Protecting Health Data Outside of HIPAA: Will the Protecting Personal Health Data Act Tame the Wild West ?

DIGITAL HEALTHCARE

Article | March 29, 2023

Managing accounts receivable (A/R) in private practice is a constant battle for physicians. Though most understand that lowering their A/R is critical for improving their practices’ efficiency and profitability, physicians often do not know how to address issues like lengthy collection periods and insurance claim denials. It can be complex to manage A/R, as doing so involves various parties, including insurance carriers, the patient, the front office and billing staff, and the provider. All must work together to achieve a clean claims rate and avoid denials. The best way to improve medical billing A/R is to reduce claim denials and speed up the patient collections process. In addition, you’ll need to ensure that patients and staff are filling out paperwork correctly and submitting claims on time. Other areas to manage are the follow-ups to correct errors and past-due accounts. Accounts receivable is a collaborative effort Each member of the practice staff plays an integral role in reducing claims denial rates. Take an all-hands-on-deck approach in order to identify issues and develop solutions. Start by making every team member privy to the A/R management process. This will ensure everyone is on the same page and involved. It will also help to increase efficiency, avoid redundancies, and eliminate mistakes that could waste time or profitability. The front office staff is the front line of A/R. They are the first to verify and update patients’ insurance and personal details like address and contact information. They must also ensure that patients sign certain documents, like financial policies. Providers are the next line of A/R. Providers select current procedural terminology (CPT) codes, and must be mindful of tedious details such as bundling correctly in order to ensure that claims are approved. A conscientious provider should not only select appropriate billing codes but also double-check the patient information that the front office staff provide. The billing office is a final line of defense and should triple check that the patient’s information and the CPT codes are correct. Billing office staff are also responsible for ensuring the claims are submitted on time and that duplicates are not submitted. Establish financial policies Every practice needs clearly defined financial policies around patients or clients. Having these policies in place helps to clarify financial details and creates workflows and processes for staff to follow. Here are a few elements to consider: State whether the practice will accept personal checks and, if so, what charges or actions are in place for bounced checks. Consider implementing technologies that convert paper checks to electronic transactions and verify them before patients leave the office. Include a financial responsibilities section with information about who is responsible for the claim(s) if a patient’s insurance carrier partially or fully denies their claim. Define the debt collection process. Patients should quickly know how long they have to pay their bills and at what point you may sell their debt to a third-party debt collectors agency. Medical records can be copious, and practices often need to make physical copies of them. Consider implementing a policy that covers a pay-per-page cost associated with medical records. Automate patient statements and payments Offer different payment options for patients by implementing technologies and creative solutions that make it easier for them to pay their bills. Look for solutions that reduce manual work and provide reporting that tracks efficacy across delivery modes. Here are a few approaches to consider: Automate sending statements via text message or email to help improve the rate of online payments. Add QR codes to online and paper statements to help patients quickly access payment portals. Offer payment plans, especially with low to no interest, to make it easier for patients to pay down balances. Establish a written collections process Not collecting patient payments at the time of service is the biggest challenge to patient collections. Establishing a written collections process can help to alleviate that pain point and clarify the practice’s policies and procedures so that patients can understand them more clearly and easily. Here are some guidelines to follow when creating your policies: Include when, how, and how often bills are sent. Provide information on payment plans and assistance programs, if available. Explain the different available payment options and whether patients can pay over the phone, online through a payment portal, etc. Clarify which extraordinary collection actions may be used, including selling the debt or taking legal action. One of the most important processes to develop with collections is to respond to patients’ behavior. Communication should not be a one-size-fits-all approach. Patients expect personalization, and reaching out to them based on their preferred means of communication leads to optimal results. Perseverance is vital when it comes to collections. By establishing clear policies and implementing integrated technology throughout your processes, you can improve the patient experience by eliminating confusion while streamlining workflow to reduce the administrative burden on billing and administrative staff. Although implementing these steps can help your practice lower your accounts receivables, sometimes choosing to outsource to a medical billing company can help you save time, money, and resources. Medical billing companies can provide medical practices with specialized expertise, technology, and infrastructure to efficiently manage the revenue cycle and ensure timely payments. Outsourcing medical billing can also free up staff time and resources, allowing healthcare providers to focus on patient care and other essential aspects of running their practice. Whether you choose to outsource or to keep your medical billing in-house, these tips will help you to reduce your costs and increase your revenue.

HEALTH TECHNOLOGY

Article | November 18, 2022

With medical system consolidation and increasing numbers of medical records created, the need for digital access and storage is gaining steam. Digitizing records allows clinicians to improve accuracy and decrease redundant testing and studies, as well as reduce treatment delays. Greater availability of digitized records has other perks too. With vast amounts of accessible medical data, researchers can move public health studies forward, also potentially improving care and treatment of individual patients. As a result, cloud storage is taking off, though healthcare organizations are adopting it more slowly than other industries. According to a 2019 Nutanix report, 71% of healthcare organizations using cloud were considered the least mature – relative beginners – in that they were using fewer cloud services. Compare that figure to finance or retail, where 13% and 15% respectively were beginners. However, that is changing.

HEALTH TECHNOLOGY

Article | September 28, 2022

During the past decade, the healthcare industry has undergone an unprecedented technological transformation. The industry, once defined by manual processes, has moved squarely into the digital age. As patients, we’ve all become accustomed to seeing physicians as well as clinical staff use laptops during office visits. And behind the scenes, hospitals and health networks have made substantial investments in financial and HR systems, among others. One of the more significant digital advancements has been the industry’s focus on applying greater levels of automation to supply chain processes. In doing so, provider and supplier organizations have improved the efficiency of their supply chains, driven out millions of dollars in cost and waste, all while keeping patient care front and center.

Article | February 10, 2020

Artificial intelligence (AI) – long an impactful technology in other industries – is in the midst of rapid adoption across the healthcare industry. What was once seen as having great potential is now making its way to real-world implementation, driving improvements in care through enhanced clinical decision support, empowering payers, providers and healthcare organizations across the ecosystem with actionable insight. Patient-generated behavioral data is becoming increasingly common for care management. Smart gadgets such as Fitbits, smartphones and other wearable sensors collect patients’ data, helping patients and physicians better understand habits and set realistic healthcare goals.