Cost of Health Care / 05.12.2024

  Unexpected medical expenses are a reality for millions of Americans. Whether it’s an unplanned emergency room visit, an unexpected diagnosis, or a sudden procedure, medical bills can add significant stress to an already challenging financial situation. For many, these expenses are not just a financial burden but also a barrier to accessing necessary care.

Why Medical Bills Are Often a Surprise

Medical billing in the U.S. can be complex and opaque. Even with insurance, out-of-pocket costs can catch patients off guard. Common reasons for surprise bills include:
  • Out-of-Network Providers: Even during planned procedures, patients may unknowingly receive care from out-of-network specialists, resulting in much higher costs.
  • High Deductibles: Many insurance plans come with deductibles that must be met before coverage kicks in, leaving patients to cover significant costs upfront.
  • Ambulance Services: Emergency transportation is often not fully covered, leading to bills that average hundreds or even thousands of dollars.
  • Hidden Fees: Charges for tests, medications, or consultations may not be clearly communicated beforehand.
These surprises can leave patients scrambling to manage their finances, especially if they’re already living paycheck to paycheck. (more…)
Health Care Systems / 09.09.2024

Running a medical practice is no small feat. Between patient care, managing staff, and keeping up with ever-evolving healthcare regulations, the last thing you want to worry about is whether or not your billing is being handled correctly. But  billing is the lifeblood of any healthcare operation. Without a steady cash flow, a practice can quickly find itself in hot water. This is where medical billing services come in, offering a way to streamline your operations and boost efficiency. Let’s dig into how these services can transform your practice.

The Hidden Time Sinks of In-House Billing

Handling billing in-house might seem like the straightforward choice at first.  But what often gets overlooked is the sheer amount of time and energy it takes to manage billing internally.
  • Staff Training - Keeping your team up-to-date on the latest billing codes and insurance regulations can be a never-ending task. And let’s not forget the frequent turnover in billing staff, which only adds to the training burden.
  • Error Management - Even with a well-trained team, mistakes are inevitable. Every error means more time spent on corrections, re-submissions, and follow-ups with insurance companies. Each of these tasks takes time away from patient care.
  • Software and System Upgrades - Staying current with billing software is another headache. Upgrades can be expensive, and the learning curve that comes with new systems can slow down your team’s productivity.
When you consider all these factors, it’s easy to see how in-house billing can become a drain on your practice’s resources. The time and effort spent on managing billing could be better utilized in focusing on what you do best: providing top-notch care for your patients. (more…)
Cost of Health Care, Medical Billing / 04.07.2024

Patient insurance coverage frequently changes, which can lead to missed details when tracked manually. This often results in claim denials and subsequent reimbursement issues. This article explores the benefits and effectiveness of automated eligibility coverage tracking platforms designed to address these challenges effectively.

The Problem: Manual Tracking Just Doesn't Cut It Anymore

Determining a patient’s status as well as his or her insurance is a crucial but time-consuming process in the billing department. Previously, it included calling insurance companies, verifying the data in different systems, and entering the information into spreadsheets. Since patient details are dynamic and various claims need to be addressed every week, it becomes impossible to manage information updates through traditional methods. Some of the problems include:
  • Time-Consuming Process - Verifying coverage manually can take up to 30 minutes per patient. For large billing companies, this may translate into big time losses.
  • Human Error - Manually compiling and updating records inevitably leads to inaccurate or outdated information falling through the cracks.
  • Claim Denials - Incorrect policy details lead to higher denial rates, payment delays and lost revenue.
  • Lack of Visibility - With records scattered across systems and spreadsheets, billing teams lack clear visibility into coverage changes.
Traditional ways of checking eligibility can't keep up with increasing patient numbers and complexity. Billing teams handling medical billing denials and solutions urgently require automation support to manage this crucial data. (more…)