Hospital management professionals wear many hats. From designing unique processes to improving patient care systems, managing budgets and achieving business goals, these health care managers are doing it all. Under their watchful eye, the medical care facilities become more effective and efficient. These health professionals are hailed as drivers of success, given the multiple roles they play.
However, despite all these efforts that focus on creating better health management systems, medical billing and coding is an often neglected aspect of hospital management. The health care industry is heavily reliant on medical billing. Medical practitioners face administrative challenges in their line of work every single day.
One such challenge is the upkeep of the billing system for a medical care facility or practice. The importance of a medical billing system cannot be stressed enough. Other than clinical risk, mishandled medical billing systems can pose a serious risk of all of the health care provider’s administrative functions.
In this dynamic world, it is essential that hospitals use technological advancements to achieve their business goals. The medical billing system must become paperless and electronic to store and track patient history, treatment, insurance plans and billing.
This very essential job of converting this crucial information into transmittable data lands on the shoulders of health care managers. From coding the diagnosis to communicating payment requests to patients’ insurance firms, this is basically what medical ‘billers’ and ‘coders’ are collectively tasked to do. Without this administrative function, the smooth running of medical care facilities is often disrupted.
It is important to mention here that according to statistics, the American health care economy, which is a $2.9 trillion industry, still hasn’t shifted to automated management softwares/systems and remains ‘stubbornly stuck in the 90’s’.
Medical billing and coding is not free of errors. It is estimated through research conducted by Centers for Medicare and Medicaid Services that medical claims are erroneous 49% of the time. However, some experts even go as far as to say that medical bills contain errors 80% of the time. If a proper medical billing system is not in place, then these errors can lead to unjustified dent to a patient’s pocket.
Physicians and other medical practitioners also need to be reminded about the realities of what being a prosperous firm entails. Prosperity in the health care industry does not wholly rely on optimum patient care. According to statistics, doctors lose out on a jaw-dropping $125 billion every year due to inaccurate medical billing procedures. Here is how your firm can put medical billing in place without an expensive setup cost.
Then there is the increased hassle of legal actions. The legal procedure to resolve medical billing and compliance complaints is not only a huge waste of time and resources but also taints the reputation of a medical practice in the long term.
With the regulations concerning medical billing undergoing change, the process of medical billing becomes all the more important for medical care providers. The billing procedure’s importance is undeniable, especially with Health Care Reform bill which has increased the number of medically insured Americans to over and above 30 million.
Medical billing ensures smooth running of the revenue cycle for a medical care establishment. Medical billing professionals are required to be up-to-date with relevant industrial regulations and insurance policies. The business goals should be kept in mind when opting for and implementing automated hospital management systems. An automated system also produces intermittent reports highlighting important aspects of the ‘health’ of the business. This leads to an improved Return on Investment (ROI) and helps in achieving the Break Even point early, especially if you’re a new practice.
Automated hospital management system also minimizes the chances of theft of medical identity and billing related data unlike the black and white records which are hard to protect from unapproved access.
Not everyone has access to the automated system where critical information is stored at a medical health care facility. An added layer of protection can be added through proper software application coding and testing.
One way of ensuring that the medical billing and coding is as accurate as possible is that the health care providers may shift to an Electronic Medical Billing (EMB) system. It is paperless and significantly decreases the chances of errors. The Electronic Medical Records (EMR) can be synced with the Electronic Medical Billing (EMB) system.
Through this automation, redundancy concerning patients’ data can be eliminated. It will also be convenient for hospital managers to run checks on the patients’ insurance policy. Electronic Medical Billing is not only cost effective, more accurate, customizable but also reduces the need for dedicated resources to update and maintain billing and coding.
An Electronic Medical Billing (EMB) system increases the chances of timely payments by insurance firms and helps avoids unnecessary delays.
Another option could be to outsource the medical billing process. Primarily, this may appear as a more expensive choice but it will reduce the staffing worries. Companies specializing in medical billing have the required resources and expertise at their disposal. They will also prioritize payment collection and resubmitting insurance claims properly as they usually become revenue partners by charging a certain percentage of it as their service fee.
The statistics shared above also indicate the importance of a sound medical billing system which is error free, user friendly, safe and contributes to the business requirements of a medical health care facility.