The processes carried out in hospitals are very different from those carried out in small practices or solo settings. The difference does not just stop at the volume of care that is provided but is also related to the quality and the difference in the processes that are carried out. Although about thirty percent of the total physician workforces in the country are solo or small practices, hospitals are responsible for providing care on a macro level as opposed to small practices. Therefore the departmental processes for solo or small practices and hospitals differ considerably.

Hospitals have many more auxiliary services that they regularly provide to their patients that are not provided by small clinics such as various specialist facilities including radiology, anesthesiology and such other similar services. The billing structure in a small practice is different from those in hospitals and is also much smaller and less complicated in nature. Various processes such as revenue cycle management, denial management, payer interaction, the way in which Electronic Health Records (EHRs) and Electronic Medical Records EMRs are implemented are different in small practices as compared to bigger hospitals. Moreover, the financial aspects and processes involved in a hospital are much more complicated compared to those in small clinics.

The fact that EMRs, EHRs and such other electronic equipment was originally made for hospitals is a witness to the reality that hospitals require and possess extensive implementation of technological equipment to provide efficient services. The billing process itself is different in a hospital compared to that in a physician’s office as well as when it comes to ‘Meaningful Use’ (MU) incentives. The physicians billing forms to insurance companies and payers are also different compared to hospitals.

The reforms have also considerably changed the medical billing processes and there have been changes on many levels in the industry. These changes are not just limited to core medical aspects but also encompass other “back-office” or departmental processes which have brought about an overhaul in every process including those for medical billing and coding. The transformation from ICD-9 codes to ICD-10, building the 5010 platform for the same, policy changes concerning insurance claims and denials, and the use of health IT has brought about numerous changes for hospitals and for small practices. However whether hospitals or small practices both these vehicles of health care deliveries need to streamline processes such as denial management, revenue cycle management, medical billing and coding, and other services to ensure revenue growth in the near future.

Experienced billers can perform numerous functions for hospitals as well as small and solo practices and can ensure timely and accurate reimbursement. Medicalbillersandcoders.com experienced professionals can not only handle the various departmental processes but can also ensure privacy and compliance of HIPAA guidelines for hospitals as well as for small and solo practices.

Even as the Department of Health & Human Services’ in order to reduce regulatory burdens, announced last month it would consider delaying the ICD-10 implementation deadline for certain entities, subsequent industry reactions depicted healthcare professionals being primarily not in favor of such a delay. Moreover a Survey conducted among more than 50 senior healthcare professionals attending the 2012 ICD-10 Summit, hosted by Edifecs, stated that most of the participants perceived a delay rather than improve would cause significant adverse effects on the healthcare industry.

The survey findings on ICD-10 delay:

64% (Nearly 2/3rdof respondents) Stated a delay will not improve readiness 76% Stated a delay will harm other healthcare reform efforts 69% Stated a 2year delay would be either “potentially catastrophic” or “unrecoverable” Healthcare industry outlook towards Cost Implications due to a delay:

Healthcare professionals and the industry observe a delay would result in halting or slowing down work on ICD-10 which would derail the healthcare organization’s progress resulting in high cost implications. With both payers and providers investing heavily for the ICD-10 switch, cost is the chief concern. Hence the industry is in favor of moving ahead while they await the final decision on the extended deadline regarding entities which will be affected.

The cost of a one-year delay to be between 25 – 30%, while officials  estimate a one year delay based on existing overall cost estimates for ICD-10 from multiple sources, to cost the industry anywhere from $475 million to more than $4 billion.

A delay of longer than a year as per 85% of respondents surveyed said would freeze budgets, slow down schedules or stop work altogether, while 59% opined that the date should be universal for all covered entities rather than mandating different compliance dates for different types of entities, the main driver behind the same being the significant cost and effort involved for the dual processing in ICD-9 and ICD-10 code sets.

Proficient ICD-10 Coders in demand!

Hence with majority of physicians vary of a delay continue their preparation for ICD-10, Billers and Coders proficient in ICD-10 transition are the need of the hour and highly demanded. As adoption of ICD-10 will lead to expansion in the number of codes available from the currently used ICD-9 codes- organizations focusing on a successful ICD-10 implementation in 2013 are cautioned to start revamping their coder development and retention strategies, making ICD-10 coders in demand.

Projections from the Bureau of Labor Statistics depict a growth in job levels for coders far above average: 20% from 2008 – 2018 and Economic Modeling Specialists Inc. project growth of 8% between 2011- 2013. Physicians amidst the transforming healthcare environment as a feasible option are opting for services of medical billers and coders who are proactive and prepared with material-requisites for ICD-10.

Personnel updated at Medicialbillersandcoders.com are viable option for physicians in smooth transition to ICD-10; equipped with experience in HIPAA, ICD-10 and other compliances. Moreover the unique ICD-10 Training Program encompassing 87 weeks of ICD-10 training and updates – strives to outline at no cost to medical billers and coders information & training- right from how ICD-10 will affect healthcare to how ICD-10 needs to be implemented within different specialties to ensure optimum revenue cycle management post ICD-10.

Health information technicians are considered as one of the 10 fastest-growing allied health occupations according to the US Bureau of Labor Statistics (BLS), with Medical billers and coders being in high demand among the allied health occupations.

Further increase in terms of job outlook is expected in the sector of Medical Coding with demand for professionals expected to increase by 18% considering the increased shift from paper to data storage in patient documentation and increased shortage of qualified professionals with specialized skill-sets.

According to the U.S. Department of Labor continued job growth for medical coders and billers is stimulated due to the increased medical need of geriatric population and the number of health practitioners. Moreover the Occupational Outlook Handbook states that earnings vary widely and pay levels are ascertained mainly as per experience and qualifications, hence various medical coders are opting for certifications in varied specializations to make the most of the growth in this sector.

Medical Coders rational in getting certified: Opportunities through certification

A national study of workers in their mid-30’s illustrated that 43% of license and certificate holders earned more than associate’s degree graduates, moreover as many employers prefer to hire candidates with certification, earning a medical billing and coding certification gives the coder an added competitive edge in the job market. On gaining experience in this field pursuing medical billing and coding certification in a particular specialty—beyond just basic certification— can immensely help in capturing the growth in this industry. In general, average salary for a medical billing and coding professionals is anywhere between $38,000 and $50,000 per year, while the ones at the top of their pay scale can earn more than $74,000.

A recent survey by American Hospital Association depicts that nearly 18% of billing and coding positions remain vacant due to a lack of qualified candidates, with most physician practices in preference of hiring well qualified medical billers and coders – certified in their field, to as far as possible avoid legal ramifications of incorrect billing. Also various medical coders working independently from home at times need to get additional licenses and certification.

Growing opportunities

In the scenario where Insurance companies and government are putting more emphasis in researching and controlling claims’ fraud, abusive practices, and medical necessity issues, has led to an increase in hiring by related healthcare entities. Being a challenging, attractive career with growing opportunities – where compensation is as per level of skills, individuals seeking a career in medical administration are well advised to opt for medical billing and coding with the entry-level pay being higher than that of comparative health care professionals in the field.

Medicialbillersandcoders.com equipped with experienced Billers and Coders well-versed with HIPAA, ICD-9-CM, ICD-10 –CM, CPT/HCPCS, DSM-IV, and ICPM, gives coders a platform to excel in their domain. Our coders are constantly training and updating themselves as per the industry requirements, striving to make the most and assist in the evolving healthcare industry effort in improving patient care.

Medical coding and billing salary range is wide, with a low percentage of employees in this medical field expecting to see a salary of $31,000 per year while another percentage expecting to see a salary range as high as $48,000 per year. However the average salary for a medical coder and biller as stated earlier is expected to get a higher scope in upcoming years, nevertheless eventually only the medical biller and coder can determine their earnings depending on variables they adopt. Medicialbillersandcoders.com providing updated knowledge, placement opportunities and analyzing current salary trends has been serving physicians for more than a decade and offers medical billers and coders an avenue to get connected with these doctors and can register with us for future job prospects. (Link to register for jobs)

The role of Physician assistants (PAs) is accentuated in a country such as United States where the physician to patient ratio is very low. The recent health reforms have added to the responsibilities of physician assistants due to numerous changes in policies and technologies. The implementation of Electronic Health Records (EHRs) or Electronic Medical Records (EMRs) is one of the biggest challenges that PAs face in the changing healthcare environment. Moreover, since physicians need time for numerous other core activities, PAs are the professionals who handle such important auxiliary functions such as successful implementation of EMRs or EHRs and handle other office based departmental processes. The health reforms also present opportunities for PAs in the country to take on more responsibility as well as prosper financially.

The incentives offered by the government for successfully implementing an EMR or EHR is not just limited to physicians but also include PAs. However, in order to receive such incentives, the PA must work in a Federally Qualified Health Center or Rural Health Clinic that is led by the PA. The need for PAs is strongly felt as a coordinator between physicians and nurses in order to provide better service to patients. They also take on numerous other responsibilities such as being on call, making house calls, providing therapy, and even prescribing medications in addition to all the work assigned by the supervising physicians and thus PAs have a holistic understanding of the various departmental processes as well as proficiency in the core aspects of medicine. These processes today cannot be carried out without extensive use of EHRs/EMRs and PAs utilize all their knowledge to optimize the EMR/EHR implementation process.

Since PAs work in such a demanding environment, they are most likely to succeed in implementation of EHRs and EMRs due to their knowledge of other aspects of medicine such as some “back-office” or departmental processes. However, for many PAs the workload is continuously increasing due to policy changes and the skyrocketing demand for healthcare services. Some factors that are hampering the handling of EHR systems by PAs are increasing demand for healthcare due to newly insured 31 million Americans, increased scrutiny by the government in the form of HIPAA, and ‘Meaningful Use’ (MU) policy compliance. Although PAs are qualified to handle EHRs and other related processes, it would definitely become difficult for them to handle the core functions involved in health care delivery due to workloads in various auxiliary processes.

The ideal solution for making time and saving money is to delegate some of these processes to experienced professionals through outsourcing. This would ensure that processes such as revenue cycle management, denial management, interaction with payers, accounts receivables, and charge entry, are carried out in a scientific and professional manner. Medical billers and coders at www.medicalbillersandcoders.com not just provide these services but also offer EHRs software that is suitable for almost all specialties and suggest after studying your practice’s processes the software best suited for your practice which would cover the gaps and shorten the revenue cycle. Medicalbillersandcoders.com also offer other value added services such as consultancy for keeping you updated on the changes taking place in the health industry.

Electronic Health Records (EHRs) and Electronic Medical Records (EMRs) have started to affect almost all the specialties and diabetes care is no exception. A study by The New England Journal of Medicine finds that EHRs can have a positive impact on the quality of the care that is provided to diabetes patients. The report titled Electronic Health Records and Quality of Diabetes Care clarifies that sites with EHRs have better quality of care compared to those with paper based records. Another survey by the U.S National Library of Medicine, National Institute of Health also presents the advantages of using EHRs for caring for diabetes patients in another case study.

There are approximately 24 million diabetes patients in the country and as the population ages, this number will grow. Moreover, since diabetes is a chronic condition that has no final cure, caring becomes a continuous process with numerous hurdles. These hurdles can be overcome by using EMRS and EHRs which are especially designed in order to periodically monitor the condition of the patient and provide better care due to this approach. The biggest challenge in diabetes is the monitoring and control of blood sugar on a daily basis which can be exhaustive for the patient to check and keep a detailed record of. This is where EMRs and EHRs can be of immense help. EHRs and EMRs can help in keeping a detailed record of blood sugar levels along with other factors such as Body Mass Index and numerous other features. Such reports can be sent to patients in the form of lab reports and assessed by the patient regularly to maintain better health.

Even though EMRs and EHRs help in assisting physicians in taking better care of diabetic patients, EMR and EHR adoption rates in the country are not very encouraging. A yearly survey by the Centers for Disease Control and Prevention (CDC) has released a report containing the EMR adoption rates in late last year (2011). The report finds that only 10.1% of physicians in the country had a fully functional EMR system.  The successful implementation of EMR/EHR system seems to be the biggest challenge in health reforms and also in aspects related to diabetes care. There are numerous reasons that have been presented for this lag in the implementation of EMR/EHR systems. Factors such as the anxiety regarding the financial viability of such systems, a steep learning curve for providers, and the complexity in maintaining such systems are the most common reasons for the reluctance to fully implement systems that demonstrate ‘Meaningful Use’ (MU).

The financial advantages of implementation of EMRs and EHRs are apparent in light of the incentives provided by the government for MU. The advantages for patients are projected and expected to be excellent with the use of EMRs/EHRs; however, the study of the impact of EMRs on chronic conditions is limited yet positive. The ideal solution for proper implementation of EHR systems is to outsource the billing and coding process to professionals who possess experience in assisting in providing solutions for streamlining various processes related to EMRs.

Choosing the right EMR vendor is just the beginning because the maintenance of such EMR systems is more difficult compared to just implementation. Vendors should be able to provide basic education about the system and also support the practice in various ways for a period of time after implementation. Medical billers at medicalbillersandcoders.com will not only provide solutions to your billing problems as a provider but also offer other value added services such as assist in implementation of EMR systems after a thorough study of your practice, revenue cycle management, denial management and consultancy services.

“Consequently, physician reimbursements would largely depend on their ability to seamlessly process medical claims with either Medicare or private insurance carriers. But, with the reimbursement environment promising to be more vigilant and stringent than ever, physicians would find their medical billing competencies invariably short of the requisite persistence.”

Physician shortage has been one of the major issues that have been plaguing the U.S. healthcare industry.  Significantly, twenty two states and 17 medical specialties have already felt the dearth of physicians. While the aging physician community and the lack of reserve pool of physicians may well have been the primary reason, it is also true that the aging patient base and an unprecedented population growth have contributed to the growing chasm. And when you consider the influx of an estimated 40 to 50 million people who were previously uninsured and the baby boomer generation now becoming eligible for Medicare, the issue is only going to be worse.

But, healthcare being one of the priority sectors and health of millions of Americans at stake, Federal Government is looking at policy changes that would make healthcare practices attractive to professionals. As Family practice, internal medicine, and geriatric specialists form the priority disciplines, a lot of stimulus is being given to physicians showing inclination to these specialties. Physicians, who used to take such disciplines as a societal cause, are now being made eligible for incentives. Apart from this priority-based stimulus, the Federal Government is also looking at correcting the regional imbalance, where in physicians from higher density regions are being wooed to regions that are acutely short on physicians.

Quite parallel to policy measures, the qualitative measures like mandatory EHR compliance – seen as augmenter of fast and efficient clinical and operational management – would pave the way for accelerating medical care. The penalty or incentive factor associated with EHR non-compliance or compliance is seen as qualitative measure for enhancing the scope of clinical reach to an ever-growing patient base. Then, you have the Accountable Care Organization (ACO) model, which would eventual ensure streamlined healthcare dispensation for a population that has grown disproportionately to the physician numbers.

While these qualitative measures by the Federal Government would invariably increase practice opportunities and revenue prospects for physicians across the U.S., there is also going to be unprecedented incidence of medical insurance reimbursements as most of the medical related expenditure is invariably met by health insurance schemes – either State sponsored Medicare or Medicaid, or private health insurance schemes sponsored by private insurance players. Consequently, physician reimbursements would largely depend on their ability to seamlessly process medical claims with either Medicare or private insurance carriers. But, with the reimbursement environment promising to be more vigilant and stringent than ever, physicians would find their medical billing competencies invariably short of the requisite persistence.

And, when physicians face up to such challenging medical billing  environment,  outsourced medical billing services would eventually become indispensable. Medicalbillersandcoders.com, whose medical billing Revenue Cycle Management is capable of ensuring both qualitative and qualitative dispensation, should prove to an ideal recourse. Its comprehensive medical billing Revenue Cycle Management – comprising Patient Scheduling and Reminders, Patient enrollment, Insurance Enrollment, Insurance verification, Insurance Authorizations, Coding and audits, Billing and Reconciling of Accounts, Account Analysis and Denial Management, AR Management, and Financial Management Reporting – is designed for augmenting revenue generation while also keeping medical efficiency enhanced perpetually.

In all the states of the US, healthcare is becoming an integrated affair with hospitals combining traditional healthcare services like surgical treatments with primary health care activities responsible for elementary requirements of a treatment cycle from blood tests to coordination of various activities within a treatment episode to ensure availability of all components of healthcare services under one roof, when seen in the larger context, and advantages like proper coordination between various components/phases of a care cycle and day-to-day patient care within the scope of a treatment episode.

Primary healthcare providers integrating with hospitals are, in a loose sense, family physicians, traditionally located outside the big organized healthcare space, relocating themselves to the sphere of hospital-provided healthcare system where they are called hospitalists. Albeit, the difference is hospitalists have to be more acquainted with sophisticated healthcare procedures to function in the environment of a big healthcare operator.

This practice of hospitals providing physician services (or integrating with hospitalists) is over a decade old in US healthcare which owes its survival to the fact that these services (or hospitalists) bring into conventional hospital treatment a combination of old-world healthcare values like individualized attention to patients and patient safety and new-age methods like proper coordination, documentation, etc., which have collectively been found to lead to improvement in quality of treatment and reduced costs.

However, primary care mostly deals with elderly patients suffering from ailments that require not a touch-and-go treatment but protracted care either through extended stays in hospitals or through recurrent readmissions. Because of their age bracket and the nature of their ailments mostly related to heart brain, lung, lever, etc., these patients account for majority of medical expenses billable to Medicare.

This being the nature of aliments primary healthcare mostly deals with, its involvement is not restricted to any one part of treatment but is spread like a grid across the treatment cycle, forming its basics starting from, if viewed from a financial viewpoint, registration to reimbursement.  And this leaves healthcare providers to handle financial administration activities that warrant a strong Revenue Cycle Management system, a process that covers the entire range of financial needs/activities resulting from initiation to termination of a treatment episode.

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Medical Billers and Coders, through its RCM consulting services, scrutinizes the areas of deficiencies in your Revenue Cycle Management, like outdated processes, software inadequacies, under-optimized   workforce, unidentified training needs, and helps detect the sources of revenue leakage and plugs them by streamlining your processes. As a result, a coherent RCM process helps healthcare organizations to prevent registration errors, lack of pre-verification of insurance coverage and facilitates an effective collection policy for insurance deductibles and co-pays, and an in-depth analysis of Account Receivables reports on a payer- patient-service basis. Additionally, it also prevents audits by detecting overpayment by Medicare and helping return it on time.

Medicalbillersandcoders.com brings these RCM benefits to its clients through a team of specialists with expertise and experience of dealing with healthcare providers for years combined with sound knowledge of changing trends and regulations operating in the US healthcare industry, resulting in saved cost and time for healthcare operators.

Medical Billing | Medical Billing Services | Medical Billing Companies

“As much as its popularity amongst larger population of patients, Alternative Therapy may well become a viable alternative in ensuring hospitals’ uninterrupted sustenance and growth. And, judging by its popularity, it may well become an integral part of comprehensive medical services offer by majority of hospital”

Many a times, proven medical treatment or intervention may not be able to ensure the requisite relief to patients. Especially, when it comes to clinical management of chronic ailments, proven medical procedures or therapies have been found wanting in as far as providing cure or relieving symptoms associated chronic medical conditions. As medical researchers try to seek answers to these elusive questions, parallel medicine has slowly been evolving as an alternative option – acupuncture, guided imagery, chiropractic, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage, and many others forming the composition of Alternative Therapy. More than a curative option in chronic disease management, Alternative Therapy is increasingly being used a proactive method for augmenting mental and physical well-being.

But, despite the enormous opportunities, both practice-wise as well as revenue-wise, medical practitioners and hospitals, in particular, have not been that inclined to adopt alternative therapies as part of their comprehensive healthcare service offer. While there could many reasons for the continued apprehension, the likely increase in workload and billing complexities associated with such appreciation in volume may well have been the prime reasons behind the reluctance. But, as the health radical healthcare reforms – Medicare cuts, Accountable Care Organization (ACO) concept, mandatory EHR compliance, and the ensuing ICD-10 and HIPAA 5010 – begin to impact on hospitals’ revenue generation, they will have to off-set the effect through alternative opportunities, such as Alternative Therapy.

As much as its popularity amongst larger population of patients, Alternative Therapy may well become a viable alternative in ensuring hospitals’ uninterrupted sustenance and growth. And, judging by its popularity, it may well become an integral part of comprehensive medical services offer by majority of hospital. As far as the complexities of voluminous medical billing, coding, claim submission, and realization are concerned, hospital can easily look to avail the services of competent and credible medical billing service providers, who along with the routine billing services, are willing to offer expertise in EHR implementation, denial management, and Revenue Cycle Management. Consequent to such combination of integrated medical billing management, hospitals can easily dispel the apprehensions associated with adopting Alternative Therapy as a viable option along with the regular medical service offers.

Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – whose long-standing reputation as the largest consortium of medical billers and coders in the U.S. is built on its credibility and competence to offer comprehensive medical billing solutions comprising Patient Scheduling and Reminders, Patient enrollment, Insurance Enrollment, Insurance verification, Insurance Authorizations, Coding and audits, Billing and Reconciling of Accounts, Account Analysis and Denial Management, AR Management, and Financial Management Reporting along with advisory on EHR efficacy and implementation – should instill  the much needed confidence to go in for Alternative Therapy as a viable option along with the regular medical service offers.

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“Before expecting your support staff or divisional departments to contribute qualitatively into the integrated EHR system, care must be taken to identify and train them for orienting them to the mechanism of the EHR”

By now medical practices must have realized that EHR is not just about technology but beyond that. As EHR becomes mandatory in clinical and operational management, practices’ responsibility to comply by EHR mandate would also double up: while they have to ensure EHR compliance for avoiding penalization for being below the EHR benchmark, they should also strive to be eligible for incentives under the ‘Meaningful Use’  criterion as determined by the HITECH Act. Therefore, the whole task of living up to the requisite level of compliance would surely demand not just physicians’ knowledge of EHR, but the integrated effort of functional divisions of medical practices/hospitals.

Before expecting your support staff or divisional departments to contribute qualitatively into the integrated EHR system, care must be taken to identify and train them for orienting them to the mechanism of the EHR.

• To begin with you have the Front Desk, which usually attends to Patient Registration and Admission. As EHR marks a deviation from paper filing to electronic registration, the Front Desk needs to be taught of ways to enter in registration and admission processes into an automated and networked EHR module, which enables viewing and interfacing across the all the connective eco-system of hospital management.
• Next, you have support staffs, who take of monitoring and administering physicians’ instructions for clinical management of patients inside the hospitals. But, for the medical support staff that hitherto has been following instructions orally or from notes, the transition to deciphering instructions from  an electronically automated EHR system would somewhat seem alien initially. But with proper orientation, they would not only be able to appreciate the change but also contribute positively towards the integrated EHR eco-system.
• Following the support staff is the clinical and diagnostic department, who play a vital role in screening and detecting the medical condition. With an integrated EHR in place, their task of collaborative sharing the clinical and diagnostic findings would surely get faster and more efficient.
• Then, you have the all important part in the hospital eco-system: the medical billing staff, who are crucial to the revenue generation from factual medical billing preparation, coding, submitting and realizing the medical claims from the Medicare as well as private insurance carriers. With a streamlined EHR that can ensure compliant billing and coding, you can always expect your billing staff to deliver efficiency and contribute to operational efficiency.
• Finally, you have the Executive Board or the Management, whose task of decision-making would surely be devoid of blemishes as they would have ready access to clinical and operational data from the integrated EHR eco-system.

But, when you consider the time and resource required for comprehensive orientation of all your functional entities, you would rather be well-off opting for outsourced services from credible and competent vendor. Medicalbillersandcoders.com – whose competence and credibility in advocating and practicing EHR implementation and training for diverse medical practices is well-known across the U.S – should be an ideal recourse for practitioners seeking to opt for orientating their support staff to the integrated EHR eco-system.

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Already halfway through the HIPAA Version 5010 noncompliance grace period and in this scenario it is imperative for doctors who still haven’t to utilize the remaining few days to upgrade to 5010, as non compliance of submitting electronic claims in the appropriate 5010 format post 1st April, 2012, will result in the Centers for Medicare and Medicaid (CMS) penalizing the medical organization. Moreover CMS too is reaching out to remind providers, of the Version 5010 standard to be enforced beginning 1st of April.

Medical practitioners who still haven’t are required to make efforts to upgrade to the new format, post January claims or bills that are not submitted in HIPAA 5010 get rejected, but delay in enforcement currently allows physicians to resubmit in the appropriate HIPAA 5010 format without penalty only till 1st April 2012. Moreover a Survey by the Medical Group Medical Association (MGMA) estimated that upgrading to HIPAA 5010 could set providers back $16,575.

Preparing for 5010 enforcement

According to CMS to ensure a smooth upgrade prior to April, medical organizations need to complete both phase I internal and phase II external testing of Version 5010 transactions. External testing includes tests conducted with outside trading partners – vendors, clearinghouses, billing services, and payers.

However as some doctor practices already implementing the new 5010 format since January are facing severe payment disruptions, hence practices can benefit by preparing for this upcoming effort by developing an implementation plan including:

• Identifying changes to data reporting requirements
• Identify potential changes to existing practice work flow and business processes
• Identify staff training needs
• Testing with the trading partners, e.g., payers and clearinghouses
• Budgeting for implementation costs, including expenses for system changes,
• resource materials, consultants, and training

Medical Billers & Coders – Need of the hour

With certain physician offices currently submitting claims in the 5010 format facing billing issues, Medical Group Management Association (MGMA) President has called for another delay on 5010 enforcement until at least 30th June, 2012, allowing physicians and insurers to do business electronically based on the earlier Version 4010 standards till then. Nonetheless physicians in anticipation of the enforcement need to gear up and in this crucial time physicians short of time can benefit from partnering with experts who can assist them with the transition process and medical billers and coders who can solely concentrate and help in minimizing certain billing and revenue issues arising through this transition.

Medicalbillersandcoders.com has been servicing the healthcare industry for over a decade now is an apt choice prior and post implementation to HIPAA 5010 to ensure smooth and efficient Revenue Cycle Management. Our Medical billers and coders are updated with all the requisite reforms and trained on ARRA 2009, ICD 9, ICD -10, HIPAA 5010 – practicing handling Revenue Management Cycle for various clients, are highly motivated to provide you with the right course of action to take in the current challenging healthcare industry.

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