Do you know the reason that why Healthcare Providers face challenges with Medical Billing?
Here are some important reasons;
TIME CONSTRAINTS:
Day-to-day business operations at a practitioner's site represent a bustling and eventful array of healthcare services. But most medical offices are very limited on administrative time as their primary focus is healthcare operations. As such, a conversion to a new system will require a significant effort and expense for the practice, a move that they are reluctant to make.
BUDGET CONSTRAINTS:
As with any successful business, one of the keys is to keep overhead costs to a minimum and to extend the useful life of all capital assets. To process claims electronically, the practice will need to acquire additional software, perhaps additional hardware, and spend a large dollar amount for training on the conversion.
On-going costs are also high. Due to the high employee turnover in medical clinics, doctors constantly hire and train new staff. Maintaining a computer system means paying for constant annual upgrades, training and support contracts.
STRICT PROCESSING GUIDELINES:
Healthcare providers are required to adhere to strict processing guidelines established by insurance companies and government agencies. Failure to comply with these strict guidelines results in claims being rejected, which in turn has an adverse effect on cash flow. Healthcare providers seldom are willing to take this chance. Additionally, when they process claims, they are required to batch claims which may result in a delay in processing, thus forfeiting one of the key benefits of electronic claims processing.
LIMITED EXPOSURE TO THE BENEFITS OF ECP:
Most healthcare providers are familiar with electronic claims processing but are unsure how the process may impact them specifically. With limited exposure, they do not have the ability to recognize the tremendous potential in cost savings, efficiency and improved cash flow that electronic claims processing can provide.
MOST DOCTORS ARE NOT TRAINED FOR BUSINESS:
Healthcare providers spend 10-15 years in medical studies. Even while they are practicing medicine, they have to stay active in medical research and development. Most doctors are not experienced in running a business. They rely heavily on professionals to take care of their business.
1) TIME CONSTRAINTS: "Day-to-day business operations at a practitioner's site represent a bustling and eventful array of healthcare services." --While this is a true statement, thus the need for efficient best practices and professionals who understand their function in the grand scheme at that practitioners site.
ReplyDelete5.) MOST DOCTORS ARE NOT TRAINED FOR BUSINESS: "Healthcare providers spend 10-15 years in medical studies."-- Doctors should not have to concern themselves with running the business end of their practice but rather leave it in the capable hands of a business practitioner. Doctors go to school to learn how to effectively practice medicine; in addition to being part of the administrative element in providing customer service and answers to ancillary providers, it is part of my job description to make sure that I provide accurate information so that the doctor can do his job without worrying about interruption in cash flow to their office.
4.) LIMITED EXPOSURE TO THE BENEFITS OF ECP: "Most healthcare providers are familiar with electronic claims processing but are unsure how the process may impact them specifically." --I admit there are problems with insurance companies communicating effectively with the practitioners administrative team (i.e. properly billing for services rendered, understanding or knowing what a patients insurance company will cover). There is a great need for Provider advocacy to help the provider navigate through the maze of expectations of insurance companies claim rules.
3.) STRICT PROCESSING GUIDELINES:
"Healthcare providers are required to adhere to strict processing guidelines established by insurance companies and government agencies."
--More information should be easily accessible, understandable and a need for simplifying the process while staying compliant with regulatory and government agencies.
2.) BUDGET CONSTRAINTS: "As with any successful business, one of the keys is to keep overhead costs to a minimum and to extend the useful life of all capital assets." --This is a challenging issue but not an impossible one. While the focus is to provide quality medical care at an affordable price we should see this challenge as an opportunity to reform the way medical coverage is extended toward every citizen in our society. There's an opportunity to look at the best ideas from the various processing systems in use to create a cost effective system that will allow more time treating patients and less time on unnecessary administrative cost.