Utilizing Revenue Cycle Management Tools

Revenue cycle management is a very important function of any business organization including healthcare setups (clinics and hospitals). The revenue cycle process in healthcare industry is too complex often resulting into great time consumption and errors. Here comes the role of revenue cycle management solutions offered by health IT companies. The tool can be of great help and support for both doctors as well as patients. 

Revenue cycle management tools help physicians to automate the back end processes, which ultimately help in saving time resources. The tools are highly effective in speeding up the over all back end processes and to bring down the errors. Due to automation the cost comes down drastically improving the overall ROI for the practice (& hospital). Revenue cycle management tools in fact help to streamline the overall back end processes of a practice resulting into benefits for both doctors as well as patients.

Healthcare Revenue Cycle Management

Effective management of healthcare revenue cycle is very important for attaining optimal level of ROI for the medical setup. The healthcare revenue process involves scheduling, registration, case management, clinical charge processing, medical records, billing, payment posting, and revenue recovery. The entire process is complex in nature and often results into errors that usually takes away the profit margin of the organization. 

Healthcare IT solutions like revenue cycle management is providing a new lease of life to healthcare organizations.  The software application helps medical professionals as well as hospitals to streamline their entire revenue cycle. The automation helps to cut-down on errors usually committed with the manual process of management. It also provides with numerous tools and facilities that can aid in the process of entire revenue cycle management.

Healthcare Outsourcing Services - Safety, Security Issues

There shouldn't be any doubt that outsourcing services are helping organizations to cut-down expenditure on back end processing. It is not only a question of cost but specialization of BPO companies is also helping to bring about an improvement in the quality of service. Healthcare industry is not an exception to the rule, practitioners and medical setups have started availing healthcare outsourcing services of various professional organizations to streamline their back end processes.

Healthcare outsourcing services may be delivering unmatched advantages, however, certain safety and security issues can not be denied. The healthcare data is very crucial, it is a legal as well as moral responsibility of the practitioners (hospitals) to respect the privacy of patient ailment and treatment. In case when a medical setup opts to go for healthcare outsourcing services utmost most care needs to be taken as regards data safety and security issues.

Huge Benefits of Healthcare BPO Services

 

 

The cost of managing the healthcare facility is rising consistently. Practitioners and hospitals are finding it very difficult to manage. The major overhead expenses are towards the back end processing activities. Most of the staff is busy managing the back end functions including appointment scheduling, maintaining electronic medical records, claims processing and so on. Here comes the role of healthcare bpo services that aims to streamline the overall back end processes of a medical setup and practice.

Healthcare bpo services ensure finding a reliable, experienced business partner who performs essential back-office services at reduced cost but not reduced accuracy, speed or security. It is a process wherein a professional organization takes over the processing of back end functions on behalf of the customer. The outsourcing helps the organization to concentrate on the main stream business and to get the processing done with lesser cost expenses.

The Increasing Need For Healthcare IT Services

There is tremendous pressure on the healthcare industry owing to both patient services as well as back end processing. The industry is so complex that major portion of time resources are spent on back end processing by doctors and their clinic staff. The same is true about hospitals, they cater to the large no. of patients as well as the huge amount of back end processing. Thanks to IT support companies that are offering healthcare IT services to streamline the overall back end process of clinics and hospitals.

These IT support companies are giving their services to medical practitioners and many other medical facilities. Services like 24*7*365 monitoring and repair, software management and up-gradation, Electronic Medical Records (EMR), Electronic Health Record (EHR) support services, virus, spyware security and protection, onsite and remote help desk support services etc are being provided by them. There are many variations in these healthcare IT services as per the requirements of practice (or hospital).

Overview of EHR Incentive Programs

EHR is the new age tool for the healthcare industry. Its transforming the healthcare industry by delivering unmatched advantages to physicians, hospitals as well as patients. EHR is collective in nature - it is a collection of patient medical records across different physician clinics and hospitals. EHR as compared to EMR provides doctors with better scope of diagnos and patient health management. However, implementation of EHR involves cost and hence the US government has announced EHR incentive programs. The Medicare and Medicaid Electronic Health Record Incentive Programs will provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. 

The Medicare EHR Incentive Program will provide eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There's an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HSPA). The Medicaid Electronic Health Record Incentive Program will provide eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program.

EHR - The Need of The Hour

Patient medical records play a crucial role in the overall process of treatment. Medical history of patients serves as the basis of diagnosis, line of treatment and patient management. The healthcare industry have gone a long way from manual process of patient medical record keeping to electronic medical records. The records are created in a digital format that facilities both doctors as well as patients. However, great benefit can be derived if these electronic medical records are stored centrally and linked to EHR (Electronic Health Records Software).

To many EMR and EHR are the same, however, in real practice there is a big different between the two. Electronic medical records are created by individual doctors for their use, however, EHR is the collective record of patient medical history across different clinics and hospitals. Collective records provide better scope for diagnosis and treatment. It wouldn't be wrong to say that EHR is the need of the hour.

Online Scheduling - Hassle Free Appointment Scheduling

Appointment scheduling is a big headache for both doctors as well as patients. At first, doctors they have to look into their records, check for appropriate slot, fix-up the appointment and so on. The task may look very easy, however, its very tedious and time consuming. Introduction of online scheduling is welcomed by both doctors as well as patients. The online scheduling system is an intelligent piece of software that keeps track of each and every appointment and provides the patients with the appropriate slot in an online web environment. 

Online appointment software scheduler eliminates the need of being available on the phone for appointments and eligibility checks. Patients can view the availability of their physician and schedule their own appointment by selecting an available time slot. Online scheduling helps physicians and receptionists to spend more time taking care of patients and delivering quality treatment.

Online Scheduling is yet another step in the process of bringing about change in the modus operandi of the healthcare industry. The solution aims at making life easier for both doctors as well as patients.

The Many Advantages of Healthcare BPO Outsourcing Services

Business process outsourcing industry is growing by leaps and bounds; in fact the advantages of outsourcing the back end processes are many. Almost all the industries are keen on outsourcing their back end processes as they can concentrate on their main stream business and at the same time can derive the benefits of cheap services and saving time resources. The healthcare industry is not an exception to the rule and the trend to go with healthcare bpo outsourcing services is catching momentum.

Healthcare industry is very complex in nature - clinical research, pharmaceutical companies, diagnostics, managed healthcare, billing, claims processing and so on. The industry is already facing severe problems with increased pressure and rising costs. In this situation healthcare bpo outsourcing services seems to be the answer as it promises to save time resources, to cut down the costs, and to bring about improvement in the quality of service delivered. 

Healthcare BPO outsourcing services is also proving employment to lacs of fresher youth, thus, helping familites and economies as a whole. It seems a win - win situation for both healthcare as well as BPO industry. 

Tags: Healthcare BPO Services | Healthcare Outsourcing Services

Claims Software - A Much Needed Solution

Claims software is considered to be a much needed solution for the healthcare industry. In fact, US healthcare industry is under tremendous pressure and finding it really very difficult to cope up with the increasing demand. Added to this is the burden of medical insurance claims processing, it is believed that physicians and the clinic staff spends their maximum time resources in entering claims data, forwarding and managing it. Also, practices find it difficult to keep up with burdensome requirements and administrative challenges imposed by insurance companies.

If we go with the statistics, over $200 billion is spent each year on medical insurance claims processing in US. It is believed that physician practices spend over 14% of their revenue in medical billing costs to submit claims and help ensure accurate payments from insurers. However, these high figures too are not helping them in achieving optimum utilization of their resources. Here comes the role of claims software that promises to bring about change in the situation. 

The AMA estimates that up to $15.5 billion in unnecessary administrative costs could be saved by medical practices if insurance companies would improve their claims processing accuracy. This would lead to lower healthcare costs and improve quality of care. Claims software seems to ease out the situation by providing readily available data entry forms, eligibility verification, error handling, one click claim generation, status check, follow up, resubmit and many more features. 

Claims software, the advantages are many, if implemented in a planned manner... it wouldn't be wrong to say that "claims software is considered to be a much needed solution for the healthcare industry".

Role of Healthcare Software

Information technology has become a part of our day to day life, practically there is no field that has not seen the intervention of IT. The advantages are huge, however, till date the healthcare industry was reluctant in implementing any healthcare software (IT). The industry was relying more on the capabilities of the healthcare professionals and was of the opinion that healthcare softwares may not be helpful to them. Now, the industry has realized the importance of information technology that would benefit doctors, hospitals and ultimately the patients.

Healthcare software is deep penetrating into the industry; no segment is in isolation. It has found its roots in each n every segment - clinical research, pharmaceutical, diagnostic equipments (machines), patient record keeping, billing, claims processing and more. The advantages are huge - readily available forms, detailed entry, verification, centralized storage, and so on. These benefits ultimately result into saving of time, costs, improving the revenue and quality of patient service. 

As the healthcare industry in US goes through an expansion spree and gears up to become the best-in-class, healthcare software is increasingly being embraced and adopted by healthcare organisations. Looking into the advantages the trend is catching up.

Electronic Health Records - Stimulus Package Conditions

The biggest barrier to electronic health records has been price, however, the US government has tried to overcome this barrier by introducing an ehr stimulus package. The package lays down certain conditions on usability and implementation time. If we look into the conditions carefully, the major emphasis is on adopting the electronic health records system by physicians as early as possible.

The stimulus package states that anyone who treats Medicare patients without an EHR by 2015 will see reimbursements decrease by 1% that year. The pay cut grows to 2% in 2016 and 3% in 2017 and every year afterwards. . If electronic health records adoption fails to hit the 75% mark by 2018, the Department of Health and Human Services (HHS) can boost the penalty to 4% that year and a maximum 5% in 2019 and beyond.

In order to avail the unmatched benefits of electronic health records system and government incentive program, the physicians has to be determined as regards the implementation of the system as early as possible.

Government Incentives For EHR Adoption

EHR is concerned with the digitization of patient records as maintaining patient records manually is a tedious task that serve as the basis of diagnosis and treatment. Physicians and their staff members are usually burdened with record keeping activity, often resulting into insufficient or error full information. The biggest challenge arises at times of emergency when records couldn't be accessed by the attending doctor. At times, when a patient wants to change the physician, they feel the heat of getting the records transferred. EHR seems to be an answer to these problems.

Looking into the advantages that EHR promises both for doctors as well as patients, US government is very enthusiastic in getting it implement. This is the reason incentive package for ehr adoption has been announced: The package clearly states that on meeting certain usability criteria a physician can receive up to $44,000 over 5 years under medicare and more on those later. Working in a "health professional shortage area" entitles you to 10% more. But to receive the maximum $44,000, you must qualify as an EHR user beginning in either 2011 or 2012.

The implementation cost is the main hurdle in the adoption of EHR, however, the stimulus package, long term advantages are all creating a smooth path for EHR. In other words, EHR is all set to explode the US healthcare market.

The Best Affiliate Program?

Affiliate programs offer great opportunity for self-employment, however, selecting an appropriate program is a daunting task. Usually people ask for the best affiliate program that can generate great income with minimal efforts. Truly speaking, the best affliate programs are the ones that are genuine in nature and are managed professionaly. Now, the other question - which one would be a best option from the available professional affiliate programs?

In fact, there is no good or bad affiliate program; one particular affiliate program may not work with some person but it may work with some other person and vice versa. Now, why does this happen - it entirely depends on our area of interest as well as our promotional and management efforts. 

If we conclude, the best affiliate programs are those programs that are managed professionally. Also, when selecting we need to take into consideration our interest and market penetration (demand) for the particular product. And rest is all our efforts...

Healthcare IT Servicves - Do We Need It?

Healthcare industry is very complex in nature - patient records, diagnostics, treatment, medical insurance management and so on. Also, there is tremendous pressure on the industry due to fast paced lifestyle (physicial and mental pressure leading into various ailments). It is believed that healthcare backend process consumes the maximum time of any healthcare professional, which otheriwse could be used for providing services to the patients. There seems to be some answer to this by way of healthcare it solutions like emr, claims system, pms and so on. Availability of specialized healthcare it service providers also seems to be a good option in cutting-down the time and cost spent on back end services. 

Healthcare IT services industry is on growth track for the very reason being specialized services offered at reasonable costs. The service providers as they work on a particular domain are highly skilled and equipped with the required infrastructure. This helps them to accomplish the task much faster as compared to healthcare professionals handling the processing themselves. At first, the outsourcing of back end process to service providers helps to save the valuable time and on the other hand cost cutting is one of the other main advantages. 

Looking into the pressure on the healthcare it industry, analysts believe that healthcare IT services is the need of the hour. It will add to the quality and quantity of patient service provided along with the reduction in healthcare costs.

Healthcare IT Solutions - For Your Life And Money

Healthcare IT solutions - Is it only for doctors? or Is it only for patients? A question often asked as to whom would benefit from the implementation of healthcare it solutions. If we have an unbiased look at the benefits - the IT solutions are beneficial to both doctors as well as patients. There are huge advantages associated with the adoption of information technology. 

IT has changed our modus operandi in each and every field and healthcare industry can not be an exception to the rule. Implementation of healthcare IT solutions like electronic medical records (emr), claims processing system, practice management systems and so on ensures to streamline the backend processes of a healthcare practice. 

Doctors are relieved to a great extent from tedious backend process, the task becomes easier due to automation. Error handling, quick process, easy access and many more benefits associated with the implementation of the healthcare it solutions. 

Now for sure doctors are benefited out of the adoption of the technology, however, patients are not kept at bay they too are benefited to a great extent. The healthcare IT solutions ensure recording of detailed, correct (error free) information at faster speeds. The time saved is ultimately spent by healthcare professionals for providing better quality of service to patients.

Hence, it could be concluded that adoption of healthcare it solutions are beneficial to doctors as well as patients as it helps to bring about improvisation in the quality of service and saving of money. For sure healthcare it solutions are for our "life (better quality of service)" and "money (cost saving)".

Advantages Of Web Based Claims Processing System

 Claims processing is a very tedious task; it is often argued that a healthcare professional or the clinic staff spends maximum time in taking care of the medical insurance submission formalities. The task involves a large number of steps to be carried out and often this results into errors; ultimately resulting into claims denial or delay in reimbursement. There seems to be some answer to it by way of claims processing system.

A claims processing system is an intelligent piece of software that helps to automate the process of claims submission. It helps to simplify the process - the task of coding becomes simpler, readily available data entry form, error handing and many more features. The systems aims at simplying the life of healthcare professionals as well as patients (by way of less denials and quicker claims reimbursement).

A claims processing system can be desktop based or web based. A web based claims processing system works on the principle of cloud computing, which is considered to be the future of information technology. It helps the employee to fill the form online and submit it so that the form is sent to CPD through Internet. At CPD, the form needs to be checked automatically by a program which will compute the amount that needs to be reimbursed to the employee for the treatment undertaken.

A web based claims processing system is definitely considered to be a better option as it provides the flexibility to operate it through any place. It can also pass through various channels (departments) for further processing.

Healthcare IT Services - Adding Value To The Industry

US healthcare industry is growing at a rapid pace, it is mainly due to the tremendous pressure on the healthcare services. There are a number of factors contributing to the huge demand for healthcare services including the fast paced lifestyle. Healthcare industry is not able to cope up with the growing demand and the effect can be clearly seen by way of growing number of medical negligence cases and also the disappointment among patients as regards the quality of service. 

The age old manual system of healthcare management was sufficient at times when the pressure on the healthcare services was in a manageable state. However, the growing pressure has made it clear that the old manual system would not suffice and that it needs to be replaced with the advanced healthcare IT services.

The healthcare IT services like claims processing system, electronic medical record solutions, practice management systems and so on are said to be transforming the healthcare industry. The IT solutions are adding value to the industry by improving the quality of patient service and overall efficiency of the organization.

EHR - For Improved Organizational Efficiency

Often patients feel disappointed after visiting a healthcare organization, this happens mainly due to lack of co-ordination between the various back end activities in the clinic including patient health record management. The increasing pressure on the support staff as regards managing the health records can be clearly seen from the growing number of error in health records. 

The errors in medical records ultimately result into the wrong diagnosis and treatment, thereby posing immense risk to the life of the patient. The healthcare it solutions like EHR systems ensures to overcome the drawbacks associated with the manual system of patient record management. Looking into the benefits associated with the implementation of EHR systems, it wouldn't be wrong to say that the EHR systems aim at improving the overall efficiency of the organization by streamlining the work-flow at physicians clinic.

Electronic Health Records - Is It Worth Spending?

Patient information management is the biggest challenge that physicians all across the world are struggling with. The task is very tedious and time consuming... it is believed that doctors spend their maximum time with the management of patient information, the time resource that could have been otherwise used for the well-being of the patients. Another fault that the manual system of record keeping carries is non-availibility of patient information at times of emergencies. 

The healthcare it solutions like electronic health records (e h r) seems to be an answer to these problems. The ehr system is considered to be adding value to the practice by digitizing the patient health records. The system ensures detailed and accurate patient health information that could be efficiently utilized in the process of diagnosis, treatment and even at times of any emergency in the future. 

Looking into the multiple benefits that a fully functional electronic health record system can deliver - it is worth spending for an ehr system !

Healthcare Affiliate Programs - Is It A Good Option

Affiliate programs are considered to be offering great opportunity for business enthusiasts. Its very difficult for people with no experience and lack of ample resources at disposal to start a business all of a sudden. However, affiliate programs ensure a ready platform for business enthusiasts - most programs offer good training, support and monetary benefits. 

There are a large no. of affilaite programs available in the market based on various products / verticals, however, not all programs can deliver long term future and monetary value. In fact, the success of a affiliate program also depends to a large extent on the market conditions for a particular industry. Healthcare industry is growing at a rapid pace... affiliate programs based on healthcare industry seems to be offering promising opportunity for business enthusiasts.

Healthcare IT Solutions - Save Life and Money

There is tremendous pressure on the US healthcare industry and as a matter of fact getting doctor appointments are really becoming very difficult. Lack of timely treatment is making the situation worst for the patients. The age old practice of manual operations in the healthcare industry needs to be replaced with the advanced healthcare IT solutions that would automate the various processes in a physicians clinic (or hospital). 

Healthcare IT solutions like claims processing system, electronic medical records (emr), practice management and others are gaining immense popularity for the very reason that it delivers multiple benefits to both doctors as well as patients. The automation helps to gain accuracy and saving of time that would ultimately benefit the patients with improved quality of service and care. The reduction in labor time also helps to improve the return on investment for the practice.

It is therefore rightly said that "Healthcare IT Solutions - Save Life and Money" !

Benefits Of Healthcare Affiliate Programs

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Affiliate programs are considered to be a great self employment option. There are a no. of benefits associated with affiliate programs. At first it provides with the necessary foundational support to start a new business venture. However, not all affiliate programs may be in a position to deliver the desired results. Healthcare industry all across the globe (in particular in US) is growing at a rapid pace. This has given rise to great profitable opportunities in healthcare affiliate programs. 

Healthcare affiliate programs are seen to be offering great long term benefits. A large no. of healthcare affiliate programs have come into picture. However, let us demonstrate the benefits offered by one of the healthcare affiliate program called Somega Network Associate Program(affiliate program):

In order to join this affiliate marketing program you should be a hardware/software vendor, medical billing company, home based medical biller, medical billing student or a aspiring entrepreneur interested to make an income/additional income between $ 80,000/- to $ 200,000/- per year through attractive revenue sharing. You should have basic knowledge of medical billing and good communication skills. The Somega healthcare affiliate program will not require any investment on your part except, one time license fee.

The program offers a no. of support benefits as listed below:

   1. Access to Somega Brand.
   2. Assist you in lead generation through its sales call center.
   3. Promote you through its centralized marketing efforts.
   4. Train you on the business operations and software.
   5. Provide you with Sales Promotion material.
   6. Manage the entire revenue cycle for the Physicians including
         1. Pre-care patient eligibility and benefits verification,
         2. Claims management and adjudication,
         3. Payment collection, payment posting,
         4. Denial management,
         5. Patient billing and payment processing.
   7. Ensure full compliance with regulatory, privacy and data security norms at all times.

Choosing The Right Electronic Health Record (EHR)

Electronic health records (EHR) is a revolutionary IT tool for the healthcare industry. It is a process of digitization of records. The manual process of maintaining patient records is very time consuming and tedious. The process often results in to insufficient records as well as with chances of more errors. The biggest problem with the manual system is that the records are maintained individually by each healthcare professional as well as hospital, hence, resulting into difficulty in accessing the data at the time of emergency. 

A doctor has to take care of a no. of issues including maintaining patient records, which being a time consuming process. Electronic health records or ehr seems to be an answer to some of the problems faced by healthcare professionals. However, a healthcare professional or a hospital has to be very careful in choosing the ehr system as not all ehr systems are alike. Each system differs in capabilities... at times some capabilities may not be suitable for a particular practice or hospital setup.

At the time of implementation of an electronic health records (ehr) system it is advisable to consider the points as mentioned below:

- Does the ehr system in a position to allow you to meet your goals

- Is the ehr certified by CCHIT

- The total cost of ehr

- Ability to interface with local laboratories and hospitals

- Is the system compatible with the existing infrastructure

- System customization

Healthcare Affiliate Program - A Great Self Employment Option

Affiliate marketing is a marketing practice in which a business rewards one or more affiliates for each visitor or customer brought about by the affiliate's own marketing efforts. Examples include rewards sites, where users are rewarded with cash or gifts, for the completion of an offer, and the referral of others to the site. There are a large no. of affiliate programs available in the market, however, healthcare related affiliate programs offer a great self employment option to those who wish to start their own business venture.

Healthcare industry all across the globe is growing, especially healthcare in USA has reached newer heights.  This situation has come up with great options for enthusiastic entrepreneurs in the healthcare industry. Starting a business all afresh without any experience is a very difficult task, affiliate programs provide with a very good option to start with some business. One can cash on the experience, brand image, infrastructure and other merits of the established company.

There are a large no. of affiliate programs available in the market, however, choosing the best one has always been a major concern for the enthusiastic entrepreneurs. An affiliate program must offer good profit return, training, support and above all longevity of life. Usually, a large no. of healthcare affiliate programs offer good profit returns, training, support and longevity of life. Hence, healthcare affiliate programs are considered to be a great self employment option.

Electronic Medical Records (ehr) – Is IT An Expensive Option?

 Electronic health records (EHR) refers to a paperless, digital and computerized system of maintaining patient data, designed to increase the efficiency and reduce documentation errors by streamlining the process. However, implementing Ehr is a complex process often considered to be an expensive investment by medical professionals as well as hospitals. 

Implementation of electronic health records (ehr) involves costs as regards purchase, implementation, training and customer support. However, the benefits derived from the implementation are many - just like any other record keeping, moving patients' records from paper and physical filing systems to computers and their super storage capabilities creates great efficiencies for patients and their providers, as well as health payment systems.

There might be initial cost of implementation, however, looking into big advantages the amount spent on initial purchase looks very small. Money is saved by using electronic medical records (ehr); not just the cost of paper and file folders, but the cost of labor and space, too. In any business, time equals money. The efficiencies created by simply typing a few identifying keystrokes to retrieve a patient's record -- as opposed to staring at thousands of file folders, filing and refiling them -- saves a doctor's practice or a hospital many thousands of dollars. That's even taking the cost of the electronic system into account.

Healthcare IT Solutions – The Multiple Advantages

 Implementation of healthcare IT solutions is considered to be a very important phase in the healthcare industry. According to industry experts the healthcare industry is under rapid transformation due to the introduction of healthcare IT systems like claims processing system, electronic medical records and practice management (PMS). The industry by and large is benefited to a great extent by the various benefits derived from the implementation of the information technology.

Healthcare IT solutions are considered to be a boon for the healthcare industry. The advantages are many - at first the it systems help in saving a large amount of time, quick & meaningful processing of data, reduction in amount of errors and so on. The above mentioned advantages are definitely helpful to the practice as well as hospitals. They help in bringing down the cost of operation and thereby improvement in the revenues. 

The advantages of healthcare it solutions are many, however, the biggest advantage derived from the implementation is the "improvement in the quality of service and patient safety".

Claims Processing System – The Important Feature to Look for

Information technology has taken the world by storm, practically there is no field without IT systems including the healthcare industry. IT systems like electronic health records, claims processing system has found its way into the healthcare industry. These IT systems ensure smooth work-flow with significant reduction in the time spent. IT system like claims processing system plays a very important role to ensure smooth processing of claims which is a very tedious task. 

A large no. of claims processing systems are available in the market, however, not every system can do justice with the practice. In fact, each claims processing system has its own capability, there are certain standard features that every claims processing must possess. A system may also have a set of standard features, however, the important feature to look for is "interoperability". The system must be capable to interact and get data from electronic medical records. 

The interoperability feature is very important as it helps the claims processing system to receive or transfer data, which makes it a "new age multifunctional device".

Claims Processing System – What To Look For?

Handling claims is a key business process for a medical professional as well as any managed healthcare setup. It is proved that claims management consumes majority of time resources. According to some recent studies, the processing cost of a claim that adjudicates on the first pass (60–70 percent of claims) is pennies compared to dollars for a manually processed claim resulting from an exception or "pended" from the core system (30–40 percent of claims).

The electronic claims processing system aims at reducing the time spent in processing the data, improving the rate of claims reimbursement at reduced time limits, providing more time resources to the professionals, improvement in the quality of service and patient safety, reduction in administrative costs and improving the revenue for the practice / hospital.

Not all claims processing systems are same, they differ in capabilities. Hence, one needs to be very careful when selecting a particular claims processing system. At first, one should look into the requirements of the practice and then compare it with the features offered by the product:

Features That an Advanced Claims Processing System Must Offer:

•    Instant verification of benefit and eligibility information
•    Access to most payer connections in the industry
•    Corrected and verified patient information
•    Low Cost Claim Processing - No charge for transmission of commercial claims
•    Flexible Claims Submission - Direct transmission or print-image
•    HIPAA Compliant Solution - Claimat's working format is ANSI X12 HIPAA v4010A
•    Unique Features - Claim Editor, Reimbursement Manager, Comprehensive Reports
•    Electronic Medical Records (EMR)
•    Online Prescriptions
•    Simple, reliable online patient scheduling solution
•    Data Analysis, Pay for Performance, HEDIS, and HCC reporting in real time
•    Integrated tools will allow for the transmission of lab results to patients, medical groups and health plans
•    Integrates crucial pharmacy data with convenience and clarity

Tags: Claims Processing System | Claims Processing Software

Claims Processing System – How Important Is The Vendor?

 

Claims processing is very important, however, a very tedious task. The manual claims processing system involves a large no. of steps to be followed. It is believed that the major time resources are spent in handling claims processing by medical professionals as well as hospitals.

The electronic claims processing system aims at reducing the time spent in processing the data, improving the rate of claims reimbursement at reduced time limits, providing more time resources to the professionals, improvement in the quality of service and patient safety, reduction in administrative costs and improving the revenue for the practice / hospital.

As far as training and support is concerned, a claims processing system no matter how advanced it is, has no meaning if it does not provide for top class personalized training and 24/7 technical support. One has to be very careful in choosing a vendor; a vendor must be able to provide with a good demo of the product, product features comparison chart (with other products in the market), assurance as to dedicated training and good technical support for the product.  The advantages of implementing the system are many both at physician/ hospital as well as patient level.

Tags: Claims Processing System | Claims Processing Software

Electronic Health Records (ehr) – The Ultimate Challenges

Computers have become a part of our day to day life; more and more manual processes are getting computerized including the implementation of electronic health records (ehr) systems. However, nothing comes without a price – the newer trend of digitization of medical records has come with a number of worries and concerns.

Currently “privacy protection” is the biggest threat that electronic health records (ehr) systems are facing. With manual system, the medical history was stored individually by various doctors and hospitals ensuring it to be accessed by only respective authorities. However, digitization of medical records has made it possible to store the data centrally that can be accessed by any authorized medical professional and hospital at any point of time.

The other concerns associated with the implementation of electronic health records (ehr) are as follows:

High Implementation Cost

Need for Training on Using the System

The System Should Be In Line With HIPAA Guidelines

Meaningful Use of EHR

Gradually, electronic health record (ehr) system is gaining momentum. More and more doctors and hospitals are embracing it, and depending on the part of the country you are looking at, conversion could be as high as 40%. With government involvement and the amount of resources it is investing, the time will come when digital medical record keeping will be the norm.

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Tags: Electronic Health Records | EHR

Benefits of Electronic Health Records (EHR)

 

An electronic health record (ehr) is a gift of information technology for “IT” has become an indispensable part of our day to day life. “IT” has made it possible to simply our lives; make our work easier and more accurate. To be a part of the trend healthcare industry is going on under rapid transformation. The industry is on its way to do away with the pen and paper system. The industry is very serious and is catching upon the trend of implementing healthcare IT systems like electronic health records (ehr).

Healthcare management is a complex process it starts with the patient visiting the doctor, registration, recording patient medical history, lab reports, allergies, treatment, claims submission, reimbursement and so on. The manual process of recording the medical history is very time consuming and often results into a no. of errors. At times it may also result into time delays when the medical history of the patient is required under emergency situations. Electronic health records (ehr) promises to do away with the flaws of the present manual medical records system.

An electronic health record (ehr) is a process of digitization of the medical records or medical history of the patients. The information is stored digitally with the help of computers and software. The whole process is scientific in nature; the information is stored in a systematic manner. The software provides with a no. of functionality that can be utilized to process the data into some meaningful information, which can be used for effective diagnosis and treatment.

The electronic health record (ehr) enjoys a no. of benefits as against the old pen & paper system:

Accurate Documentation

Scientific Storage of Data

Time Saving

Reduction in Administrative Costs

Improvement in the Quality of Service

Increased Patient Safety

Reduced malpractice insurance premiums

Just like any new approach to doing things, Electronic Health Records (EHR) has its own advantages and disadvantages. However, it for us to “weigh” as to which side is heavier and to go accordingly with it. 

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Tags: Electronic Health Records | EHR

How to Speed Up Medical Claims Processing?

 

 

Healthcare costs all over the world is rising & so is the need for medical insurance. The warren of complex claim forms as well as insurance policy procedures all over the world besieges even the doctors. The claims submission, approval and reimbursement is a time consuming process. Healthcare professionals and hospitals need to concentrate on the quality of patient care, however, it is believed that a majority of their time resources is spent in handing the insurance claims processing. Information technology or healthcare IT is bringing about drastic change in the situation. Healthcare systems like claims processing system is giving a new lease of life to the healthcare industry. 

Manual claims processing involves a large no. of steps and also errors in the work can not be denied. In fact, errors can not be denied even in the computerized work, however, errors can be minimized. Implementation of claims processing system have changed the way claims processing was handled at medical professionals clinic or a hospital. A no. of claims processing steps can be automated and the time resources spent can be reduced to a great extent. 

An advanced claims processing system provides with a no. of advantages to both healthcare professionals as well as patients. The biggest advantage observed is that it provides with the capability of checking claims eligibility beforehand, thus avoiding denial at a later stage of treatment. Once the patient is eligible, the claim can be submitted with minimal data input and claims status can be checked. In case of errors, the claim is not submitted and automatically its denied by the system. The errors can be corrected at the point of submission itself, thus avoiding the delay that could have caused due to denial of the form.

In case of special eligibility criteria, form resubmission the manual process is very complicated and time consuming. However, with the implementation of an advanced claims processing system the over all process of claims processing can be streamlined. It helps to cut down the total time required for reimbursement and also to cut down the cost of managing the claims drastically. Its a win-win situation for both healthcare professionals as well as patients.

Claims Processing System: Making Our Life Easy

Claims processing and management is a very tedious task. There is always a tremendous load of claims processing on medical practice as well as insurance companies. Manual claims processing is a time consuming process and often leads into a no. of errors resulting into delayed reimbursement of claims. This is also a hit back on the image of a medical practice or the insurance company. However, the advanced claims processing systems available in the market today are making our life easy. It is also said that behind every successful insurance company is a sophisticated claims processing system. 

A competent claims processing system helps in timely settlement of claims and to build up positive rapport with the client. An advanced claims management software eliminates human error by automating the entire process providing complete access to claims data records with the simple click of a mouse. A powerful management tool, claims management software helps to analyze and organize data to deal with complex litigation. It helps to bridge the gap between the applicant, submitter and the payer. Its an intelligent, unique piece of software that aims at simplifying the process of claims management. 

Every competent claims processing system offers certain basic advantages: Claims Eligibility Checking, Claims Submission Module, Claims Status Verification, Error Handling & Resubmission,  Seamless Integration,  Remote Access and Security, Quick Overall Claims Processing, Increased Claims Processing Productivity and Reduction in Administration & Claims Processing Cos.

Taking into consideration the above features; choosing the appropriate claims processing system is of utmost importance, know that the best system options will reduce the risk of exposure, increase corporate productivity, develop preferred customer service relationships, and reduce claims processing time. The choice is more than just a claims processing system, as your decisions could potentially differentiate your company over that of the competitor.

Claims Processing System: A Cost Saving Option for Claims Processing

The world is changing and so is the healthcare industry; the healthcare IT systems like claims processing systems are gaining immense popularity across the entire healthcare and medical insurance industry, In fact, the manual methods of processing the medical claims is very tedious, which involves consumption of large no. of man hours. The processing takes long time and is often not free from errors that again results into more wastage of time. The reimbursement usually takes long time resulting into inconvenience for the submitter.

Taking into consideration the advantages of claims processing systems; the penetration of electronic claims processing has increased by leaps and bounds. According to a recent study, the 3 / 4 ths of all health insurance claims are now submitted electronically, up from 24 percent in 1995, allowing 98 percent of claims to be processed within a month of receipt from the health care provider. The proportion of insurance claims submitted to health plans electronically has more than tripled in the last decade, reducing administrative costs and significantly speeding up payments to doctors and hospitals.

In 2002, just 44 percent of claims were submitted electronically, compared to 75 percent today. More & more healthcare providers are implementing claims processing systems. The reason is quite obvious - there is often a significant delay before health insurance plans receive claims from health care providers, especially for those claims still submitted on paper.  In 2006, nearly 3 claims in ten were received more than 30 days after the date of patient service, with one-third of the paper claims not reaching the insurer for 60 days or more. Electronic claims processing has put a check-mark on delayed claim submissions.

Manual claims processing is very costly; the amount spent on paper claims processing is about $1.58. Pended claims requiring manual or other review cost $2.05 on average per claim to process. Where as, the average cost of processing a clean electronic claim with the help of claims processing system is just about 85 cents, nearly half the cost of processing a clean paper claim. Pended claims requiring manual or other review cost $2.05 on average per claim to process.  Huge quantity of claims need to be submitted & processed each month; the amount saved by implementing a claims system could be a big money for the providers and healthcare facilities.

Total Health IT Solutions - The Somega Advantage

Somega is a complete healthcare IT solutions company. Hardware, software, connectivity and 24/7 tech support solutions for healthcare providers, that automates key processes of revenue cycle management and electronic health records in secure, compliant and cost effective manner. Somega is determined to offer the entire gamut of healthcare information technology solutions under one roof.

Healthcare IT is transforming the face of healthcare industry. The physicians office, hospital setup and various healthcare facilities are all getting automated. There are various obvious advantages of automation - effortless management, time savings, minimization of errors, improved patient care, and reduction in costs. The healthcare IT systems are not only helpful to the physicians, however, they have also proved to be of great help to the patients.

Here at Somega Healthcare, we understand your needs... we understand how important it is to implement healthcare systems in a physicians office or a hospital setup. The implementation involves a no. of steps to be followed. Somega believes in offering a complete range of services to avoid the difficulties involved in the implementation. It is very difficult for a healthcare professional or a hospital to deal with each n every piece of IT requirement separately.

Somega, offers all the healthcare IT solutions as a package - hardware, software, networking, IT systems and support under one roof. Somega is determined to simply the whole process of implementation of healthcare IT systems and to make life easy for the healthcare professionals. Here at Somega we have developed  advanced healthcare IT systems to suit your requirements, we implement the system, we train you and also offer you with 24/7 customer support.

... The Somega Advantage!