testing, most of the follow up testing involved a cardiac imaging test of some sort, or a visit to a cardiac specialist.
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The conclusion of the investigators is that : “Care cascades after preoperative EKG for cataract surgery are infrequent but costly. Policy and practice interventions to reduce low-value services and the cascades that follow could yield substantial savings.”
It’s an interesting conclusion that has been lapped up by a wide audience of head nodding tsktskers.  I say interesting primarily because the data comes from a large Medicare Claims database populated by physician entry of billing codes.  The claims database that this creates is used frequently by researchers as done here, but is plagued by limitations.
For instance, Mr. Smith’s complaint of chest pain during his preoperative visit should generate a chest pain code and a preoperative testing code.  The reality of practice is that the goal for physicians is to do the minimum amount of billing necessary to make life work, not to do the most accurate billing necessary.  If a physician or his staff did not happen to add a chest pain code to a pre-operative evaluation, a completely appropriate further test being done to evaluate his chest pain, would fall under the rubric of low value testing in this paper. 
This limitation would be easier to dismiss as insignificant if 80% of patients undergoing a preoperative cataract evaluation received an ECG.  But the number isn’t 80%.  It’s ~  10%.  What percent of patients had an ECG and an echocardiogram done because a loud murmur was heard? We simply don’t know.  So studies like this should tell us very little in a strong fashion.  But the agenda of some is to publicize research that highlights waste and excess, and so we have strong conclusions built on data that can’t possibly support it in a high impact blue chip journal used to influence policy makers. It wouldn’t matter so much if these papers stayed in the echo chambers of academia, but unfortunately, all that stands between this paper and Elizabeth Warren’s ‘evidence based’ website is a NewYorker deep dive and some publicity from the right kool-aid drinking journalists.
But even if we assume the data is actually robust, and that all or most of the cascade of testing is happening driven only by an untoward ECG, the conclusion being arrived at still misses the mark.
It should be a relief that only a small minority (10%) of elderly patients getting cataract surgery actually get an ECG. As the flow chart above shows, of  this small minority, 1717 (~90%) patients had tests, treatment or hospitalization related to a new diagnosis made of ischemic heart disease, structural heart disease, or an arrhythmia.  The prior limitations of billing codes used for these diagnoses apply.  We don’t know if meaningful heart disease is being found.  But carrying the researchers assumption of the veracity of the dataset forward, it would appear that a low yield test that costs Medicare $18 results in 13%  (1717/12,408) of the screened population being diagnosed with an important cardiac condition that a specialist thought important enough to initiate treatment.  That doesn’t sound like low value.
As mentioned above, pre-operative medical evaluations aren’t solely for the benefit of the surgeon.  The priority isn’t just what a patient needs to safely undergo a specific procedure, its to take care of the patient.  This is all muddled when it comes to cataract surgery, which is one of the very low risk procedures that is done today.  It is indeed the case, that unless a patient is in the throes of a heart attack, there is likely little medical optimization needed prior to these very low risk procedures.  But our mission is to keep patients from harm, not to ‘clear them for their cataract procedure’.  It is the case that the 55 year old gentleman who has been having progressive exertional dyspnea and a loud murmur at his pre-operative visit will survive his cataract surgery.  But this does not mean that the cardiac ultrasound that follows this test to diagnose the severity of his underlying valvular pathology is a wasted test. 
Also spare a moment for the anesthesiologists charged with taking care of these patients during these procedures.  They usually have never met the patient, and are asked to take medical responsibility of the patient.  It may help to know the patient you’re putting to sleep has right ventricular failure with severe pulmonary hypertension.  To say we don’t care because it only affects a small minority of patients, may be good population health, but it’s bad medicine.
But even If the data were to be believed, and that’s a big if because it rests on claims data, the cataract medical evaluation would seem to serve an important opportunity for screening an older population with no prior history of heart disease.  Almost 15% of this particular population screened were found to have important cardiac disease that both patients and their doctors want to know.  Doctors, patients and researchers may want to remind themselves that the biggest danger to the Medicare age population isn’t the incidentaloma, its death from cardiac disease, followed closely by death from cancer.
The real question to ask may be why it takes an evaluation prior to a cataract procedure to find this disease? Perhaps, like Mr. Smith, this represents a population that generally stays away from the medical community, unless ‘forced’ to.  Some of the analysis demonstrating that the screened population is older, sicker, and located in urban areas makes the cataract screening story a victory for medicine, making inroads in areas where it’s needed, rather than one of waste and excess.
But this isn’t the story social policy researchers hopeful for influence over government bureaucrats struggling to lower health care costs will tell. The monotonic message rings true in yet another paper from earlier in the year from the same brain trust published in the same journal based on a physician survey of cascade testing.  Physicians were asked about their personal experiences with cascade testing as a result of incidental findings.
The conclusion of the paper was unambiguous:
“The survey findings indicate that almost all respondents had experienced cascades after incidental findings that did not lead to clinically meaningful outcomes yet caused harm to patients and themselves. Policy makers and health care leaders should address cascades after incidental findings as part of efforts to improve health care value and reduce physician burnout.”
But it requires reading the paper to find that more than 70% of physicians surveyed reported that cascade testing resulted in “finding a clinically important and intervenable outcome” several times a year.  So while ~60% of those surveyed found that cascade testing often found nothing, more of those surveyed found something clinically important.  This describes the clinical practice of the generalist.  Most of the interactions with patients are benign affairs.  The majority of patients the primary care physician interacts with are healthy.  Some are not.  The art and practice of medicine is to find some balance between sending every patient for an MRI, and putting on a blindfold and noise cancelling headphones before entering a patient room. 
Mr. Smith got an ECG. It was normal. There were no further tests prior to his cataract surgery.  There was a cascade planned after his surgery. He’s following up for a high blood pressure, and was convinced to go for another potential cascade initiating event: the first blood work he’s had in 10 years. Hopefully the republic survives.
Anish Koka is a Cardiologist in Philadelphia.
The post Low Value Testing and Unmet Cascades appeared first on The Health Care Blog.
Low Value Testing and Unmet Cascades published first on https://wittooth.tumblr.com/
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norabliss · 4 years
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Medical service of Georgia is brightened with 247 medical billing  Georgia is the British colony with people living happily and with great joy. There are many places to explore with the city with huge population of people. The attractive features will surely be the pathway for fun and entertainment. Once if you visit the place then it will keep on attractive you with huge healthy benefits. Now Georgia is ready to get 247 medical billing which has got some of the best software’s to deal with billing for health care industry.
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jennyvergeese · 5 years
Text
Pros and cons of Outsourced Medical Billing Services
A lot of medical practitioners are thus choosing to outsource their billing needs to a medical billing company rather than going for an in-house team. However, both in-house and outsourcing have their benefits and complications. As per Medliminal Healthcare Solutions (MHS), at least four in five medical bills have mistakes, which cost US$68 billion annually in unnecessary healthcare expenditure by doctors and patients alike.
Tumblr media
There are a few challenges involved in outsourcing billing services rather than keeping it in-house. One of the major concerns is patient's data security. There have been cases of data breach where personal medical data has been made public. However, a good medical billing company understands its significance and invests a considerable amount in maintaining strict data security. Another common problem with outsourcing is the lack of accessibility as compared to getting billing errors rectified with an in-house team. Third most common challenge medical practitioners’ face is of hidden costs. Medical billing agencies often charge extra fees for some additional services. However, in dealing with a reputed billing service provider, there is no need to worry about hidden charges because everythingis mentioned beforehand in the contract.
Why should practices choose to outsource?
·        Outsourcing is lighter on your pocket. Maintaining an in-house medical billing department will cost you around 10-12% of your annual income. Whereas, medical billing service providers charge you around 4-8%. It saves you from additional expenditure involved in the set up of in-house department, and hiring and training of staff.
·        Coding errors are one of the common causes of claim denials. Codes increased from 13000 in ICD-9 to almost 68000 in ICD-10. This significantly increased the chances of error, especially with newly trained staff. Outsourcing gives you access to professional coders who are constantly updated with coding changes and requirements.
·        In-house billing requires regular monitoring. You will have to dedicate considerable amount of time for its proper functioning. This robs you of valuable time that can be invested in patient care, and other vital administrative tasks. Outsourcing lets you focus on your core responsibilities, which in turn improves engagement with patients, and increases their satisfaction level.
·        Working with a reputed medical billing firm can boost your cash flow. With their latest technology, and automated claim submission software, claims are reimbursed faster. Quick and error-free claims submission means quick payments.
About 247 Medical Billing Services:
We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses. Contact:  247 Medical Billing Services Tel: +1 888-502-0537 Email: [email protected]
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