Outsource Your Medical Coding to Meet ICD 10 Requirement

Medical coding is the process of transforming descriptions of medical diagnoses and procedures into universal code numbers. The medical practitioners can improve their efficiency and concentrate on providing superior healthcare services to patients, if they outsource medical coding billing task to a service provider. All providers, including physicians, as HIPAA "covered entities," are required to convert to ICD 10 by October 1, 2015. While this change will help usher the U.S. Healthcare system into the 21st century, it will initially lead to confusion and doubt within most practitioners' offices.

Outsourcing your needs to your offshore partner will help you to gain correctness and consistency in a better way. These professional service providers make best use of latest software and technology to perform accurate and effective medical coding.

Outsourcing companies have professionals skilled in the latest coding protocols and standards, insurance and governmental regulatory requirements and payer-specific coding requirements. They ensure that coding processes are done efficiently and utilize innovative technology, coding tools and advanced medical coding software packages to ensure reliable coding.

Icd-9 codes are quite limited in terms of specificity and reporting. The new icd-10 medical coding has introduced new dimension of specificity by providing the accurate code for diagnosis and procedure. It is very important to understand the advantages of outsourcing medical billing and coding. Some of the important advantages that medical billing companies can look at are as follows:

• Cost Benefits
• Meeting Standards
• Using Specialists
• Quality Assurance
• Transparency
• Accuracy

Private clinic and hospitals has the main reason behind outsourcing online medical coding services is to improve in their medical billing payment profitability and turnaround time. Medical coders are like private detectives or investigators. They assign various codes to the patient's signs and symptoms.

MDofficeManager do follow the complete transparent method while delivering the output, providing certified and experienced medical coding specialists who manage the accuracy with latest technologies to improve the speed also following HIPAA rules and regulations so there is completely trustworthiness.

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What Practitioners Need to Look for Choosing Right Medical Billing Company

One of the most important decisions physicians has to make is selecting the right medical coding company to outsource their medical billing. When you use the services of a medical billing company to handle your transactions, you gain assistance from experts in the complexity of the health care industry.

Premium Services That Medical Billing Company Offers:

Claim Generation: The process involves entering patient demographic details plus insurance and encounter information into the medical billing software.

Claim Submission: This process relates to the claim submissions sent through a clearinghouse if it is in a digital format. If it is on paper, the documents are sent by mail.

Quality Assurance: The quality assurance applies to electronic claim submission and paper claim submissions. The premium medical billing software programs have inbuilt quality assurance check features called 'Scrubbers' that enable the billers to track any mismatch of procedural codes and diagnosis.

Following-up of claims with carriers: The billing company ability to follow-up on the claims submitted should come into sharp focus, because reimbursements and revenue collections of a practice have a bearing on the kind of follow-up provided by the service provider.

Workers compensation claims: These secondary or tertiary claims require additional documentations and deft handling. The service provider has to be experienced in documenting these unique claims, because it entails entering many details into the documents.

Reporting & Analyzing: Billing software's have a report generating feature and as part of medical billing service, regular reports provide practices in-depth information that will help increase profitability, save costs and provide the practice the direction towards growth.

Patient Invoicing: This detail-oriented process if done professionally enhances the revenue of the practice. Medical billing companies will also need to take care of queries that patients may raise after they receive the statement, that the company has good infrastructure and customer support will eventually reflect the quality of your practice.

HIPAA compliance: The billing company's awareness of HIPAA regulations also needs a look-in, apart from health care providers these regulations apply to any agency that has access to patient information.

Most medical billing service providers offer the highest amounts of reimbursements and maximum profitability. How do you go about choosing the one that actually does what it says. If you are determined to run a successful practice and increase your business, using a reputable billing company can really help you towards this goal.

Reasons to Hire a Medical Billing Company

It's simple, by hiring a medical billing company you will not need to hire a huge billing staff that means you don't need to pay extra salaries and can have that sum in your account as an asset for further investments or you won't need to establish an extra department or an office and that means that you are going to reduce or eliminate the extra budget of office equipment and at the same time you are eliminating the mental tensions relating to your billing processes as all things would be standing on the company's side that you are going to hire.

Outsourcing medical billing services to a professional medical billing company dedicated to providing quality solutions can ensure you more tangible benefits.

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Medical Practice Management System - Keeping an Eye on Your Practice

There are many challenges associated with Practice Management within a given healthcare entity.  MDofficeManager’s PMS system alleviates, or completely eliminates those challenges. With our cloud-based platform, and “user-friendly” model, it allows us to provide a tremendous amount of flexibility, adaptability, and customization for each and every provider’s particular needs.  Three of the challenges practices encounter include the following:

Challenge 1: Administrative Burdens

Statistical analyses states that physicians say mounting paperwork is precluding them from spending enough quality time with patients. This trend is eroding physicians’ on-the-job happiness.

Prior authorizations are a major source of physicians’ paperwork burden. More payers are requiring prior authorizations for drugs and procedures.  In a Kaiser study, it is estimated that the nation’s physicians spend more than 868 million hours annually on prior authorization activities. Payers say prior authorizations hold down costs, improve treatment efficacy and ensure patient safety. To physicians, however, they are an obstacle to providing the best care for their patients.

Technology-driven changes, from meaningful use to ICD-10, are one key administrative task that’s taking up time.  From prior authorizations to struggles with implementing and operating EHR systems, physicians are increasingly struggling to squeeze patient encounters in between bouts of paperwork and other red tape.

A quality Practice Management System which MDofficeManager employs addresses these frustrations with providers, and allows for more time to focus on patient care.

Challenge 2: Independence vs. Employment

For some physicians, joining a large hospital system offers a haven from the rising administrative burdens. But joining a hospital system is not a panacea for the challenges facing physicians.

Some physicians are returning to private practice because their compensation from hospitals became less attractive after the expiration of their initial contract. During an initial “honeymoon period,” providers’ pay was based on the previous three years of tax returns. However, after the contracts were up, the hospitals switched to performance-based pay, which ended up being lower.

While the trend towards consolidation and hospital employment is continuing, the AMA data suggests it has not happened as quickly as many analysts expected. Still, the pressures on independent physicians are such that more physicians are likely to seek to join a hospital in the coming years. 

As large networks acquire more and more physicians, they direct patients to their physicians. If a provider is outside of the network in most communities, this means the hospital systems will hire people to compete with providers and take the losses up-front that are involved to ultimately secure the patient base.

Challenge 3: Payers Dictating Healthcare

Physicians have to deal with a range of audits tied to meaningful use and other programs. The federal government can audit Medicare patients’ charts, while individual states can audit records for Medicaid patients, since they fund Medicaid, up to 10 years after a patient’s treatment.

The audits are just one sign of a trend toward payers influencing—or some would say dictating— patient care that, for many medical professionals, can erode their satisfaction with their profession. 

Factors like these remind providers of how prescient their decisions to stay independent of these outside payers really were.  Providers believe in the sanctity of the doctor-patient relationship. That third-party—whoever it is—should not be in the middle of it.

Audits are not the only way payers are inserting themselves into the physician-patient relationship. Prior authorizations are another ways payers attempt to take decision-making out of the hands of physicians.

More payers are tightening their provider networks in an attempt to reign in costs. This move toward narrow networks means many physicians are being evaluated.

THE SOLUTION:

MDofficeManager provides an affordable, speedy, and effective Practice Management System to healthcare facilities throughout the USA, and to prevent the aforementioned audits from occurring.

The revenue cycle management for medical practices has become more complicated than ever. With ever-changing insurance, company policies, government policies, compliance regulations and healthcare reforms, it has become difficult for physicians and their staff to keep pace. This results in incorrect or delayed filing of claims and poor reimbursements. MDofficeManager can help you streamline your revenue cycle and get better reimbursements, thus saving you precious time and effort and allowing providers to concentrate on patient care!

With our Practice Management System, collection rates will dramatically increase, as will your peace of mind. Also, processing costs are reduced by as much as 60%. We file both electronic claims and paper claims to over 1500 payers across the United States. We have certified medical billing experts at our disposal whose sole focus is on billing, and, consequently, this frees up the staff to concentrate on other issues. We place a premium on accurate billing, reducing the rejected claims rate to 2%-3% and not 30%. We file both electronic claims and paper claims to over 1500 payers across the United States. We bill accurately the first time, dropping the rejected claims rate.

MDoficeManager’s complete Medical Billing, Coding System and Credentialing includes the following:

• Patient Registration and Verification: We enter the patient demographic information and verify its accuracy.
• Eligibility and Benefits Verification: We check the benefits and eligibility of the patients before the provider renders service and records it in the Practice Management System.
• Coding: Coding for diagnosis, services rendered, and appropriate modifiers is verified and set.
• Charge Posting: Charge information is entered into the system for medical billing claim generation after a thorough reconciliation from both the provider’s office and MDofficeManager.
• Claims Management: E-claims and paper claims are generated and sent out to payers via a medical billing clearinghouse. Claim receipt acknowledgements are checked and unsent claims are re-filed. Payer responses are checked and processed.
• Payment Posting: ERAs and EOBs are processed and payments are posted into the system.
• Denial Management: Claims denied on EOBs are corrected and re-filed or appropriately appealed.
• Reports: Monthly billing summaries with collections, billables, and outstanding AR’s will be provided. Client-specific reports are also submitted monthly and/or yearly. You can generate 250+ different reports and see what we do anytime.
• Credentialing/Re-credentialing Services: We make sure your provider’s record is up to date with all insurance companies.
• Clearinghouse or statement mailing there are NO added charges for these services.

The medical practice management services offers proper management of the revenue cycle through proper billing and coding of medical services offered to patients so as to ensure that all the income of the practice is maximized through proper insurance claim processing and increased claim settling rate.

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The Importance Of A Professional Medical Coding Specialist

Theodore Roosevelt once said: “Nothing in the world is worth having or worth doing unless it means effort, pain & difficulty.” While the former president’s outlook is a bit extreme, sometimes the most challenging things we encounter garner the greatest rewards.

There’s no denying that healthcare careers are complicated. Professionals in these fields attempt to understand, interpret and diagnose problems in the human body, the most complex organism on the planet, and this includes the significant role a medical coding specialist plays, and why MDofficeManager places a premium on medical coding specialists.

What exactly is medical coding?

Medical coding is a component of the medical billing process that assigns codes to claims from a patient visiting a healthcare facility. The coder is responsible for allocating medical codes (CPT, ICD and HCPCS) to the claim. Put simply, whenever a patient goes to a clinic or hospital for any reason, the visit has specific medical codes assigned to help track the reason of the visit for medical and billing purposes.

Is medical coding difficult?

Medical coding is not difficult for the right person.  It requires attention to detail because nothing can be missed when processing patient information and everything needs to be assigned the proper code.

Generally medical coding specialists read and review medical documentation provided by physicians and other health care providers in order to obtain detailed information regarding their disease, injuries, surgical operations, and other procedures that are translated into numeric codes.

The most challenging point comes from having a solid knowledge of anatomy, physiology, pathophysiology, and medical terminology to successfully learn the coding systems. Having to acquire and retain this diverse knowledge base is the reason MDofficeManager only hires AAPC Certified Coders.

What are the most challenging aspects of medical coding?

Human anatomy has a lot of grey areas but medical coding is black and white. The challenge comes in transforming cloudy and complex medical symptoms into clear, discernible codes.

For example, ICD-10 coders must understand the symptoms that are integral to a disease. The doctor will pass along case information with notations about the symptoms and coders are responsible for pulling out the important parts to document.

Attention to detail is critical. A medical coding specialist has to re-check his/her work against the alphabetical coding list which can be time consuming and tedious, but ultimately helps to eliminate errors.

It is also challenging to keep up with industry changes. Existing medical codes are updated, changed or discarded every year.  And the most important part for learning medical coding is applying the guidelines set by the industry regulators.

It is critical for professionals working in the field to stay on top of these changes to avoid documenting inaccurate information.

To sum it up…

If you are willing to put in some work at the front end and to keep up to date on all of the changes, the challenges of becoming a valued medical coding specialist will be even easier to overcome.  A lot of variables can occur from the time a patient arrives at a clinic to the time that they leave, and it is up to a medical coding specialist to ensure that nothing gets missed.

Medical Coding is one of the KEY’S for MDofficeManager’s success

As a provider or staff member, are you troubled with:

• Cash flow spiraling downhill.
• Lost checks.
• Screaming at insurers over the phone.
• Sleepless nights.
• Problem coping with rules and constant updates.

With higher self-pay and compliance increasing exponentially, there is greater opportunity for risk. Medical coding is a key activity that impacts the financial health of your practice.

Have you thought why medical coding services must be accurate, error free & quick? The reason is that without coding breaches there is a higher reimbursement rate and a constant flow of income. Accurate and error-free medical coding not only ensures that medical claims are reimbursed timely, but also takes care that you get paid optimally.

MDofficeManager Benefits

• Higher profits.
• Easy-to-access documentation.
• Optimized workflow.
• Timely & accurate reimbursements.

Why should you count on medical coding services with MDofficeManager?

• AAPC credentialed coders.
• Medical coding audits.
• Efforts to reduce RAC audits.
• Specialty-specific versatile coding services.
• Hospital/in-patient coding.
• Emergency room e-code evaluation.
• Accurate & stringent quality checks.
• Coding turnaround.
• Quick setup and go-live.
• ICD-10 readiness.
• ICD-9-CM coding validations.
• CPT and ER with E&M medical coding.
• ICD-9 coding based on AMA and CMS guidelines.
• Compliance with all medical coding systems, such as ICD, CPT and HCPCS.
• Variety of statistical reports generated.

We offer more than what is required for MDofficeManager to be your favorite online medical coding company. 

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Digitizing EMR Medical Transcription for Quick and Convinient Healthcare Solutions

MDoffice Manager’s EMR Medical Transcription/Integration Services is an interface with any Electronic Medical Records or Electronic Health Records (EHR) system. It provides no-cost custom interface services on a quick turn-around for both standards-based (HL7) and proprietary systems. There are many types of electronic interfaces. The two primary ones are as follows:

1. Document Interface

Document interface transfers transcribed documents to the EMR Medical Transcription system in a structured data format building it ready to be import by that system. This mechanization saves significant time and generally makes transcribed reports immediately available for review.

  2.  ADT Interface

Admission, Discharge, Transfer (ADT) interfaces transfer non-clinical demographic information from a third-party EMR Medical system to our Transcription system. It is a dual system where we receive ADT messages and match these messages with the transcribed document in our system to give our clients this document in real time & eliminates the need for physicians to spell-out patient names and is totally comprehensive.

From meaningful use compliance to value-based purchasing, the ability to compete for today’s healthcare organizations is driven by the accuracy of structured narrative reports and the speed with which they are fed into their electronic health record systems.

Financial and clinical coding processes rely upon these reports — which make up 50% of a patient’s record — as their primary source of information. Providers depend upon dictated text to communicate the unique, expressive and complete patient story to other healthcare providers. However, to be leveraged by the EHR, narrative reports have had to evolve into discrete and interoperable patient data available in readable and scannable formats.

The impact of an EHR doesn’t end there. It has also altered the process of transcription and the role of the medical transcriptionist.

Multi-faceted impacts

When conversation turns to the aspects of healthcare most affected by EHR adoption, the move toward a fully digital environment characterized by real-time data sharing and exchange is not commonly mentioned. The truth is that the move to digital has technically and functionally transformed transcription.

On the technology front, EHRs are able to interface directly with transcription platforms to parse data. Transcription now creates discrete data fields rather than flat files or static information snapshots. In addition to complying with HL7 data requirements, these capabilities created demand for dictation software with advanced speech understanding to create greater efficiencies in data transfer.

Specifically, admission, discharge, transfer feeds and clinical dictation can now be integrated between systems, eliminating manual transcription. Instead, patient demographic information can be systematically merged for editing, which also speeds turnaround times.

That transition to editor is perhaps the most significant effect EHR adoption has had on the role of medical transcriptionists. As speech understanding software becomes more commonplace, creation of a typed document will become extinct. Instead of creating documents, transcriptionists are now responsible for editing them for medical accuracy. Adapting to this new role has been a challenge for some transcriptionists. For others, it has opened doors to new professional opportunities, including quality assurance and coding.

Making the transition

Just as the role of transcriptionists has evolved under the influence of the EHR, so too must the technology infrastructure, in order to effectively transition reports from one-dimensional text to reusable patient data. Today’s narratives are now subject to natural language processing (NLP) — technology capable of “understanding” spoken dictation and converting it to electronic text that can be parsed and mapped to specific data fields.

When paired with transcription management software, NLP technology enables hospitals to seamlessly integrate dictation into the EHR based on pre-defined templates that determine where the data should wind up within the electronic record. While the presence of an EHR on its own does not alter the front-end look or content of the narrative report, it does introduce greater flexibility into the look and feel of the templates themselves.

This is particularly useful for transcriptionists working with multi-facility systems or outsourced transcription vendors. In a manual environment, these transcriptionists would spend a portion of their time formatting clinical narratives to meet the requirements of individual hospitals. Now, formatting is handled by the software behind the scenes. The end result is higher productivity levels, faster turnaround times and greater standardization.

Outsourcing change

One of the most important aspects of a successful transition to the new era of transcription is establishing the framework to guide software implementation and adoption. In many cases, hospitals find it helpful to seek out the support of a vendor experienced in identifying needs and capable of designing an effective strategy to meet them.

The best firms will follow established best practices, which should include early and ongoing involvement of the facility’s leadership and medical staff to ensure top-down adoption of and compliance with the new processes.Proper training and education is at the heart of any successful transition, which is why it is important the vendor selected to guide the process provides education at appropriate milestones. At a minimum, education should be given during the kickoff phase and at go-live.

The typical training plan should include, at minimum:

• Identification of training facility needs
• Initial training of in-house trainers (“training the trainers”)
• Identification and selection of an in-house training coordinator

Identification, design and development of facility-specific training materials should also be provided, including roles-based guides for instructors, administrative users and report users. Finally, customized workflow mapping should be conducted to ensure any areas of weakness are identified and addressed.

Maximizing outcomes

Whether it is the promise of incentive funds or the threat of reimbursement cuts, the pressure to transition to an EHR is increasing. To maximize the return on their investment, hospitals and other healthcare organizations should pay close attention to the impact the resulting changes has on their transcription processes — and the transcriptionists themselves.

The adoption of NLP and front-end speech understanding software, combined with targeted transcriptionist training and education will ultimately increase accuracy, efficiency and productivity. It will also speed access to patient information by those who need it to make the decisions that impact care quality and financial outcomes.

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Advance Electronic Medical Practice Management in 2015

Electronic Medical Records (EMRs) are replacing outdated paper record systems. The U.S. government has mandated a nationwide switch to EMRs by 2015, and is prepared to offer up to $64,000 in incentives for medical practices that adopt the new technology.

The 2009 law creating the Medicare and Medicaid EHR incentive program established payment reductions that begin in 2015 for eligible physicians and other health professionals. The incentive structure pays Medicare bonuses of up to $44,000 over five years, although bonus payments sent after April 2013 are reduced by 2% because of the recent federal budget cuts known as sequestration.

Physicians must adopt EHRs and begin to meet meaningful use requirements by July 2014 to stop the penalty from taking effect in 2015. The penalty would reduce Medicare pay by 1% for the first year and grow to 3% by 2017. Starting in 2015, hospitals and practices are expected to be well along in demonstrating their meaningful use of EMRs — for this reason, the report concludes that most EMR prominent adoption will have been accomplished in two years’ time, and thus, the market will wane.

2015 Six Action Items for Every Medical Practice:

• Develop your patient portal.
• Implement an EHR, if you don't already have one.
• Develop your website.
• Get active on social media.
• Prioritize cyber security.
• Pay attention to your reputation.

EHR Audits to come in 2015

• Identify EHR system fraud and determine "how certified EHR systems address these vulnerabilities.
• Review Medicaid and Medicare EHR incentive payments and ascertain if providers or hospitals received payments they should not have received.
• Analyze the IT security of community health centers funded by the Health Resources and Services Administration.
• Review the Centers for Medicare & Medicaid Services health information technology systems and verify the agency adopted necessary security controls to protect EHR data.

Your mission is to provide quality care for your patients while at the same time managing your practice's with our healthcare revenue cycle management to streamline workflows and help ICD-10 code transition with our compliance in medical coding and billing services.

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