Tag - Medical Practice

Medical Debt

How To Reduce Medical Debt? 6 Options To Consider!

Medical Debt is very common nowadays and unfortunately, the underprivileged communities are affected a lot. Throughout the year due to high inflation the purchasing power of the common people is decreasing drastically. Having proper medical care is a right of every human being.

Paying off medical bills is not as easy as dealing with other kinds of medical bills. Here in this article, we will evaluate the common reasons behind the high medical Debt and how we can reduce them effectively. But first, let’s have a quick look at what exactly is medical debt.

What is Medical Debt?

Medical Debt is pretty much different from other kinds of Debt. It is defined as a Debt incurred on any person who availed of any medical treatment from any medical service provider.

Impact of Medical Debt 

Medical Debt is not only associated with financial liability. But various studies suggest that it can also impact the overall health condition of an individual. Like if an individual is facing some medical debt, this financial strain can restrict him to avail of further medical care. Which itself is alarming.

It has been seen that debt is also associated with negative health behaviors due to mounting stress. The person may start smoking, adopt other kinds of bad habits or start consuming low-quality food.

If you are a credit card holder then you can damage your credit card history and those low credit scores ultimately put you at credit risk.

6 Options To Reduce Medical Debt

Following are those options that can help you to reduce the medical Debt.

Create a Payment Plan

You can create a payment plan with your health service provider. The payment plan will help you to divide the amount you owe to the service provider. Which surely you can’t afford to pay in a single bill.

The amount of payment you can give to your service provider each month will depend on the amount incurred on you and on the terms and conditions of that particular health care system. The payment plan is one of the best solutions available to avoid medical debt.

Check Your Bill Again

Before paying for the bill you have to check it out again. Because there are chances that the health care center charges you for the services they never rendered. So try to verify the bill before planning to pay. While if you are having the services of any insurance company then you can also cause them to confirm that amount.

Take Medical Insurance Plans

Having insurance plans can give you an advantage. Get yourself insured and read all the insurance terms and agreements carefully. Also read out about your insurance coverage. There are some procedures and treatments which are usually excluded from the general insurance agreement. So you have to make sure about the treatments which are the parts of your insurance coverage.

Avail Medical Credit Cards

As a patient, your first priority is to make an efficient payment plan with your health service provider. But if somehow you fail to negotiate for the payment plan then you can also avail advantage of medical credit cards.

These medical credit cards are issued for specific medical purposes usually for emergency situations. Allowing many patients to get immediate medical care when needed.

Many medical credit cards are interest-free for up to a 12 months period so if you are planning to apply for a medical credit card then you should make sure that either you are capable of paying your debt within the given time period or not. In that case, the medical credit card would be the best option for you to avoid medical Debt.

Take Assistance from a Medical Billing Advocate

Having a medical Billing advocate can also help you to reduce your medical debt.

Those billing advocates are experts in understanding the actual cost of any medical procedure.

So you can hire them to negotiate with the health service providers on your behalf. A good medical billing advocate can also help you to set up a good plan to get rid of your medical debt.

Reconcile to the Service Provider on your own

In that case, if you don’t want to take assistance from the medical billing advocate then you can also negotiate on your own with the health service provider. For that purpose, you have to be fully aware of all the regulations, treatment procedures, and costs. Also, go through your medical bills and detect any charges that look inaccurate.

Apply for Income-driven Hardships Plans

The income-driven hardship plan is exclusively for those individuals in the country who fall into the low-income category. Many health care units have financial assistance programs that help people to manage their medical expenses. Talk to your healthcare provider to confirm your eligibility in that scenario.

While on the other side the income-driven hardship plan can also help you in making a payment plan similar to the plan we have discussed previously.

Medical Debt reduces options for Senior Citizens

It is estimated that an immense amount of people aged above 65 are living with chronic disease. These senior citizens required special medical assistance and in that phase of their life, no one wanted to get a medical debt.

The US government has designed many programs, especially for these people. State health insurance assistance programs (SHIP) Medicare, and Medicaid programs are examples of it.

The Medicare and Medicaid program is designed to give citizens proper healthcare and also they work in reducing their medical debt through insurance assistance. While the SHIP is the state-organized program that offers counseling and assistance to the recipient of the above program and they also help them to overcome their medical debt.

Paying off your medical debts is not always easy for every individual. While throughout the article we have discussed how it can cost you a lot if you are not seriously considering it. The best way to tackle medical debt is to negotiate with the professional. You can also benefit from a no-interest payment plan and federal relief plans if you are eligible for them.

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Hipaa Compliant

Tips That Will Help Your Practice Become HIPAA Compliant

Every healthcare service provider and insurance company needs to ensure HIPAA compliance.

It will help them to secure the sensitive medical information of the patient. Making your practice compliant with HIPAA will save the practice from common breaches in the system and also save them from any penalties. 

These complaints are based on some set rules under the health insurance portability and accountability act. In this article we will discuss some tips which will make your practice compliant with HIPAA.

What Is HIPAA Compliant?

It refers to the health insurance portability and accountability act. This act is responsible to set a standard for the protection of the sensitive data of the patients. This act is applicable to any entity which is responsible for holding the sensitive information of the patient. 

The covered entities include health care service providers and insurance service providers and anyone who has access to the sensitive information. All these entities are bound to comply with HIPAA.

What Is Protected Health Information (PHI)?

It is defined as any kind of information that is used to get the identification of the patient and this is the information that is protected under HIPAA rules and regulations.

This information includes the name of the patient, his address, social security number, contact information, medical history, and financial information.

What are Covered Entities?

Under HIPAA regulations the covered entities are one which is responsible for maintaining the PHI. These entities are usually involved in collecting, creating, transmitting and accessing sensitive information. The health care service providers, insurance companies, clearinghouses are all included in this category.

What are Business Associates?

Under HIPAA the business associate is any entity that links with PHI in anyways.

When you find out the business associate you will see that there is a wide range of business associates involved in this process because this sensitive information is transferred from one entity to another and many service providers handle and process this information.

This business associate includes lawyers, Information Technology specialists, accountants, administrators, third-party consultants, cloud service providers, and email service providers.

HIPAA Rules and Regulations

These rules and regulations were first introduced way back in 1996. The essential HIPAA rules and regulations are:

HIPAA Privacy Rules

HIPAA  privacy rule is exclusively for the covered entities. These privacy rules are responsible for protecting the sensitive information of the patient.

As sensitive information is under the covered entities which are responsible for handling this PHI data. They’re also responsible for reporting the violation of HIPAA rules and regulations. The HIPAA set some privacy rules which includes:

  • A patient’s right to access protected health information.
  • A healthcare service provider also denied Access to protected health information.
  • They’ll also advise for the proper training of their staff they are pretty much aware of the handling of the sensitive information.
  • They also have to ensure written permission from the patient before using his sensitive information for any kind of purpose.

HIPAA Breach Notification Rule

Under this regulation, the covered entities and business regulations are required to notify the breach in the protected health information.

All the covered entities and business associates are bound to report any kind of breach whether it is external, internal, smaller, or larger.

This breach notification includes:

  • The kind of protected health information involved in the process.
  • The person who accesses the PHI whether it is authorized or unauthorized.
  • A Confirmation that the sensitive information is actually acquired or not.

HIPAA Omnibus Rules

These sets of rules are designed to expand the HIPAA scope towards business associates. The Omnibus rules are introduced to cover the gaps which are ignored in the previous updates.

The Omnibus rules cover these key areas of HIPAA regulation.

  • This includes the introduction of the final amendments under the requirements of health information technology for the economic and clinical health act which is a part of the American recovery and reinvestment act.
  • This includes the incorporation of the penalty structure, the final rule on breach notification, and some modifications that are required by the genetic information nondiscrimination act.
  • Last but not least it also includes the restriction on using the PHI for marketing incentives.

Tips To Become HIPAA Compliant

Following are some tips to make your practice HIPAA compliant.

Identifying Common Breaches

One of the first steps to becoming HIPAA compliant is to identify some of the most common breaches which are happening in the system. These common breaches include:

  • Theft of those machines that are required to store the protected health information.
  • Any hacking attempt.
  • Transferring the protected health information to any wrong entity or any wrong Business administration.
  • Disclosing sensitive information on any public platform.

By avoiding all these breaches you can make your practice fully Hipaa Compliant.

Complete Awareness about Fines and Penalties

Service providers who are responsible for the patient-sensitive data should be aware of any kind of breach which can lead to heavy fines and penalties. It should be your first priority to avoid all these penalties and fines to maintain your financial cycle.

To effectively manage it, you have to be aware of all the existing violations that lead to heavy fines. These violations include Tier 1,2,3,4. Having a complete awareness of this will make your practice fully compliant with HIPAA.

Fulfill Transaction Standards

The majority of the health service providers handled the protected health information on a daily basis. The health care service provider has the intention to get the claim from the insurance providers. 

To protect that sensitive data HIPAA sets some transaction standards which include the eligibility, premium claim payments claims and encounter information,  claim status, and advice in maintaining the remittances and payment method, full coordination of benefits, and a secure authorization and referral process.

Keep Yourself Updated

After fulfilling all the safety rules and maintaining all the standard procedures. You must update yourself on a daily basis about the new developments of HIPAA.

In order to keep yourself fully compliant with the latest regulations, your practice needs to work with your compliance partner to ensure the fulfillment of all the requirements.

Med-Miles can help you to keep your practice updated about all the latest regulations. We are serving the healthcare industry in managing their revenue cycle management for more than 8 years. Call us at (888) 598-9181 to get more information.

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Revenue Cycle Management

Revenue Cycle Management: Get Paid For What You Do

In the medical billing process, Revenue Cycle Management is the key for any practice to smoothly manage its revenue and make the health care center financially stable.

The whole revenue cycle management system revolves around managing, identifying, and collecting revenues.

It has become essential for any health service provider to efficiently manage its revenue otherwise an outstanding account receivable can badly affect the operations of the services.

Steps of Revenue Cycle Management

The revenue cycle management system revolves around multiple steps. Some of them are described below:

  • Patient Details

When the Patient comes for the services, the first step for the revenue management system is to record all the essential details of the patient. It includes his name, age, address, etc.

Your front desk staff can note all these details with accuracy and these details are essential for the billing process.

  • Checking Insurance Coverage

The next step is to verify the insurance eligibility of the patient. In many cases, some services are excluded by the insurance coverage and the patients are unaware of it.

After checking the eligibility the next step is to make them aware of their insurance coverage and tell them that these services and procedures are excluded from your insurance scope and you need to pay for them.

  • Check Code

In the next step, all the documentation is converted in the form of codes by the coding team. Because insurance companies process only those claims that are in the form of coding.

  • Submitting The Claim

When all the documentation has been done in the form of coding then the next step is to submit the claim to the insurance company. Your claim will be processed by the insurance company.

If there is no error found in the claim then it will be approved in case any error is found in the submitted claim then it will be rejected. 

  • Follow-ups

It’s one of the essential parts of revenue cycle management. When your practice faces a denied claim then your billing team must follow up. Check the claim and find the error and resubmit it.

And for the services that are excluded from the insurance coverage and patients are liable to pay for them then it’s the responsibility of a follow-up team to send them reminders to pay their dues.

How To Make Your Revenue Cycle Management Efficient?

It’s essential for every health service provider to manage their revenues at full potential. Here are some ways in which you can maximize your revenues.

Keep The Record With Accuracy

Record keeping is one of the first steps of the medical billing process and it should be accurate. This information is important to get the right coding done. So if your practice is successful in keeping the record then you can easily get the reimbursement.

Highly Skilled Staff

A highly skilled staff minimizes the chances of error in your billing activity. Your practice should spend more resources in the training of the staff or can hire a professional staff to manage the billing activity.

Reducing The Manual Working

There are higher chances of error in the manual form of working. The paper records can be lost and they are very difficult to manage.

On the other hand, you can lessen these errors by using the automation process, utilizing the latest EHR/EMR technologies and administrative tools, and cloud-based systems.

Efficient Coding Practice

An efficient coding practice is necessary to minimize the claim denial rates. While coding use CPT and HCPCS coding approved by the American Medical Association. Follow the set regulations and hire an expert coding team.

Give Your Patients An Alternative Payment Method

These services are exclusively for those patients that are liable to pay their bills. Many times patients can give your practice an instant payment because you don’t give them multiple payment gateways.

Some might prefer to use their credit/debit card or some might be interested in paying through any mobile application. Make sure that you give them maximum options for payment so that you can receive the revenues without any delay.

Timely Submission of The Claim

The insurance companies only approve those claims that are timely submitted. If your practice fails to submit the claim on time then your account receivable can expand at a significant amount. So a timely submission can save you revenues.

Tracking Denial Rates Frequently

Tracking denial rates are essential for any medical service provider. A consistent denial rate in your billing is the indication that there is something wrong that needs to be corrected. It might be due to frequent errors in coding or late claim submission or might be the inexperienced worker.

A team that monitors the denial rates can give you solutions to overcome them is essential for revenue cycle management.

Financial Responsibility

Many times, patients are unaware of their insurance coverage. So after verifying the insurance eligibility it is the responsibility of your practice to make them aware of their insurance coverage and tell them that they are liable to pay the uncovered bills.

Outsourcing

Outsourcing is one of the best ways to manage your Billing activity. The majority of the time your practice lacks resources to effectively manage the revenue cycle management. Either you have a lack of staff, improper infrastructure, or inexperienced staff or ineffective management.

A Billing service possesses a team of experts who can manage the revenue cycle of your practice. At the same time, they are managing the billing of many other practices so they better understand the regulations and latest trends and nature of different insurance providers.

Revenue cycle management is an essential part of any medical service provider. If you fail to get the desired results after all the hard work then you can outsource your billing activity. 

Med-Miles can help you to achieve your goals. Our vision is to provide a smooth billing process with better solutions. We assure low denials rates with a maximum profitability ratio. Call us at (888) 598-9181 for more information. 

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Billing Codes

3 Billing Codes Every Physician Should Know

Medical Billing Codes are a crucial part of RCM or Revenue Cycle Management which enables the communication between medical practitioners and insurers.

Physicians and other practitioners are always looking for different ways to increase revenue. One of the basic ways that medical providers miss out on generating revenue is by not billing for services that are provided.

Coding mistakes are common, whether from a lack of understanding of using the right codes at the right time or having a lack of knowledge about certain codes.

In this blog, we talk about what medical coding is and the different types of codes we see today. We also look at 3 codes that are often underrated or are often unknown to the billing staff. 

This should be avoided, as knowing about the codes, and how to use them, can earn medical firms a decent amount of income that was previously missed.

Medical Coding 

Medical coding is a technological advancement that has made the medical process so much simpler than it used to be before.

Medical codes translate huge reports into codes used within the healthcare industry. Summarising often piled-up medical reports into efficient codes.

A medical coder is responsible for translating huge medical reports of physicians into medical codes. These people work behind the scenes in different settings, ensuring all appropriate information is coded consistently and accurately.

After a patient is treated by a medical provider, the process of billing starts where the insurance company needs to understand what medical service was provided to further process the bill.

To make things simpler and have a common language, specific codes are entered into the software to give the insurance company accurate details.

The role of a medical coder is basically to provide the information in a way that is easy to understand and effective.

There are the three main codes used today: Current Procedure Terminology (CPT), International Classification of Diseases (ICD), and Health Care Procedural Coding System HCPCS. The code sets help coders to document the condition of a patient and also describe the procedures performed on the patient.

Different Types Of Medical Codes

ICD-International Classification Of Diseases

The ICD was designed as a health care classification system that provided diagnostic codes that classified diseases, including classifications of different symptoms, and external causes of the illness or injury.

The ICD is a system developed by the World Health Organization (WHO) and ten international centers in collaboration.

The idea was that the medical terms and bills reported by physicians examiners can group them for statistics. In the US, the National Center for Health Statistics manages any alterations to the codes alongside the WHO.

CPT (Current Procedural Terminology)

CPT codes offer doctors and professionals a language for coding their medical services and procedures to make reporting efficient and increase accuracy.

Administrative management, like claims processing and guidelines for medical care reviews, also uses CPT codes. The terminology used in CPT is the most widely accepted across the country which helps in reporting medical, radiology, surgical, anesthesiology, laboratory, evaluation, and management services under public and private medical insurance programs.

CPT codes contain five digits which are either numeric or alphanumeric, depending on the category of the medical service. CPT code descriptors utilize common standards so that users have a common understanding of the clinical health care model.

HCPCS (Healthcare Common Procedure Coding System)

HCPCS or Healthcare Common Procedure Coding System is another coding system used across the US.

The Healthcare Common Procedure Coding System is a collection of codes that represent procedures, products, supplies, and services that are provided to Medicare receivers and people enrolled in private medical insurance programs. The HCPCS codes consist of Level I, II, and III codes.

  • Level I codes are the AMA’s CPT codes which are numeric.
  • Level II codes are the alphanumeric code sets. These primarily include non-physician products and procedures.
  • Level III codes or HCPCS local codes were developed by Medicaid agencies, and private insurers, and are used in specific programs included in the HCPCS coding book. These codes are preferred by payers compared to the Level I and Level II code sets. However, Level III codes are not recognized nationwide.

Why Is Medical Coding Helpful And Issues Of Inaccurate Coding?

Medical Codes are a common language between payers and medical providers and are used for communication for billing. The financial importance present in the case of medical billing a provider has to be accurate in entering codes for the given medical treatment. 

Why inaccurate codes are bad:

  • One case of inaccurate codes is “Up-coding”. This is when a code is recorded for a higher level of service, however, the service provided to the patient was not as high. This makes Up-coding a serious offense and entering accurate codes is crucial. 
  • Vice versa, “Down-coding” is entered at a lower level of cost than what was provided to the patient. Down-coding is often not done on purpose, instead, it requires both the provider and the coders to be trained and educated on the losses the firm may face if down-coding takes place.

3 Billing Codes To Keep A Look Out For

Telephone Services (99441-99443)

Due to doctors being busy these days, especially since the emergence of the COVID-19 pandemic, patients skipping the line and calling to speak to the doctor is not rare anymore. CPT codes include codes specifically for telephone services provided by physicians and other healthcare providers.

Used for reporting E/M services provided over the phone, telephone codes can only be used for regular patients, not for patients who come in for a face-to-face visit within 24 hours. Time is a crucial factor, as codes are different for different durations.

Emergency (99058)

Patients needing an emergency visit are coded “99058”. This code is used if a patient demands and needs immediate attention from the medical provider, which will as a result, cause disruption in the schedule of other appointments. This code can only be used for in-office visits.

Health Assessment (96160)

Code 96160 is used to provide a health risk assessment on a patient, with or without a guardian. It is used when assessing risk diseases and disorders, like those pointing to mental health.

Outsource To Med-Miles LLC

Medical Coding is a very complicated procedure that requires you to stay up-to-date on the latest coding updates in order to avoid errors and omissions and to generate a lot of revenue for your practice.

It’s a tedious task that takes up too much of your time and distracts you from your dream goal. To get yourself out of these burdensome tasks, there are Medical Billing Companies that can help you by providing Medical Billing Services Like Med-miles LLC.

So if you hand over these tasks to our team of experts who can handle the Medical Coding operations appropriately that would be a bigger step towards success.

Save Your Time Today! Call us at (888) 598-9181 for Medical Coding Services.

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make practices stand out

How Do You Make Your Practice Stand Out?

In this competitive healthcare field, it is difficult to differentiate your practice from all other practices.

To stand out, you need to separate yourself from the other doctors and prove that you are the best choice who is solving the problems that people are struggling with.

You must know one thing that your patients always have a choice. They can choose you or another practice easily. So, it’s important to think about what makes you unique? We found that patient experience is the core reason for your practice’s success. From pre-care to post-care, patient follow-up is necessary.

So, How do you make your practice stand out to get more patients and increase revenue? Here are 7 ways that you should know. Let’s have a look!

1. Connect and Engage With Your Patients

One of the best ways to differentiate yourself from competitors is to connect with patients and make them feel that you cared for them. Moreover, patient and provider connection is the center of effective delivery of the services. In ancient times, there had been a lot of pressure on the human-to-human healing connection.

If your patients want to connect with you then it means they will keep coming back to you and surely they will recommend you to their friends and family.

As a matter of fact, connecting with your patients doesn’t mean that about how much time you spend with them. It actually means how much you understand them better than others. It is also said in the research that if you understand your patients’ problems it will result in saving time for both of you.

However, the secret to achieving success in healthcare is to give your patients an empathic connection feeling rather than a set of particular words. 

2. Delight Your Patients

Are you giving your patients more than what they would expect from you? It is more important to deliver your patients more than they expected. As it is said that 

“Patient can get a prescription anywhere, but they can’t get that experience everywhere”

Well, you know that patients can go anywhere to get their treatment. In this technological era, it is easy for patients to talk to a doctor from the other side of the globe and get a prescription.

However, it is important for you to make your patients a reason to choose you as compared to personalized service. How would you do that? The answer is as simple as it is “Delighting your patients”

Now, you will understand that a patient’s experience is key to your practice’s success. So, don’t ignore this if you want to stand out from the competition. 

3. Be Responsive To Your Patients Online

Regardless of your practice size, it is annoying if your patients have to wait on the phone to talk to customer service. For that reason, it is important for you to use a secure communication system for your practice, which immediately translates patient phone messages into text that will allow you, administrative staff, to quickly respond to patient’s questions or direct them to the suitable provider. This all is private, secure, and meets all the HIPAA regulations.

Make sure to respond to your patients within 2 hours or faster because people don’t like to wait on the phone to talk to you. What they actually want is to feel cared for. Provide them a variety of open, flexible touchpoints for communication.

Therefore, having secure, demanding, and communication platform signals is important to understand your patient’s needs.  

4. Train Your Team

Train your staff today to get a great first impression. Because your team will get to interact with your patients before they come to you. You should address the patient’s questions to your staff regarding your practice.

Give them details about the services you provide and also tell them other specific details such as pricing, equipment that are used during procedures, etc.

5. Improve Ratings and Reviews

To make your practice grow or stand out then you should actively improve ratings and reviews. As it is one of the most efficient ways to attract new patients. 

According to research, 72% of patients use online reviews to find a new doctor. So, if you aren’t actively monitoring review sites, you will be losing a huge opportunity to attract new patients.

What you need to do is encourage your patients to share their feedback in an online review. This would be done simply by sending a follow-up email thanking your patients for their visit and encourage them to review you online. 

There are also other ways such as offering discounts or free services to provoke patients for posting positive reviews of your practice.

You can also share your patient’s review publicly on your website that will help you to make a stronger patient relationship and to get your identity out there.

6. Use Technological Advances

Nowadays your patient’s only need is to get a technologically connected healthcare experience. Are you giving them that experience or not? If not, then it’s the right time to switch towards technological advances and provide your patients’ cost-effective technical updates.

If you think it is costly for you to get technological equipment then outsource your all technological needs to us. We at Med-Miles LLC provide you with consultancy services that will help you to focus on your core business.

7. Be Specific

Want to make your practice stand out from the rest? Then be specific about your positioning. Your practice can’t be all things to all people. So, be specific in what actually is as a medical professional? Or as a practitioner? 

If you are clearer about your position then you will attract more prospective patients for what they are looking for. 

Now, you understand that your patients are the center of your practice success. So, improve your practice performance by using the ways above mentioned. If you will not do it today then you would stand last among your competition. 

 

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