Thursday, October 28, 2010

UPDATE FOR ARIZONA PROVIDERS




Beginning October 1, the Arizona Health Care Cost Containment System, the state's Medicaid program, has cut coverage for basic health services such as physicals, most dental care, podiatry, some organ transplants, and other programs.  The state also has cut benefits for medical equipment such as insulin pumps, hearing aids, cochlear implants, computer-controlled lower limbs and joints, and other equipment.  State officials say the cuts were necessary to deal with the state's budget crisis and an increase in the number of enrollees due to the bad economy.  The benefits cuts are projected to save an estimated $20 million through the end of June.  More than 1.3 million state residents were enrolled in this program as of September 1, 2010.  For more information, visit http://www.azahcccs.gov/.

Sunday, October 24, 2010

Initial Decision - Outsourced or In-house Billing

One of the largest decisions a Provider needs to make is whether or not to outsource his or her medical billing.  This decision has to be based on whether or not an outsourced billing company can increase the bottom line of your practice.

We have been in business for over a decade now because of our success in doing just that for physicians and ancillary providers in all specialties.

Managed Care Alternatives was founded in February of 1999 by our President and CEO, Michael T. Williams.  Prior to starting this company, Mr. Williams served for 11 years as Western Regional Vice-President of Arizona’s largest PPO network.  Therefore, we know the tactics of the insurance plans to reduce your reimbursements and we know how to appeal those reductions successfully.  With our assistance, several practices in various specialties over the years have advanced from being on the verge of closing their doors to, instead, being prosperous business entities receiving insurance payments over $1,000,000 within two years of signing a contract with us.

A competent billing service should be able to provide you with a substantial reduction in many of your day-to-day frustrations and financial challenges.  These include: practice management software issues, cash flow issues due to denied or delayed payment of claims, patient requests for extended payment plans, etc.  Each and every one of these issues takes your time away from the activity you were trained to do: managing and treating the healthcare needs of your patients.

Few providers realize just how much it costs them to absorb all of the expenses associated with maintaining a billing staff in-house.  Payroll taxes, workers compensation insurance and health insurance premiums, and many others expenses impact your cash flow and reduce your annual income.  If your billing staff is not achieving the results you expect as far as collections from insurance companies and patients are concerned, the negative impact to you and your practice is even greater.

Ask yourself the following questions:

1.  Is your overall frustration level regarding your billing/business office very high?  2. Are you facing a major capital investment in new hardware or software?  3. Are you having a difficult time keeping or hiring experienced billing staff?  4. Are you spending too much time on the business aspect of medicine?  5. Are you concerned that your staff has knowledge of your income?  6.  Are hardware, software, and information technology issues disrupting the operation of your practice?  7.  Are you so dependent upon your office manager that if he/she were to leave, your Practice’s financial situation could be dramatically impacted – at least in the short term?

If you answer yes to most of the preceding questions, you should consider outsourcing your billing.

Another reason you might want to consider outsourcing your billing now even if you were hesitant to do so in the past is that the fact of the matter is: times are changing.  The powers that be in Washington are legislatively mandating the degree to which every provider and the businesses that serve them must comply with pre-determined standards in many areas.  If you don’t – whether purposefully or simply because of an innocent oversight - the financial penalties and impact on your practice will be significant.

Is your Practice in compliance with the Red Flag rule?  Are you familiar with the government mandated changes for your medical office regarding the increased specificity of privacy rules and the introduction of Health Information Exchanges?   Is your Practice familiar with the compliance dates and ramifications of ANSI 5010 and the conversion from ICD-9 to ICD-10? 

Unfortunately, very few providers – or their employees - find themselves in the position of managing to stay current with all of the new government mandated rules or constantly changing insurance plan billing requirements.  The reality is that there is absolutely not enough time…and time is your most valuable asset.

The Practice Management software we utilize for our clients’ billing is a technologically state-of-the-art, web-based program that incorporates a highly-rated Electronic Health Records component that is guaranteed to be “meaningful-use” compliant.  The EHR component is completely integrated with the software we use to do our clients’ billing and completely eliminates any difficulties trying to incorporate electronic medical records from one vendor’s EHR/EMR package into another vendor’s practice management/billing software.  Should you choose to utilize this product in conjunction with our billing services, you will be eligible for the government’s significant incentive payments – if, of course, you meet the governmental requirements mandated for the Provider compliance with “meaningful use” guidelines.

 We can also offer you electronic eligibility verification and e-prescribing capability.

Please call us today at (602) 246-0756.  We will increase the bottom line of your practice, see that you remain well aware of governmental deadlines and compliance issues, and ease the stress of daily hassles you – as a medical professional whose time is the most valuable asset you possess – should not have to experience.

Thank you.

View Michael Williams's profile on LinkedIn