Health Technology, AI
Article | July 18, 2023
As competition for patients intensifies, more hospitals and health systems are embracing a consolidated, single-bill approach for services rendered. Creating a single bill for the patient’s portion of inpatient or outpatient services can help eliminate confusion and reduce the ill will that frequently results when patients receive multiple invoices for a single care event. Yet incorporating anesthesia charges into a consolidated invoice is often problematic due to the unique nature of the anesthesia billing compliance.
Anesthesia Billing Service Hurdles
A few weeks ago, I met with the CEO of a 300-bed hospital. We discussed anesthesia billing, and he explained that his hospital traditionally outsourced this portion of its billing due to the more complex nature of anesthesia coding and the need to collect anesthesia minutes for billing. Unlike most inpatient services, anesthesia charges are not directly derived from CPT codes but instead utilize minutes and modifiers unique to the specialty.
That means coders must use a CPT crosswalk to account for ASA codes, base and time units, emergency- and physical-status monitors, split anesthesia units reflecting CRNA involvement, and other specialty-specific nuances. Most coders and hospital billing staff are not trained in these complexities, and hiring and retaining capable staff in today’s competitive market can be difficult. Moreover, many billing platforms are simply not equipped to incorporate all the variables necessary to produce an accurate anesthesia bill.
As a result, producing a consolidated patient bill that includes anesthesia is tricky. Yet leaving anesthesia off a single bill can undercut its value since, after facility and surgical charges, anesthesia often is one of the largest cost items patients incur. Fortunately, we at Change Healthcare know how to roll anesthesia charges into existing hospital billing systems to produce an accurate and timely single patient bill.
Helping to Reduce Costs
The benefits of consolidated billing extend beyond an improved patient experience. Producing just one bill reduces costs and repetition at both the front and back end of the revenue cycle management process. It can also ease staff burden when collecting on self-pay accounts, since there’s only one bill per patient. Finally, consolidated bills can help increase revenue by simplifying collections when patients present for follow-up care.
Here’s an example: When the patient comes back for post-surgery physical therapy, a hospital employee at the registration desk can remind them that they still owe $150 for anesthesia and ask if they’d like to take care of that now. In my experience, patients usually hand over their credit card and settle their bill on the spot when asked at the time of care about a balance due.
System-Agnostic Billing Across Hospital Platforms
Change Healthcare has a long history of providing full-service, outsourced anesthesia-billing services to hospital and health-system clients. Unlike most other billing vendors, we’ve developed what we call a system-agnostic approach. That means we’ll provide billing services on our proprietary system or on the hospital’s existing billing platform, regardless of type, to generate accurate anesthesia-billing results.
In practical terms, we’ll function as part of your billing team and use the same system your coders and billing staff rely on to generate anesthesia charges that can be included in a single patient bill.
System-agnostic billing also allows us to provide clients with custom anesthesia reporting that wouldn’t otherwise be available with an outsourced billing solution. This helps clients gain far greater visibility and insight into anesthesia-billing charges. And by incorporating our anesthesia coding and billing capabilities into your existing billing system, you’ll be spreading the platform’s fixed costs across a greater number of departments.
The bottom line? It’s not a heavy lift for us to virtually embed our trained anesthesia coders and billing professionals into your system. Our specialists will review your existing platform and provide, at no obligation, a return-on-investment analysis that can help you determine whether outsourcing anesthesia billing to capture claims on a single hospital bill makes sense for you.
We expect the answer will be yes. Not only will you enjoy greater system efficiencies, but you’ll be in a position to produce a single bill that truly reflects the entire episode of care.
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Health Technology, Digital Healthcare
Article | September 8, 2023
The fall is a time of renewals and choices. It is also a time of so called “open enrolment” for health plans. It is the one time of year we can study and learn about the options offered through employers or government sponsored plans. Individuals and small business owners alike are also are faced with a myriad of choices with confusing and often contradictory language promising lower premiums with higher out of pocket costs for covered services subject to deductibles. What does it even mean anymore when your monthly premiums exceed your pay check and you still have to pay for your colonoscopy or your insulin? Where is it all going?
Let’s imagine you twist your ankle playing basketball. You might go to an urgent care, receive an X-ray, probably be examined by a non-physician, and then referred to your primary care, who can’t see you for a few weeks but eventually sends you to an orthopaedic who takes another X-ray and treats your injury. Weeks have passed, multiple visits, time out of work, and co-pays, not to mention the out-of-pocket fees associated with imaging and perhaps a $100 ace bandage. What stops you from going straight to the ankle specialist in the first place? First, we have become conditioned to follow the directions dictated by the insurance companies, even when restrictions are not in place, patients have been convinced that stepping out of line will make all insurance promises null and void resulting in catastrophic bills and financial ruin. Second, the doctors and their office staffs have been conditioned to deny entry to any patient who does not have the proper referral, authorization, or identification. There are dire consequences for both if the insurance rules are not followed and fear keeps both sides aligned.
The past two decades have seen an explosion of healthcare costs. Health insurance has become the single biggest line item second only to payroll for most businesses. It is no coincidence that as the government increased its role as payor with state subsidies, the prices have gone up. Much like college tuitions, when loans are easy to obtain and guaranteed by federal support, there is little to deter those in charge from increasing the price. After all, everyone is doing it, it must be OK, and even if students end up in debt, it will be repaid because they have received the value of a great education. Right? But unlike higher education, healthcare is a necessity. We cannot avoid it, and there needs to be a reliable mechanism in place to guarantee access.
Ironically, as charges and prices have continued to escalate, payments to doctors have diminished. Why medicine is the only service industry where there is no transparency is truly astounding, especially since the there has been no increase in so called “reimbursements” for decades. As physicians, we have been complicit, being fully aware of the discrepancies between what is charged and what a patient’s insurance will pay. Even as patients began to have higher deductibles, and therefore higher out of pocket expenses, we continued to follow the rules, asking insurance permission to collect payment from the patient. It is not surprising that bad debt accounts for over 50% of most account receivables and why over 70% of doctors are now employed by hospital networks or private equity, who not only go after patients, but benefit from the repricing that occurs when insurers pay a negotiated amount as opposed to the charge. In other words, we pay more not just for less, but for nothing.
But what if we twisted our ankle and went directly to that specialist and paid out of pocket a transparent price? What would it take for that to happen? Not much, the cost of care is predictable, and because payments have always been decreasing, most physicians have learned to be economical. Plus, out of pocket costs are capped by federal law, so no patient is really responsible for catastrophic bills. Charges inflate to cover overhead, but if payments were guaranteed and immediate, then the cost of doing business goes down. Add technologies like telemedicine to a practice and you have increased patient access to a doctor without adding more personnel. Direct pay doctors are emerging all over the country and have consistently offered better access and more affordable care. The bar is also being set by independent surgery centers and imaging centers who offer better outcomes at lower costs. Perhaps motivated by prohibitive pricing, better options have emerged that have moved patients away from expensive operating rooms to safe, office-based procedures. Even cutting-edge cancer therapies can be delivered at home, preserving more of the healthcare dollar for medical care rather than the complex system built to manage it.
Competition and choice inevitably drive prices, but in a monolithic system the price is not negotiated, but instead it is set by only a few, in this case the big insurers. Small businesses cannot compete when bigger companies come to town. Eventually, the local hardware store gives way to a national brand, and the consumer is left with fewer choices and eventually higher prices. Amazon disrupted this equation by creating a marketplace for individual buyers and sellers. The convenience of finding a trusted brand, no longer available locally, is irresistible and the reason why we became loyal consumers. Healthcare is no different. Trust exists implicitly between a physician and patient, because it is an authentic, empathetic, and logical relationship. Trust does not exist between a patient and their insurer, on the contrary it is an unsympathetic business relationship without transparency or consistency. Few doubt the insurance company’s top priority is the premium, not the patient. Creating a direct relationship between the doctor and patient is a common-sense approach that serves both stakeholders well, and requires merely a fair and affordable price. But do doctors have the capability or the will to do it and if so, can the rest of the system follow?
Never in the history of modern medicine have physicians been more dissatisfied. US healthcare used to lead the world in innovation and outcomes, now we struggle to break the top thirty. We may have the most brilliant doctors and scientists with access to the best resources, but the need to maximize profits while catering to special interests, be they commercial or political, has led us to favour certain therapies over others despite marginal proven benefits. Doctors have little autonomy and less authority; prescribed treatments are routinely denied by insurance companies without a second thought or appropriate peer review. In fact, insurers even renamed us “providers”, a term used to by Nazis when referring to Jewish doctors to devalue them professionally. Over 56% of physicians are burned out, nearly all report moral injury and as hospitals have systematically replaced doctors with non-physicians with limited training, we have watched the standard of care deteriorate. It is no wonder we have witnessed the single biggest loss in life expectancy since WWII. The prognosis is grim, but there are solutions.
We need to reinvent healthcare by removing the middleman. We don’t have to set the price, but we can make it transparent so patients can decide for themselves if it is worth the inconvenience, the delay, and the co-pay to use insurance or just pay directly. Health savings accounts are tax deferred and can cover an out-of-pocket maximum in just a couple of years. Paying for care means there are no surprise bills or out of network costs, because there are essentially no networks and therefore no need to follow restrictions. You’d be hard pressed to find a doctor or hospital unwilling to accept an immediate cash payment, especially when it costs nothing more than the service provided. There are no billing cycles, or claims to prepare, no up coding, or authorizations. Doctors free to care for patients, patients treated individually and not subject to protocols designed to maximize charges. There are literally thousands of direct pay primary care and specialists now available all over the country and they are building alliances with likeminded people providing imaging, ancillary services, surgery centers, and prescriptions all at fair market prices. More and more employers are moving toward medical cost sharing plans that not only lower the cost of care but the cost of administration. Even the biggest payor, namely the government, sees the benefit of price transparency and is piloting models of direct contracting.
We will always need coverage for those unexpected events, emergencies, or hospital-based services, but all the rest - doctor visits, screening tests, and outpatient procedures - are easily affordable. After all, do we use our car insurance to pay for an oil change? If we did, the cost would be prohibitive and few of us would drive. But health insurers have lost our trust, they no longer cover necessary services and no longer honour contracts with physicians or patients. It is time to offer another option and let the patients and doctors get back to the real business of medicine.
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Health Technology, Digital Healthcare
Article | July 14, 2023
2020 was very challenging for those working in the healthcare sector. As Covid-19 is looking unlikely to go away anytime soon, healthcare marketing strategy is crucial in 2021. Do you know that one in every 20 Google searches is health-related? Also, almost 90% of 18-24-year-olds trust the health information they get on social media channels.
Consultations and appointments are being carried out online. Information on all medical things is available digitally and things in the medical industry are changing rapidly. Updating yourself and adapting healthcare marketing trends is more than a necessity. This blog provides some of the useful healthcare marketing tips for you in 2021 in light of Covid-19. These tips will help you stay ahead of the competition in these chaotic times.
Be Aware of the Covid-19 Impact on Healthcare Marketing
Due to the unexpected effect Covid-19 had in the healthcare sector, healthcare marketers have to integrate the latest healthcare marketing trends in 2021 in their campaigns. Here are some tips:
Demand for Healthcare Information
There is a huge demand for healthcare information, especially related to the pandemic. Engaging people with relevant informational and educational content is crucial. This content can be made on handwashing, mental health, being safe, staying healthy at home, etc.
Reputation is Key
The key to healthcare marketing is reputation building. Encourage and make patients leave positive feedback online. Learn and improve if you get any negative feedback. Almost 90% of patients use online reviews before consultation or booking an appointment. So, it is vital to have a safe and robust reputation in 2021.
Be Transparent
Being transparent, you can become a trusted source of information. You can achieve it by keeping your patients updated on any scaling back of operations and policy changes. Answering the queries of patients online will also increase your reputation.
Invest in SEO
The demand for relevant user-generated content and organic searches has not gone away during the pandemic, it has just shifted. Many businesses reacted to the pandemic by pausing marketing campaigns. In 2021, you will have to keep adapting to the new normal in your healthcare marketing. Since the pandemic outbreak, most consumers are using search engines to look up symptoms, checking reviews of various healthcare providers, and making appointments. Here are some tips for ranking highly on search engines in 2021:
Link Building
Linking the business website with other quality websites of the same category will increase your reputation and rankings on search engines.
Mobile optimization
Mobile optimization of your healthcare business website is essential in healthcare marketing. It is more important than ever in 2021 to stay connected with your patients on the go. So, if your website is not mobile-friendly, you will miss out on a massive number of patients, especially during this pandemic time.
Blogs
Another essential thing in healthcare marketing is to create engaging and relevant content for your potential clients. Engaging, informational, and educational blogs will increase your online visibility in the healthcare industry and rankings in the search engines.
Local SEO
People searching for something, including healthcare providers, ‘near me’ is a trend. Optimizing your healthcare marketing content and being visible on Google My Business platforms will help you get ranked in search engine result pages.
Create a Seamless Patient Experience
The global pandemic has drastically changed the way the world works during 2020. These practices expect to be with us in 2021, too, perhaps even beyond. Therefore, the patient experience also has changed hugely. The pandemic has brought out new customs like online appointments due to recent social distance and other safety measures. As an effective healthcare marketing practice, it is essential to communicate with your patients in time to make any changes to your healthcare procedures.
Update your website
Ensure you update all the essential information about scheduling, appointments, new procedures, and phone consultations clearly on your business website. You can even add a Covid-19 section with FAQs on your website. FAQs can be about what patients can expect and how you are operating safely.
Personalize email and text notifications
Sending out new safety protocols, appointment reminders, and any changes to your policy via email or text is the best way to communicate with your patients. It can be an effective way of healthcare marketing during the pandemic. It will also ensure that you do not leave out any patients.
Mobile app experience
Creating an app for your healthcare business will provide your patients with an excellent customer experience. It allows patients to see test results, schedule appointments, chat with consultants, and upload images. Moreover, it will be a great healthcare marketing initiative as it will be valuable in the future of healthcare marketing too.
Update your social media
Updating your social media channels regularly with how you are operating during the pandemic will create a clear communication channel with your patients.
Healthcare content is key
Creating reliable, educational, and informative content for meeting user demand is critical for healthcare marketing in 2021. The best way to engage and inform patients is through video content. Video content is also easily accessible for potential customers to consume. It can be in the form of explaining a healthcare issue, what to expect at your appointment, or a Q&A with an expert. Educational, informative, and engaging video creation and distributing it in various channels can be an effective healthcare marketing tactic in 2021.
You can also publish statistics, studies, blogs, and news articles to project yourself as an expert in the healthcare industry. Healthcare marketing is all about building a strong reputation and driving up potential customer engagement.
The priority in 2021 is to stay on top of your healthcare marketing. We at Media 7 offer bespoke services for the healthcare industry. We generate leads, convert them, and make them your happy customers forever. To know more, visit Media 7 website.
Frequently Asked Questions
How does social media help in healthcare marketing?
Social media is a practical means to establish and manage public awareness and reputation. As part of an overall healthcare marketing plan, social media helps healthcare marketers interact with the public to attract new patients.
How do you create a successful healthcare marketing strategy?
The first step in creating a successful healthcare marketing strategy is to understand your target audience. After understanding the audience, you can have a step-by-step online marketing process, such as building a website, making your presence on social media, etc.
What are the benefits of healthcare marketing?
Some of the benefits and advantages of healthcare marketing are improved competitive advantage, networking, visibility, absence of misinformation, creating, communicating, and providing value. It also helps in building up a sustainable relationship with patients.
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Health Technology
Article | November 1, 2021
Throughout my professional carrier, I iused to visit many companies involved in drug discoveries and had seen the challenges they go through. Some are pleasant as the investigational molecules were moving forward in value chain whereas few faced bottlenecks at the end. The association with Pharma industry over the years had taught me about many new ideas and allowed me to see that how innovative ideas are impacting our social and scientific world to a great extent. The changes we see today, are the results of ideas came from various quarters globally and I feel digital innovation had shaped today’s world differently. The impact of digital platform in today’s Pharma world is a “Game-Changer".
Innovation is a continuous process which simplifies challenges into reality and plays a very important role in our society. Centuries ago, scientists used to spend years in laboratories to understand material science. The chemical science evolved around discovering elements, synthesis of compounds or even isolating products from natural resources. Today’s world is highly indebted to those discoveries and efforts and modern science has gradually moved towards digital platform. Last few decades, innovations based on new technology platforms has made huge impact in scientific discoveries and few such ideas and action I feel has brought significant changes. Our lifestyle and social environment have witnessed deep impact due to such innovation. The chemical science is evolved not around only chemists today but have huge influence of mathematicians and technologists for faster development.
Advancement of digital science, new algorithms to solve the problems has modified the way of drug discovery to a great extent. In the recent past, we were heavily depended on big machines, but innovation has brought the whole items in a small packet now. The technology platform is modified, speed has increased in identifying new drugs with artificial intelligence (AI) and machine learning is accelerating the drug discovery and development processes. Today’s Pharma industries for commercial supplies are now depended on automation, optimization of the manufacturing processes, as well as designing effective marketing and post-launch strategies. The process is aimed to have better control on the operation, improving safety and better predictability of quality. For conducting clinical trials, identifying patient’s profile, an eligibility criteria is crucial which has been made by the processes being faster and cost effective by introducing Artificial Intelligence (AI).
Earlier when focus was to identify the origin of life, finding new elements, compounds or building blocks, today’s world is heavily dependent on data or ‘Big Data’. The amount of information available throughout drug discovery and development process, analyzing, interpreting, and predicting right candidate require high-performance systems to analyze data properly and derive value from it. There is advancement of analytical techniques, which provides more accurate information about the clinical trial reports and the data across patient pool, zeroing down towards right candidate is a real challenge and there are several AI enabled tools available where the processing time is reduced significantly which might have taken several years. The exciting part is that innovation is not only limited to laboratory work but works in coordination of mathematical interpretations, data analysis and provide significant clues to develop new molecules and even provide approach towards therapeutic categories. Currently available advanced technologies enhance drug development process, making it less time-consuming and cost-effective process where AI can recognize hit and lead compounds, and provide a quicker validation of the drug target and optimization of the drug structure design. Data scientists play a very significant role in all these activities.
Innovation focusing personalized medicine is now a reality and companies involved in such basic research have made breakthrough to understand how the human body responds to drug. Software solution is also available for simulating effects of drugs in patient body based on individual characteristics, scientific data for real time prediction of efficacy and drug interaction on individual. These predictive models are shortening drug discovery pathways to a great extent. Small molecule drugs or even large molecules development are heavily depended today on such modelling and predictive approach. The aim to reduce cost of drug development, shortening discovery path, focus on clinical trial mechanism is more productive with a higher success rate. During the pandemic period, in a shortest possible manner, several companies started working to develop new drugs or vaccines using drug-specific exposure models for drugs under investigation for the treatment of Covid-19.
Similarly, discovery platform is also working on cutting edge technology ‘Organ-on-a-chip’ that can emulate the physiological environment and functionality of human organs on a chip for disease modeling, mimicking the impact and could be a game changer in future. I will be happy to see when technology platform can accurately predict human mind and with the help of AI, can find a probable solution to avoid any such complex conflicts. It would be interesting to see that AI is analyzing and predicting the chemical change in the bodies impacting human mind and analysisng it quickly to predict psychological behavior of the patient and guide physician for right therapy. This may lead to predicting problems one may face in old ages where the decays may be prevented at early stage. This is a challenge but understanding and predicting psychological behavior may improve patients’ life. Depression and its remedy may be based on understanding changes, patterns of physicochemical behavior and its impact during mood swing and predicting such things in advance by using the advanced AI tools could be a game changer.
Another path breaking development where technology involving both engineers and scientists to help drug design to obtain maximal therapeutic benefits for patients including designing drug delivery systems and biomedical devices is 3D-printing technology. This involves high end computer simulations making analysis faster and predictive than before. Influence of 3D printing in designing variety of dosage forms has simplified its preparation. Though further study is under progress but the technology implementation at late has reduced cost of drug development to a significant extent and will add value in future drug development. It is interesting to see how this 3D printing technology works on human brain mapping and predicting a right path for treatment for betterment of large patient pool. Today with advanced technology, we are now more dependent on machines, limited close interaction with our near and dear ones, but created more friends on social platform. Though life looks easy, but over dependent on machines is creating another complex environment and this growing complexity may change the disease pattern. It will be interesting to see that how these technology platforms improve further to ease out such complexities for a healthy future.
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