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.
