One of the biggest challenges facing medical institutions today is concerned with the business side of health care – medical billing and coding.
Medical billing is an extremely important component of the health care industry. In fact, the U.S. government is spending more than $22 billion to encourage hospitals and doctors to adopt electronic medical records (EMR).
Electronic medical records paved the way for a centralized system of patient records which ensures clinical information is always available and easy to access. However, there are flaws of the EMR that were detected. One of them is failure to put safeguards to prevent the technology from being used for inflating costs and overbilling.
Electronic Medical Records Cause Overbilling
According to a report by the Office of the Inspector General for the Health and Human Services Department that was published in New York Times, the lack of guidelines around the widely used copy-and-paste function, also known as cloning, has been detected in many of the largest electronic health record systems.
The technique, which allows information to be quickly copied from one document to another, can reduce the time a doctor spends inputting patient data. But it can also be used to indicate more extensive and expensive patient exams or treatment than actually occurred.
Critics say the result is that hospitals and doctors are overcharging for the care they are providing.
Outsourcing Medical Billing
Hiring a third party hold responsibility for billing services can be an effective way not only to increase revenue, but to also gain control of the situation. Here are the reasons:
- The amount of time doctors and nurses spend on billing and staffing concerns can be eliminated. They won’t have an opportunity to alter records – and the freed-up time can be used to care for patients.
- Outsourced billing companies have more billing and coding expertise and necessary resources. An outside service can assist in providing proper software, such as EMR, packaged billing, and practice management. And most probably, they can identify best practices for defecting fraud.
- Sometimes for an added fee, there are companies that provide appointment reminders, electronic eligibility verification, patient follow-up, coding, consulting, and data reporting.
Certified billing companies are compliant with the latest health care laws, like Health Insurance Portability and Accountability Act (HIPAA) and the Health bill, so your staff can rest assured that the law is being followed.