There is a lot of uncertainty on the healthcare front which is affecting the U.S. public, healthcare providers, and the physician billing companies that serve them. In this context, experts say that the best option for physicians is to focus on providing cost-effective, quality care and improving practice management. Here are some key steps that physicians can take to stay relevant as they grapple with change:
- Focus on value-based care: Rather than volume and profitability of services provided, today it’s all about a patient-centered system organized around what patients need. The Access and CHIP Reauthorization Act of 2015 (MACRA) bases physician payment on quality. According to a recent Forbes report, medical schools are restructuring courses to give way to value-based care. Physicians can improve care delivery by following evidence-based protocols that reduce hospital-acquired conditions and associated costs, and scrutinize return on investment from IT, and supply and services contracts.
- Ensure claim submission with proper documentation: With the move away from volume to value, documentation is critical. Medical billing and coding companies help with this by checking for insufficient documentation errors such as incomplete progress notes, medical records that are unauthenticated or unsigned, and incomplete or missing signed order or progress note detailing intent for services to be provided. Payers will reimburse claims only if they are supported by accurate documentation that supports medical necessity.
- Streamline revenue cycle management: With higher patient payment responsibilities, physicians need to strengthen their collection efforts. Efforts should be made to improve coding, documentation, tracking and denied claims management. In addition to performing insurance eligibility verification before services are provided, physicians have to educate patients on their financial responsibilities. Such counseling is critical to patient satisfaction and to protect the practice’s financial stability.
- Collect bad debt: Even as they focus on providing value-based care, physicians should explore various strategies to collect bad debt:
- Offer convenient payment options and incentives, especially for patients who have difficulty paying
- Have a compassionate approach towards answering billing questions
- Implement credit quality rating strategies to target collection efforts
- Get professional help to deal with uncollected balances
- Optimize technology: Increasing reporting and administrative responsibilities will push practices to harness technology to align care with the value-based healthcare model. Optimizing technology is necessary for access to meaningful patient information.
In the rapidly evolving healthcare environment, medical practices need a trusted partner that can help them stay competitive and financially viable as they focus on improving service quality. Physicians can rely on physician billing companies to support them in their endeavors.