The Best Medical Billing Practices Are Controlled and Outsourced

You do not have to be a genius to recognize that the healthcare industry is constantly transforming due to rapidadvancements in technology and medicine.  Thinking back to simpler times when physicians made house calls and gained “fans” by always having the best lollipops for patients, it is surprising how many things providers have to worry about nowadays.  Between social media demands, EHRs on iPads, ICD-10 Changes and the lowest-ever reimbursement levels, it is no wonder that KevinMD blogger, Dr. Juan J. Reyes and his peers, would be concerned with physicians disillusionment of the industry.  He discusses that the way for physicians to become more motivated is to add more to their plate, essentially. He focuses on improved “fulfillment” for physicians, and while we are all for physician involvement, he suggests drawing physician attention away from finances.

Ah, common ground. We agree that a provider’s time is being wasted if he is constantly focused on where they are losing money.  The solution is, of course, outsourcing the billing and collections to an agency that specializes in the process.  Often times, physicians are hesitant about this process because their billing and coding is so internalized they do not want to lose control, or their staff, who they tend to have personal relationships with. The fact is that antiquated coding principles are costly and mistakes go un-noticed, which leads to practices scratching their heads wondering where all their money is going.  Unforeseen costs of doing billing internally add up quickly as well when you take into consideration things like; phone bills, software, training, penalties, materials etcetera.  The key to success for practices that suffer low collections, is accepting that they need help.  Once struggling practices outsource these steps, they can get back to focusing on care, which is why they got involved with this industry in the first place.

It is important for practices to be cautious in their choices however when it comes to billing and collections, because you don’t want to shoot yourself in the foot by sacrificing control and practice values. Before making any decisions, physicians need to be assured that the medical billing practices are in line with their practice’s expectations in regards to control of payments, personnel and data.

Social Media in Health Care: Tricks of the Trade

When the first signs of social media surfaced in the early 2000s, who would have guessed that it would serve as the platform for how public relations and marketing operate? The reality is that social media has truly transformed each and every consumer industry in existence, and that includes health care.                                              

We have come a long way from MySpace and chat rooms.  Now, Twitter can serve as a major news source, Facebook spreads the word about your business to your community, LinkedIn enables professionals to make networking connections to individuals they would have never seen as a peer and blogging has expanded the barriers of learning. 

The trouble with this social media revolution is that the train has been trucking along for a few years now, and the health care industry is just now trying to jump aboard.  It is funny, considering most people would suspect that the medical world would be rather technologically advanced, but it is quite the opposite.  Almost every radiologist that we have met with or spoken to has voiced their interest in getting involved with social media, but the problem is that they do not even know where to begin. No one wants to devote time and energy to something that will end up having little to no return on investment, which is where we have been able to come in and save the day.

* [Taken from our Social Media Analytics]

The proof is in the pudding, though and the sheer amount of website traffic we have generated to our website over the past few months is a direct result of our efforts.  While there is no exact recipe to follow for social media success, Shama Hyder Kabani’s book The Zen of Social Media Marketing, can serve as a great starting point.  Since the book focuses on businesses as a whole, and the health care sector of business is it’s own unique niche,we have also created a basic checklist for physicians to determine where they are on the path to social media stardom, so please feel free to reference it as a guide.

If you are still skeptical of the benefits of online media marketing, simply take a look at any of the health care blogs that have been discussing the new trends in technology, you will see that patient-friendly and physician-friendly website applications and programs are having a huge impact on where care is headed. The new frontier of personalized health care, price shopping for services, and the entire patient experience and sense of control is being put directly into the hands of patients and providers alike, in the form of their iPhones, Androids, Blackberries and iPads. So run and catch that train to success folks.

Charitable Giving: The New Standard for "Quality Service"

Atlantic Health Solutions is dedicated to our mission of devoted service; this involves establishing a culture of care at all of our facilities throughout the year, but focusing especially on that mission during the holiday season.

The staff at Atlantic Health Solutions focuses on charitable giving throughout the year in many ways and challenges our facilities to be involved with community outreach as well.  The diagnostic imaging centers we work with donate their time to service opportunities in their area and also work to start charitable traditions of their own.

  Advanced Imaging Centers (Florida) and Compass Imaging (Mississippi) worked together during October to promote the Pinky Swear Campaign they created which worked to spread the word about the importance of Early Detection and fundraising during Breast Cancer Awareness Month.  The campaign utilized a “pay it forward” approach, in which patients, staff and referring offices vowed to tell three people important to them about early detection and swearing that they would get screened, due to the role that early detection can have in the survival rate of breast cancer patients. They also participated in Making Strides Against Breast Cancer walks and handed out coupons for discounted screens on their new Digital Mammography unit.

At Northeast Nebraska Imaging Center in Norfolk, they tried something new this year. The center as a whole has adopted a family of three, a single mother and her two children. The staff went shopping and found everything on their list, which means that they have provided the family with all of their needed supplies as well as some holiday cheer. Northeast Nebraska Imaging is also helping to grant a Christmas Wish for a Northeast Nebraskan Family by donating to US92’s Christmas Wish Program.  The Christmas Wish Program, put on by the local radio station in Norfolk received hundreds of letters from Northeast Nebraskans who nominated someone that was in need this year. With the help of the Fraternal Order of Police and donations such as Northeast Nebraska’s, US92 can continue to grant as many wishes as possible. 
 
In November, Northeast Nebraska Imaging also participated in The Warm Heart, Warm Hands Glove Campaign, delivering boxes to area clinics so that their staff and patients could donate gloves, hats, mittens and coats to help the area’s Bright Horizons locations. The center collected 127 hats, mittens, gloves, scarves and coats for charity.

                                

Atlantic Health Solutions ourselves have donated gifts and our time to the Metropolitan Ministries, a charity dedicated community outreach and providing resources to help those in need find food, clothing, shelter and other services all year around but especially during the holiday season.  Their mission is to alleviate suffering, promote dignity and instill self-sufficiency, which if you think about it, are things that our facilities work towards each and every day.

Metropolitan Ministries is in the running to win a $50,000 grant from The Pepsi Refresh Project, please vote here to increase their chances of being awarded this miracle-making grant.

CMS to Cancel Group Practice Provision of MPPR-PC

The following announcement was released from the RBMA today regarding the CMS announcement regarding MPPR and further reimbursement reductions on services rendered by the same physician or group practice. The ACR and RBMA worked fervently, opposing this new policy, due to the impact these further cuts would place on American radiology professionals.

The Centers for Medicare & Medicaid Services (CMS) announced Friday that due to “operational limitations”, CMS’ contractors will not apply the Multiple Procedure Payment Reduction (MPPR) of 25 percent to the professional component (MPPR-PC) of subsequent CT, MRI, or ultrasound services to group practices in 2012.  The 25 percent reduction, effective January 1, 2012, remains in effect for subsequent CT, MRI, and ultrasound services when furnished to the same patient, by the same physician, during the same session on the same day.  The expansion of the MPPR-PC to group practices was opposed vigorously by the American College of Radiology (ACR).  RBMA also opposed the policy and supported the ACR’s efforts in recent meetings with CMS.

In last month’s final rule for the 2012 Medicare physicians’ fee schedule, CMS announced its plans to expand its Multiple Procedure Payment Reduction (MPPR) policy to the professional component (PC) of CT, MRI, and ultrasound services when furnished to the same patient, by the same physician or group practice (emphasis added), in the same session on the same day.  The procedure with the highest PC and technical component (TC) payments would be paid in full, but the PC payment of the subsequent procedure will be reduced by 25 percent.

CMS’ proposed rule for the 2012 Medicare physicians’ fee schedule included a 50 percent MPPR-PC but failed to mention it applying to physicians within the same practice. 

By publishing the group practice provision only in the final rule, ACR argued that the agency violated public rulemaking and that the group practice provision was counter to current subspecialty radiology patient care.  Bob Still, RBMA’s President-Elect, added that the provision would be difficult to implement for contractors and practices alike.

After this announcement on Friday, CMS released the following statement:

“The Medicare Physician Fee Schedule claims for services rendered on or before December 31, 2011, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.  The Administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate (SGR) formula-driven cuts, and has put payments for health care for Medicare beneficiaries at risk.  We continue to urge Congress to take action to ensure these cuts do not take effect.”

SGR Bill Passed House of Representatives Now On to Senate

Well we have dodged the first bullet, but there is still a whole war to be won concerning H.R. 3630, known as theMiddle Class Tax relief and Job Creation Act that was passed on December 13th by the U.S. House of Representatives.  The Act prevents a further 27% cut to Medicare physician reimbursement and provides physicians with a 1% increase in Medicare payments for 2012 and 2013. So far, there have been no additional medical imaging cuts, so kiss your babies but keep your fingers crossed folks, because we still have to make it through to the Senate.

There is still the concern that this act does not contain information from the Diagnostic Imaging Services Access Protection Act (H.R. 3269), which protects against the implementation of a 25% payment reduction on professional fees for multiple MRI, CT and ultrasound procedures.  Fortunately, there are 127 supporters of H.R. 3269 in the House of Representatives and the ACR has announced that they will continue on their plight to add the language from H.R. 3269 as the SGR legislation heads to the Senate.

This SGR adjustment means good things but since it still does not address the proposed rule from CMS that would severely cut the Medicare reimbursement rate for radiologists who interpret multiple images, we have to hope that pressure from all concerned, including the ACR, pushes the Bill through. Although this is certainly a step in the right direction, this could just be a “quick fix” and the proposed cuts to radiologists would be the 8^th cut in the past six years to Medicare funding for Diagnostic Imaging.  The seven cuts that have occurred over these past six years have totaled more than $5 Billion and with imaging growth at less than 2% annually, additional cuts would end up limiting American’s access to quality diagnostic imaging due to the facilities that would suffer and end up closing their doors if the cuts went through. Republican representative James Renacci did introduce a legislation that would allow for a six-month grace period for new diagnostic imaging centers, so that those certain suppliers of Medicare imaging services could bypass the MIPPA accreditation requirement to receive reimbursements during that period of time.  The grace period begins when a new physician or facility submits images to the accreditation process and ends either with the approval or denial of their request, or after 6 months have commenced.  The center will be able to receive reimbursements during this time, however if they are unable to get accredited by the end of the period, any reimbursements they received would need to be paid back.

It can be assumed that due to the Senate’s Democratic leadership, they will attempt to create their own version of the legislation that will include a one to two year “doc fix,” which equates to questionable Senate action timing.  TheRBMA estimates that a package will be put together by the end of the week and voting will take place Monday or Tuesday, dependent upon the ability to create a package that gains some Republican Senate support.  This brings a whole new meaning to the term, a house divided sports fans, and we could end up waiting on a decision until well into 2012.

Tags: health care reform, diagnostic imaging, affordable health care, DSO, reimbursements, ACR, RBMA,Medicare, imaging cuts, SGR