Health Technology, Digital Healthcare
Article | July 14, 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.
Read More
Health Technology, AI
Article | July 18, 2023
Introduction
Healthcare supply chains are highly regulated, high-margin domains with stringent quality criteria, such as the demand for cold-chain storage and shipping. In addition, due to a lack of adequate understanding of the complicated rules governing healthcare products and services, medical aid providers are encountering inefficiencies while outsourcing capabilities to logistics service providers (LSPs).
In today's value-based care paradigm, healthcare leaders are tasked with improving patient outcomes while decreasing costs. With surging globalization, the growing cross-border nature of several medical products, and rising complexities in healthcare logistics, the need for building a robust supply chain is rapidly increasing across the healthcare industry.
Key Ways to Enhance Healthcare Supply Chain
A resilient supply chain plays a vital role in managing supplies, procuring resources, and shipping medical goods, among others, which assists in improving patient outcomes, enhancing service efficiency, and declining costs. Healthcare organizations are aiming to strengthen their supply chain to enjoy these benefits such as increased reimbursement, improved quality control, reduced inventory and overhead costs, and better collaboration with suppliers.
Here are some of the key ways to assist medical aid providers in building a strong healthcare supply chain
Develop effective inventory management
Manufacturers frequently encounter difficulties with timely inventory movement through their supply chains. Revenue is lost, and profit margins are harmed when products expire because they are not used adequately. This is why it is crucial to effectively manage the inventory process.
Hence, healthcare executives should deploy a high-quality equipment management system and increase collaboration between organizations, suppliers, and manufacturers to assist them in controlling inventory levels and effective inventory management.
Use technology and analytics to make operations run smoother
When it comes to supply chain management automation, the healthcare sector continues to lag behind other sectors. This is true for both the enterprise resource planning (ERP) functions and data analytics use for making decisions about forecasting and product choice.
Healthcare executives should make use of efficient technologies, such as solid analytics, in order to successfully improve a supply chain. Implementing data analytics and automation tools can assist in making healthcare supply chain management more efficient and effortless.
Widen and strengthen the supplier base
One of the most effective ways to build a robust healthcare supply chain is by increasing the number of suppliers and enhancing supplier base management.
Manufacturers and purchasers should abandon using single-or limited-source supply chains for raw materials and finished goods. This will assist healthcare companies in expanding their network of raw material suppliers and helps in careful consideration of which suppliers to use for procuring which resources.
Improve order accuracy and order cycle times to lower costs
Healthcare providers sometimes encounter a large number of errors during the ordering process. When incorrect products are ordered, the facilities face losses in revenue and are sometimes unable to deliver specific services due to the unavailability of products they need. Errors in placing orders can also result in medication errors. This can lead to a decrease in patient outcomes and negatively impact the company’s revenue growth.
To reduce the frequency of errors, these providers should deploy a computerized provider entry system. This will help improve order accuracy, increase supply chain efficiencies, and shorten turnaround times in healthcare ordering processes.
Consistently track and calibrate performance
Regardless of the size of the healthcare facility, it is of great importance for medical aid providers to carefully track and calibrate their performance frequently or on a specified timeline. This enables clinically integrated supply chains in healthcare to use key performance indicators (KPIs) to compare outcomes in terms of cost and quality and make decisions about products.
What’s Next?
The rising integration of novel disruptive technologies such as data analytics, the internet of things, artificial intelligence, and blockchain into healthcare supply chain management software is facilitating smooth operations, transparency, growth, and security across the life-science industry.
With a growing need for enhancing supply chains, healthcare providers are focusing on deploying advanced supply chain management solutions, such as healthcare logistics software, to strengthen their supply chains. As the trend continues to grow, the sales of healthcare supply chain management software and services are anticipated to rise from the US$2.2 billion registered in 2020 to US$3.3 billion by 2025.
Read More
Health Technology
Article | September 12, 2023
Unlock EHR interoperability solutions with this article. Discover how healthcare overcomes EHR interoperability challenges to facilitate seamless information sharing for better clinical decisions.
1. Exploring Hurdles in EHR Interoperability
2. Addressing EHR Interoperability Challenges: Mapping Effective Paths
2.1 Upgrading from Outdated Legacy Systems
2.2 Managing Inconsistent Information Across Multiple Sources
2.3 Overcoming Organizational Resistance to Sharing Data
2.4 Balancing Security and Consent
2.5 Harmonizing Data Standards Across Diverse Software Systems
2.6 Optimizing Training Resources for EHR Interoperability
2.7 Strategizing Costs for Specialist-driven Interoperability Management
2.8 Navigating Budget Constraints in EHR Interoperability
2.9 Unifying Patient Identification Standards Across HIEs
2.10 Advancing Allergy Management to Enhance Patient Care
3. Embracing Interoperability for a Connected Healthcare Future
1.Exploring Hurdles in EHR Interoperability
Despite significant efforts and investments in health information systems and technology, coupled with many years of widespread availability, the full benefits of electronic health records (EHRs) still need to be realized. The reality is that most physicians continue to rely on faxing and mailing patient records, just as they did a decade ago. Numerous government-certified EHR products are being used, each utilizing distinct clinical terminologies, technical specifications, and functional capabilities. These differences make it challenging to establish a unified standard interoperability format for data sharing. Interestingly, even EHR systems built on the same platform might not be interoperable, as they are frequently highly customized to an organization’s specific workflow and preferences. Given these circumstances, the article examines ten challenges and their corresponding EHR interoperability solutions to enhance patient care.
2.Addressing EHR Interoperability Challenges: Mapping Effective Paths
The primary goal of healthcare interoperability is to enable seamless sharing of health-related information between healthcare providers and patients, aiding in clinical decision-making. Here are several challenges to accomplishing this aim, along with their corresponding interoperability solutions:
2. 1 Upgrading from Outdated Legacy Systems
One of the significant challenges in achieving EHR interoperability is the need to transition from outdated legacy systems. Many healthcare facilities still rely on older, proprietary EHR systems that need more compatibility and standards to communicate seamlessly with modern, interconnected healthcare networks. These legacy systems often need more data exchange capabilities, leading to inefficiencies, data inconsistencies, and barriers to collaborative patient care. The intricate process of upgrading or replacing these systems while ensuring data integrity and continuity of care poses a considerable obstacle to achieving comprehensive EHR interoperability.
Healthcare institutions need to implement a strategic and phased approach to address this challenge. This involves assessing the existing EHR, identifying interoperability gaps, and selecting modern healthcare interoperability solutions that adhere to industry standards, such as Fast Healthcare Interoperability Resources (HL7 FHIR) and open APIs. A well-defined migration plan should be developed, including data migration, new system integration, and staff training. Collaboration with EHR vendors, IT experts, and clinical stakeholders is crucial to ensuring a smooth transition.
2.2 Managing Inconsistent Information Across Multiple Sources
As patients move through different healthcare settings and encounter various medical professionals, their health information becomes distributed across multiple sources, leading to discrepancies, duplications, and variations in data. This inconsistency can compromise patient safety, treatment accuracy, and healthcare quality. Furthermore, different institutions' varying data formats, coding systems, and documentation practices exacerbate the challenge of creating a unified and accurate patient record.
A potential solution to this challenge involves developing and adopting standardized data exchange protocols. By implementing common data standards and practices, healthcare providers can ensure that patient information is accurately represented and uniformly understood across different systems. In addition, robust data validation processes and reconciliation algorithms can help identify and rectify inconsistencies during data integration. Moreover, creating a centralized patient identity management system that links various patient records to a single, accurate identity can significantly mitigate the issue of duplicated or mismatched information.
2.3 Overcoming Organizational Resistance to Sharing Data
This EHR interoperability challenge pertains to the reluctance of healthcare institutions, clinics, and providers to readily exchange patient information and medical records due to concerns over data privacy, competitive advantage, and operational complexities. This resistance often leads to fragmented patient care, hindered medical research, and compromised clinical decision-making.
Addressing this challenge necessitates the establishment of clear data-sharing protocols, robust privacy safeguards, and incentivized collaboration. By fostering a culture of trust, emphasizing the collective benefits of data exchange, and implementing interoperability standards, the healthcare ecosystem can encourage reluctant organizations to actively share essential patient data, ultimately leading to improved patient outcomes and more efficient healthcare delivery.
2.4 Balancing Security and Consent
This challenge in EHR interoperability revolves around the delicate equilibrium between ensuring patient data security and privacy while enabling the seamless sharing of EHRs across different healthcare systems. Striking the right balance involves addressing concerns about unauthorized access, data breaches, and patient consent preferences. While robust security measures are necessary to safeguard sensitive health information, overly stringent restrictions can hinder the efficient exchange of vital medical data, potentially impeding timely and informed patient care, medical research, and healthcare system efficiency.
Potential EHR interoperability solutions to this challenge include implementing a layered security and consent management approach. This involves combining strong encryption, authentication protocols, and access controls to ensure the integrity and confidentiality of EHRs. Moreover, the adoption of standardized and granular consent mechanisms empowers patients to regulate both access to their data and the purposes for which it can be accessed. An integrated framework that employs advanced technologies like blockchain for secure audit trails and data-sharing logs can enhance transparency and accountability. Furthermore, patient education and awareness campaigns can empower individuals to make informed data-sharing decisions, fostering a collaborative environment where security, consent, and interoperability coexist harmoniously.
2.5 Harmonizing Data Standards Across Diverse Software Systems
This challenge encompasses integrating and exchanging medical data across various software platforms and applications used within the healthcare industry. To tackle this challenge, a comprehensive solution includes the widespread adoption and adherence to standardized data formats, coding conventions, and communication protocols by developers, healthcare organizations, and EHR integration software.
To address this challenge, a comprehensive solution involves the establishment of standardized data formats, coding conventions, and communication protocols widely adopted and adhered to by EHR software developers and healthcare organizations. This could be achieved through industry collaboration, government regulations, and incentives for adopting interoperability standards. Additionally, implementing APIs that translate and map data between different formats can help bridge the gap between diverse software systems.
2.6 Optimizing Training Resources for EHR Interoperability
This hurdle involves preparing healthcare professionals, IT staff, and other stakeholders to effectively navigate and implement interoperable EHR systems. Ensuring that healthcare personnel possess the necessary skills and knowledge to seamlessly integrate, maintain, and utilize interconnected EHR systems amidst rapidly evolving technology and standards poses a significant hurdle. This challenge involves understanding the intricacies of interoperability protocols and grasping the broader context of data security, patient privacy, and efficient data exchange among diverse healthcare entities.
To address this challenge, developing comprehensive and up-to-date training programs that cover both technical aspects (interoperability standards, APIs, and data formats) and practical considerations (security protocols, data governance) is crucial. Collaborations with vendors, industry experts, and academia can ensure the training content remains aligned and updated with current EHR trends. Integrating EHR interoperability education into medical and IT curricula can also lay a foundation for future professionals. Continuous learning opportunities, including EHR analytics courses, certifications, and knowledge-sharing platforms, can further bolster the continual development of skills and knowledge exchange. This process cultivates a skilled workforce capable of fully leveraging EHR interoperability while upholding the integrity and privacy of patient data.
2.7 Strategizing Costs for Specialist-driven Interoperability Management
This challenge pertains to the complex and costly task of ensuring seamless data exchange among diverse EHR systems, mainly when managed by specialists with domain-specific knowledge. These specialists play a crucial role in tailoring EHR interoperability solutions to the unique needs of their medical domains. Still, the financial implications of such endeavors can be substantial, involving customization, integration, and maintenance expenses.
Finding an effective solution requires a multi-faceted approach involving standardized interoperability frameworks, modular system design, strategic resource allocation, and collaborative partnerships among EHR vendors, healthcare institutions, and specialists. By optimizing the balance between customization and standardization and leveraging technological advances like APIs and cloud computing, healthcare ecosystems can mitigate costs while achieving efficient and secure data exchange that benefits patients and healthcare providers.
2.8 Navigating Budget Constraints in EHR Interoperability
This issue relates to healthcare organizations' significant financial limitations when striving to establish seamless EHR data exchange across disparate systems. As healthcare entities aim to enhance patient care coordination and data accessibility, the cost of implementing and maintaining interoperable EHR systems becomes a substantial hurdle. This challenge necessitates a delicate balance between allocating resources for EHR integration, customization, and ongoing maintenance while ensuring that patient data remains secure and accessible to authorized stakeholders.
A possible avenue to deal with the budget constraints in EHR interoperability is the strategic adoption of open-source frameworks. By leveraging open-source solutions, healthcare organizations can reduce licensing fees and development costs associated with proprietary systems, allowing them to allocate resources more efficiently. Additionally, collaborating with industry consortia and governmental initiatives that promote standardized data exchange protocols can foster economies of scale, streamlining the implementation process. Moreover, investing in cloud-based technologies can offer scalable and cost-effective data storage and sharing infrastructure.
2.9 Unifying Patient Identification Standards Across HIEs
The crux of this issue involves the need for consistent patient identification methods across different healthcare systems and data-sharing networks. This inconsistency results in errors, data duplication, and compromised patient safety as information is exchanged between entities. Without a standardized patient identification system, accurate matching of patient records becomes a complex endeavor, hindering the seamless exchange of EHRs and undermining the potential benefits of interoperability.
To address this challenge, a comprehensive solution involves establishing and adopting a universally recognized patient identification standard that spans all participating HIEs. This standard could include using unique patient identifiers or a combination of demographic, biometric, and cryptographic identifiers to ensure accurate and secure patient matching. Additionally, implementing advanced data governance practices, strong privacy protections, and robust data validation algorithms would enhance the accuracy and security of patient identification. Collaboration between healthcare organizations, government agencies, and technology experts is crucial to developing and implementing this standardized approach, fostering a more interconnected and effective healthcare ecosystem while safeguarding patient privacy and data integrity.
2.10 Advancing Allergy Management to Enhance Patient Care
Healthcare providers need help seamlessly sharing allergy-related patient data across different EHR platforms, hindering comprehensive patient care. This lack of interoperability leads to fragmented information, potential medication errors, and compromised treatment decisions, ultimately impacting patient safety and outcomes.
One viable solution for addressing this challenge is to establish standardized data exchange protocols alongside a unified health information exchange framework. Implementing FHIR standards can enable the consistent and secure sharing of allergy information among EHR systems. Additionally, incentivizing healthcare organizations to adopt these interoperability EHR standards and invest in compatible technologies will promote a cohesive ecosystem where allergy data can be accurately and swiftly exchanged. Collaborative efforts among EHR vendors, healthcare providers, and regulatory bodies are essential to ensure the seamless flow of allergy-related information, resulting in enhanced patient care, reduced medical errors, and improved healthcare efficiency.
3.Embracing Interoperability for a Connected Healthcare Future
With the goal of a cohesive healthcare future in mind, the value of embracing interoperability is immeasurable. This article highlights the essential role of interoperability in overcoming the challenges posed by fragmented data and improving patient outcomes. As healthcare systems continue to develop, the smooth exchange of EHRs becomes crucial, fostering collaboration among diverse stakeholders and facilitating well-informed decision-making. By creating an environment in which EHRs can seamlessly communicate, healthcare providers have the potential to offer more comprehensive, patient-centered care, minimize duplication, and expedite both diagnoses and treatments. Although achieving an interoperable healthcare ecosystem may involve complexity, the benefits of efficiency, precision, and overall quality of care underscore its necessity as a transformative journey.
Read More
Article | April 6, 2021
Health technologies range from devices, systems, and procedures to vaccines and medications that help deliver high-quality care, reduce costs for hospitals and patients, and streamline operations. It can be any software or IT tool that improves administrative productivity, eases workflow, and enhances the quality of life.
New technology in healthcare includes supportive, educational, information, organizational, rehabilitative, therapeutic, preventive, and diagnostic solutions that improve patient access and healthcare provider capabilities. Virtual concierge, artificial intelligence, voice search, and virtual and augmented reality are promising emerging technologies for 2021.
Read More