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Revenue Cycle Management Outsourcing

  |  2021  |  June
June 24, 2021
Healthcare IndustryRevenue Cycle Management
healthcare

Revenue Cycle Management Outsourcing

Revenue Cycle Management (RCM) Is Crucial Enough. Know When Hospitals Should Think Of Outsourcing It

T
o be more efficient has got to do everything with saving money.

In fact, it’s a driving factor to staying in balance financially for any healthcare institution at large.

And, the thing that people at large will be agreeing is – When the finances become tight, it is always worth looking at the cost-saving solutions.

The bottom line is – When health services are rendered, healthcare institutions and organizations should bring positive figures coming down the road.

Whether it is about serving patients or taking care of the other maintenance operations, making sure you avoid operations that kill the productivity, time and excessive resources at the same time.

It’s again more like an initiative in the right direction.

Well, what’s going to turn out?

To answer – Seamlessness and convenience at large!

Thus, to address the cost concerns, a lot of private healthcare institutions as well as organizations look their way towards outsourcing.

The fact is –The rising costs any healthcare organization will ever bear.

Again –From maintenance to having personnel and qualified staff on board, and then again ensuring things such as payment is received when services rendered in the best possible manner.

Therefore, responsibly taking care of two or more operations, even out of the context of serving patients becomes a big point for any healthcare organization to the greatest degree possible.

In saying so –We are going to discuss when any hospital or healthcare institution should think of outsourcing its revenue cycle management.

In addition to it – We will also discuss what revenue cycle management is, and what you should learn about, to the fullest potential.

Let’s get started and make sure to stick with the guide.

WHAT IS REVENUE CYCLE MANAGEMENT?
Let’s cover it with an instance.

Suppose – A patient hits to arrive at the clinic.

Discussed the sufferings and difficulties, or needed advice on ailment he was affected through.

The doctor or specialist treated, and finally things have been sorted out successfully for the patient.

Now, the thing is – In order to record the complete process in the best possible manner effectively and efficiently becomes a deal one has to cover.

How about the situation – When the healthcare service provider doesn’t get the payment for the services rendered?

Well, there are countless instances to consider.

Thus, the revenue cycle management is all about supervising, administrating and undertaking the complete process of generating revenue out of the services rendered.

And, now –Would you consider outsourcing it because you have got a lot of patients coming to your healthcare institution and you want to serve without looking at every aspect we talked about?

To add – That’s the key.

INSTANCES IN WHICH HOSPITALS SHOULD THINK OF OUTSOURCING THEIR REVENUE CYCLE MANAGEMENT

  • Reduce Billing Errors & Provide Seamless Experience To Patients
  • Improve Patient Condition Quickly & Efficiently
  • Save Time, Resources, Utilities In The Best Possible Manner
  • Proper Follow Up Of Billing Compliances
  • Streamline Practice Functions & Other Operations
  • Reduce Administrative Burdens & Other Losses
  • High Chances Of Attracting Other Revenues

As we discussed about the instances of outsourcing revenue cycle management, and now – It’s time to discuss what includes in revenue cycle management!

WHAT DOES REVENUE CYCLE MANAGEMENT INVOLVE?

  • Charge Posting
  • Claim Submission
  • Denial Management
  • Patient Registration
  • Eligibility & Benefits Check
  • Coding & Billing
  • Clearing House Denials
  • Payment Posting
  • Secondary Filing
  • Account Receivables
  • Appeal Procedure
  • Patient Billing

FINAL THOUGHTS
So, we have finally contributed to what it takes to know everything about revenue cycle management.

The trend of outsourcing essential operations is more connected to bring about the convenience and seamlessness in the medical operation and rendering of other services.

It is one of the best forces to ensure things stay up to the mark, and have complete vibrancy in any regards possible.

That’s how it keeps things in the system.

Thus, would you think of outsourcing for revenue cycle management?

Well, just see the growth of outsourcing in the healthcare industry, and you will surely think of doing it at the best.

On a sweeter note – Thanks for the read, though!

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June 24, 2021
Healthcare IndustryMedical Billing
healthcare

Documentation Requirements for Filing Medicare

New Documentation Requirements for Filing Medicare Cost Reports

O
ne of the clearest intentions of the guide is to have you on board and share what’s important with regards to the current trend.

Thus, what matters is having all the facts laid down on the table of discussion.

Now, we won’t discuss straight up the context; however, it’s again important to keeping a complex reasoning and constructive view on what we will be sharing hereon.

So, what is Medicare Cost Report?
For every healthcare activity that takes place, that’s involved cost and charges.

Therefore, consider Medicare Cost Report as a charge sheet or financial report that is always put forth and submitted in the most standardized formats possible.

This has now become pivotal as well as mandatory by far.

Why?

Well, to prevent it from the rejection.

If your report gets rejected, then no reimbursement and things will backfire drastically on you!

Such Medicare Cost Reports are submitted to the Centers for Medicare & Medicaid Services (CMS).

Furthermore, CMS keeps the complete task and aligns Medicare Cost Reports in the Healthcare Cost Reporting Information System (HCRIS).

The one who submits such Medicare Cost Report are Medicare-Certified Institutional Health Care Providers.

Again, you may have questions what CMS stands for and their purpose of existence in the complete story?

To ascertain the fact, CMS is a part of the Department of Health & Human Services (HHS) that oftentimes looks into several federal healthcare programs.

CMS sticks with a one-stop approach, that’s more about value-based reimbursement.

Including this, the department also administers the Health Insurance Portability and Accountability Act (HIPAA) and Medicare Access and CHIP Reauthorization Act (MACRA) law.

Moving forward – Stick with the guide since beginning is always playful and adventurous.

In short, let’s answer quickly questions readers may have at large.

Why Medicare Cost Report Is Used For & The Purpose
It is used for an accurate and correct reimbursement to physicians as well as other healthcare organizations for the services they have rendered to patients respectively. It’s important to keep a note of such healthcare activities, so they can get paid at the same time.
What’s That Included In The Report
The report includes information such as Facility Characteristics, Utilization Data, Total & Medicare Costs, Inpatient as well as Outpatient Charges, including Medicare Payment Data and Financial Statement Data to be more specific and precise.
Who Files It
As discussed, it requires for a Medicare-Certified Institutional Health Care Provider to file for Medicare Cost Report in the most effective manner, so the reimbursement process never gets rejected, and the purpose it is used for.
At a glance:
Medicare Cost Report has to be filed annually. It’s an imperative job all home health agencies have got to perform on a consistent basis. Failure to doing so will result in termination of all cash-inflows. All it means, you won’t get paid for the healthcare activities you rendered under the program.
About Monarch RCM
It’s never now easy to be all prepared to gather a whole new range of information at a glance. In fact, filling for Medicare Cost Report requires detailed information and documentations that physicians as well as other healthcare institutions should be aware of. So, it’s highly recommended not to skip the phase and perform your due diligence at hand. On top of everything – By any chance, you ever need assistance in order to filling and submitting Medicare Cost Report in the most proficient manner, we are always here to support and get you on board. In fact, do contact us today and we will set the stage to prevent every Medicare Cost Report from getting rejected to the greatest degree possible.
Common Medicare Cost Reports Can Get Rejected For Lack Of Supporting Documentation Such As:

  1. Teaching Hospitals (Section 413.24(f)(5)(i)(A)

This Medicare Cost Report requires Intern & Resident Information System Data to not get rejected.

  • Bad Debt (Section 413.24(f)(5)(i)(B)

This Medicare Cost Report requires a Detailed Listing of Bad Debt Listing to not get rejected.

  • Disproportionate Share Hospital (DSH) Eligible Hospitals (Section 413.24(f)(5)(i)(C)

This Medicare Cost Report requires a Detailed Listing Of Hospital’s Medicaid-Eligible Days to not get rejected.

  • Charity Care & Uninsured Discounts (Section 413.24(f)(5)(i)(D)

This Medicare Cost Report requires A Detailed Listing Of Charity Care and/or Uninsured Discounts to not get rejected.

  • Home Office Cost Allocation (Section 413.24(f095)(i)(E)

This Medicare Cost Report requires a Detailed Listing Of Home Office Cost Statement (Home Office or Chain Organization) to not get rejected.

Final Thoughts
The standard process for filling and submitting Medicare Cost Report has to be followed and implemented upon.

Unless you do it, things will become messier with the passage of time since this can affect your venture financially under the program.

Thus, it’s always recommended that you consult and have a constructive view on the parameters we have discussed so far.

With that being said – Do share what is that you loved the most about the guide.

On a sweeter note – We at Monarch RCM are more committed to assisting and helping you out constructively to ensure you stay at the safer side.

And, thanks for the read, though!

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June 24, 2021
Healthcare IndustryMedical Billing
healthcare

Reimbursement Review

New Electronic System for Provider Reimbursement Review Board (PRRB) Appeals

Y
ou are not sure what we will be discussing about?

Is it – You want the complete context to be covered to the fullest potential?

If you answer yes, we have now got you all covered.

Whether you are new to the update or just getting a refresher, which just depends on the level of information you want to have things rolling in positively if you are a Part A Provider, Medicare Contractor, or other PRRB Stakeholder.

To make the context completely sensible and understandable, let’s discuss what is what:

Part A Providers
When it comes to providing Inpatient Care in the Hospital, Skilled Nursing Facility Care, including Hospice as well as Home Health Care, Part A Providers comes into the picture.

Medicare Contractors
You can call Private Health Care Insurer Medicare Contractor. The best of everything – They manage to process Medicare Part A and Part B (A/B) Medical Claims, including Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries.

PRRB Stakeholders
Those who directly involve in PRRB Electronic Filing and make things go as expected and required complying with the statutory norms and regulations, PRRB Stakeholders take the courage to go hand-in-hand.

Now, it has become completely viable to discuss the guide more thoroughly, getting every equation keeping forth for a constructive understanding and reasoning.

Now, let’s discuss what is Provider Reimbursement Review Board (PRRB)?
Any Medicare Contractor or the Centers for Medicare and Medicaid Services (CMS) can release final determinations. If such determinations are not favorable and intended to satisfy Certified Medicare Providers, they have got the rights to approach Provider Reimbursement Review Board (PRRB) as it’s an independent panel for the resolution.

Along the same lines, PRRB publishes its rules, current alerts, final substantive and many other jurisdictional decisions to take a look at.

With that being said – Here’s the next question that comes up straight.

Why would any Certified Medicare Provider would approach and seek Provider Reimbursement Review Board (PRRB) involvement?
When it comes to intervening and resolving appeals as well as claims due to improper Medicare Payment to Health Care Institutions and Providers, it becomes a necessity to contact and seek Provider Reimbursement Review Board for its involvement.

Following everything – Now, we are going to share a good update.

It’s one of the biggest breakthroughs that the Department of Health and Human Services (HHS) has finally decided and worked upon to creating a new E-Filing System to speed up such appeals and claims.

Well, the system works amazingly seamless for Hospitals & Other Medicare Part A Providers, further settling beneficiary appeals or claim disputes down further in the most unbiased and clearest manner possible.

You can call E-Filing System or New Electronic System – OH CDMS.
Let’s discuss the benefits for a leveraged understanding.

First of all, OH CDMS’s full form is – The Office Of Hearing Case & Document Management System.

It’s a web-based portal that can allow Health Care as well as Part A Providers to submit claim appeals or disputes they felt affected from.

Below are the benefits of OH CDMS:

  • You can manage and view disputes and appeals at a glance
  • You have 24/7 real-time access
  • The interface is super cool and worth the efforts
  • For every development, notices as well as decisions, parties as well as designated representatives are easily notified
  • If there’s any new case, the opposing party gets the best view over!
  • The best of everything – You get system-generated confirmations, including portal-based submissions
  • Now, there’s no need to send a separate copy of the correspondence to any relevant contractor at all

Just the pretext:
Initially, it was least to impossible to the Department of Health and Human Services (HHS) to look and work around numbers of Medicare Reimbursement Disputes.

The situation was uncontrollable and dense to take over.

Well, when final determinations were laid out, Medicare Contractors, PRRB Stakeholders as well as Part A Providers felt helpless and found unresolved with their appeals and claims.

That’s how the Department of Health & Human Services (HHS) took things on radar and introduced the New Electronic System for Provider Reimbursement Review Board (PRRB) Appeals.

So, when you can approach the Department of Health and Human Services (HHS) for?
The answer is when:

  • You are not satisfied as a Medicare or Health Care Provider with the final determinations CMS or a MAC has rolled out
  • You should be able to demonstrate the amount that you are appealing or putting the claims for is minimum $10,000 or more (or $50,000 for a group)
  • Last, but not the least – You should just manage to file a request within 180 days for a hearing from the date the final determination gets flouted out

About Us:
Thus, as a Health Care Institution or Clinic, it’s always important to have a Medical Billing and Coding Solutions at hand. Whether you got impacted and didn’t get pay back for the health activities under Health Care Programs, that’s when raising concerns as well as necessary appeals become the toughest job possible. Thus, we always recommend you to contact us at Monarch RCM to ensure you are all covered and given the best resolutions. We always make sure our customers are satisfied and experience seamlessness through Medical Billing & Coding Solutions we provide at large. Do contact us, today!
Final Thoughts
So, ultimately – It’s a relief to cut off cumbersome manual appeals and claims.

HHS has significantly altered the best versions and made sure things go systematic and in the best possible manner.

With that being said – We would like to know what are your thoughts about the guide!

Do comment, and on a sweeter note – Thanks for the read, though!

Read more
June 24, 2021
Orthopedic CareHealthcare Industry
healthcare

Total Knee Arthroplasty

Total Knee Arthroplasty (TKA) Removal from the Medicare Inpatient-Only (IPO) List

B
efore we cover every aspect of the update, let’s discuss important terms.
What Is Total Knee Arthroplasty (TKA)
To relieving pain from Osteoarthritis or Knee Diseases such as Rheumatoid & Psoriatic Arthritis and other Disabilities, a Knee Replacement Surgical Procedure is performed. It’s also known as Knee Arthroplasty.

Now, we are going to discuss what is Medicare Inpatient-Only (IPO) List?

Well, not now.

Time to Learn About Covers Type:

  • Medicaid Cover

It’s for low-income people and their long-term care. It includes:

  • Hospital Services
  • Physician’s Services
  • Screening & X-Ray Services
  • Transportation & Translation Services & So On!
  • Medicare Cover

This coverage comes with a major medical care for seniors.

Do follow and learn more about Medicare Cover.

Medicare Cover Consists Of:

  • Medicare Part A

This covers Inpatient Hospital Stays, Home-Health Care Services, Short-Term Nursing Home Care, Including Care In Hospice & A Skilled Nursing Facility!

  • Medicare Part B

It’s a Medical Insurance that covers Laboratory Tests, Medical Equipment, Mental Healthcare, Doctor’s Services, Outpatient Care, and Medical Supplies & Preventive Services.

  • Medicare Part C

It has Medicare Advantage Plans that offers Dental, Vision, Hearing Programs & Coverage from a Private Insurance Company. Furthermore, this plan may include Rx Coverage.

  • Medicare Part D

It has the coverage for Certain Prescription Drugs. With that being said – It’s a voluntary program that offers Low Premiums and Wide-Access to Drugs!

Similarly, why not to discuss about Inpatient & Outpatient Care?

Medicare Cover Consists Of:
Let’s get started & learn through.

  • Inpatient Care

It requires for patients that need immediate hospitalization on a doctor’s order. Following their admission in the hospital, they get treated till they are discharged.

  • Outpatient Care

This is a sort of care that may include Medical Procedures, Tests and Services that patients get without being admitted or for a stay of less than 24 hours in the hospital.

Again, it’s high time to discuss what our subject title says us all about.

Total Knee Arthroplasty (TKA), also known as Knee Replacement Surgery, has now called off from Medicare Inpatient-Only (IPO) List.

All it means the procedures as well as services involved in Inpatient Care does not have Knee Replacement Surgery included in it.

This is a change has already been made to live by CMS which is The Centers for Medicare & Medicaid Services.

To ensure we are on the same page and follow the context constructively, every year CMS evaluates Inpatient & Outpatient Only List, and makes amendments as needed and required.

Therefore, to be a healthcare profession or doctor, you always have got to understand the seriousness of these notes and changes to stay updated and advanced since this can impact reimbursement and affect other intersections pertaining to the procedure at the same time.

P.S. It’s never easy to do all we can to have perfect medical billing solutions in place. That’s why we at Monarch RCM recommend doctors, medical and healthcare professionals to contact us. We provide robust and constructive medical billing solutions to ensure you get all covered. Therefore, do contact us, today!

On the same note – This removal has also been a significant advantage to patients.

Patients who want to have their Knee Replacement Surgery to be done in a day can have it treated and leave for home later that same day.

Needless to say – We can understand the fact ‘Outpatient Knee Replacement Surgery Has Just Arrived’.

Final Thoughts
What are you thinking about the guide which we have just discussed?

Do share your thoughts, and comment below what is that you liked the most!

Similarly, thanks for the read, though!

Read more
June 24, 2021
Healthcare IndustryAI Healthcare
healthcare

Artificial Intelligence in Healthcare

Artificial Intelligence (AI) Is Transforming Healthcare Industry

H
Healthcare AI is a brand new approach.

More like Machine Learning (Artificial Intelligence into Healthcare Industry).

Now, it’s a way to give Reliable, Accurate & Concise Medical Care to Patients.

In fact, Big Hospitals around the world have started investing in Healthcare AI Applications.

Sounds something we are unfamiliar with?

Well, yes – It is.

The magical part of AI in Healthcare industry is to automate Hospital, Clinical & Medical-Related Administration & Functioning in the best possible manner.

Thus, it’s so rewarding and worth the deal.

Let’s dig and get to the point.

We use Electronic Health Records.

All it means is we can now store Medical Health Records & Other Details of the Patients Electronically.

The best part is – It avoids cumbersome paperwork.

With that being said – Below are the Benefits of Healthcare AI:

  • Least Multiple Blood Samples & Myriads of Redundant Tests
  • Quick Symptom Checkers & AI Diagnosis
  • Extraction/Prediction of Billing Codes from Medical Records
  • Digitized Screening for Cancer & other Chronic Ailments
  • Automated Medical Transcription, Documentation, Prescreening & Scans
  • More Transitioning into Medicine/Healthcare & Drug Discovery

About Us:
We at Monarch RCM are into Medical Billing & Coding.

What we ensure that the healthcare provider is properly reimbursed for their services.

It’s something we have been doing for a longer period of time.

Once a patient is diagnosed and treated with right medication, Medical Coder records the disease or symptoms, and translates them into numerical value.

What it does further the Medical Biller takes all the records, and prepare for Financial Billing Report to see how much a patient has to pay, and if anything is covered in patient’s insurance coverage.

Thus, if you own a Hospital or Clinic, you always need Medical Billing & Coding Services in place.

Schedule an appointment and get to the work straight for the betterment and accuracy, today!

Final Thoughts
How about the feeling wherein Patients can have access to their Virtual Physical Therapy Application, and they are guided what angle they are moving and what they should be doing, instead?

Imagine how amazing it would be?

So, it’s good to share – Artificial Intelligence (AI) is becoming very promising in Healthcare Industry.

To add – Optimizing Patients transfer between Departments can speed up the operation process and effectiveness in the treatment.

The reason is – Widespread AI Use can make our life better and easier.

Furthermore, it will become possible to identify High Readmission Risk Patients & figure out Early Sepsis Prediction Everlastingly.

The best of everything – Doctor Offices & Hospitals can simply explore more into Patient’s Medical Background and History, and further avoid any wrongful Diagnosis.

So, you can state that Healthcare AI can Perform, Assist with Diagnosis, Decision-Making, and Therapy Recommendations & Healthcare Management at the same time.

And, thanks for the read, though!

Read more
June 24, 2021
Healthcare IndustryMedical Billing
healthcare

Effectiveness of Medical Marijuana

A
re you affected with Cancer?

Have you been to Mental Health Conditions such as Schizophrenia & Posttraumatic Stress Disorder?

If yes, follow the guide.

In addition to it, is Medical Marijuana a questionable term?

Is it?

Well, to clear objections, it is because it works pretty well to cure severe disorders and diseases.

Are we still not sure?

Frankly speaking – It’s time to dump unreasonable myths.

Let’s learn.

Following are the different conditions Medical Marijuana works amazingly at:

  • Alzheimer’s Diseases

Consider it a brain disease! It destroys memory and thinking skills.

  • Appetite Loss

It’s when you lose desire to eat!

  • Crohn’s Disease

Call it an Inflammatory Bowel Disease (IBD). Affected people experience inflammation in their digestive tract!

  • Eating Disorders such as Anorexia

Reduction in body weight!

  • Epilepsy

It’s a neurological disorder. People with Epilepsy happen to create unusual behavior, sensations and loss of awareness!

  • Glaucoma

Eye disorder! It causes blindness.

  • Multiple Sclerosis

People with this disorder experience double vision weakness!

  • Muscle Spams

Contractions of body muscles! However, painful, though.

  • Nausea

It’s a disorder that affects individuals with gastrointestinal disorders, food poisoning, motion sickness, migraine and low blood sugar.

Thus, we covered why Medical Marijuana is inevitable and vital enough!

Similarly, we have something to share.

P.S. Are you looking for Medical Billing Experts? Do you need Medical Billing End-To-End Service? If this is what you are thinking of, then it’s high time to get started with us at Monarch RCM! We provide clients with One-Stop Solution for RCM, meaning Guaranteed Client Satisfaction. With that being said – Let’s schedule an appointment, today!

Final Thoughts
In addition to everything being stated, what is more important is the resolution we get with the help of Medical Marijuana.

Even, Cancer is disturbing disease.

It gets cured through Medical Marijuana.

Now, we have a question – How effective it seems to you, just comment!

The best part is – Medical Marijuana has been proven to improving human lives.

It’s good and super effective to cure typical disorders and diseases at the same time.

And, thanks for the read, though!

Read more
June 24, 2021
Healthcare IndustryOrthopedic Care
healthcare

Importance of Orthopedic Care

H
ow about the suffering when it comes all along through Tendon, Muscle, and Joint Pain?

Furthermore, things typically go off due to musculoskeletal aliments at the same time.

In saying so – From Joint Deformities to Pain in the Muscles, what measures do you take to ensure you are given an edge to cope up with the difficulties and minimize pain effect by far?

With that being said – Do comment and share what you do uniquely for sure!

Well, here in the guide itself, we will be discussing the importance of Orthopedic Care which we usually neglect and do not take into the consideration.

So, the question is – Are you the person who feels completely Off-Track and feel difficulties in performing everyday operations in your life?

If you are the person who has a vast range of Musculoskeletal Issues such as Osteoporosis, Arthritis, Bone Tumors, and Sprained Ankles, then it’s certain – You are a good candidate for Orthopedic Care.

Yes, you need the care that certainly helps you recover and bring about the best version of yourself.

P.S. Are you looking for the robust and highly preferred Medical Billing Solutions? If yes, do contact alphabillingsolution.com and get yourself started right away!

So, follow the guide to understand the importance of Orthopedic Care and Treatment:

  • You Get Rid Of A Plethora Of Disorders
  • You Are Always Taken To Extensive Programs & Courses For Betterment
  • You Can Always Rely On Knowledgeable Physician(s) & Surgeon(s) For Their Expertise
  • Orthopedic Care Is Good & Proven To Work On Sufferings Such As Osteoporosis, Arthritis, Bone Tumors, & Sprained Ankles and so on
  • You Get Timely Treatment & Diagnosis
  • You Can Track Your Recovery Status Effectively

Final Thoughts
What are your thoughts about the guide which we just discussed?

Are you a person who goes along and have deformities issue?

If this is what it is, then it’s high time to get note of Orthopedic Care since this will manage to get you out of the pain you have been for a longer period of time!

And, at the same time – Do share your opinion in the comment below!

Read more
June 24, 2021
Healthcare Industry
healthcare

Tele-medicine and its Effectiveness

Tele-medicine and its Effectiveness

T
he best part – You get the best treatment when you are not able to visit hospitals as well as clinics.

Sounds amazing?

Well, it is!

We will in the post itself, discuss why Tele-medicine is trending by now and then.

So, do follow through the guide as well as understand its benefits at the same time.

Therefore, let’s get started!

What is Tele-medicine?
Have you ever been to healthcare services online or sitting at home? If not, Tele-medicine works the same way. You don’t have to go out to get treated, and instead – Every health-related resolutions, consultations as well as assessment is done over telecommunication mediums such as Video Conferencing and telephone! So, it’s great!

Now, we will start with benefits to ensure that we understand how effective Tele-medicine has been so far in our lives.

Followings are the benefits of Tele-medicine and why you should seriously get to it everlastingly:

  • One of the best things you will come to experience is – You can manage to find specialists in any area to get you treated effectively
  • You can see whether tele-medicine provider is competent enough to work on your suffering or cause!
  • The chances are – You can get through and schedule appointment without a doubt! Here, you don’t have to waste time to standing in a long queue by far!
  • You will experience the greatest as well as effective consultant being at home! So, it’s always win-win in the same regards!
  • Minimize your expenses (Travelling cost)!

Well, we discussed what Tele-medicine is as well as benefits you should be looking after!

P.S. Are you looking for Medicine Billing End-To-End Services? Do you perform medical practices or work at ambulatory surgery centers? Furthermore, does it become impossible to submit medical billing, manage AR, and improve collections and capture hard to collect payer reimbursements? If this is the case with you, then all you have got to do is to get through us at Monarch RCM since we will help you take up each activity efficiently! With that being said – We are looking forward to hearing from you!

  • Makes sure you are always treated effectively, without incurring other unnecessary expenses!

Final Thoughts
Do let us know your thoughts about the subject title since this will manage to help our readers to know more about Tele-medicines!

And, thanks for the read, though!

Read more
June 24, 2021
Healthcare Industry
healthcare

Worker Compensation

Increased Worker Comp Fee Schedule Effective 04/01/2019

N
ew York Worker compensation Update and Increased medical reimbursement fees schedule for 2019

This is not an April fools joke, it is really happening. Effective 01 April 2019, all WC claims will be paid using the new and increased formula released by the NYWCB. As many medical practices know that the WC fee schedule has not changed for the past 9 years, and many doctors have stopped seeing worker comp patients due to lack of reimbursement and many different problems with worker comp carriers. I am not going to discuss the various problems with worker comp carriers, I will say that out of 100 claims only 50-60 % get paid or even less for some doctors due to lack of information in their billing department or contracted billing companies. This is implemented to improve the quality of Healthcare for patients and for Medical Providers.

Now, let’s talk about medical reimbursement fees.

Effective 04/01/2019 conversion factor and RUV (Relative Value Unit ) is getting changed.

There is a conversion factor for each geographic region and general type of medical service provider (e.g., E&M, surgery radiology or maybe medicine.)

The region is divided into 4 parts, Region 1 and 2 will be identical, I mean medical reimbursement fees will be the same.

The fee schedule is updated for Medical (It’s for all specialties), behavioral health, Chiropractor/PT dental, pharmacy, DME and podiatry.

DME codes are not covered by worker comp, however, DMEs are covered with a specific CPT code and its subject to invoice cost and other things.

Now you must be wondering that if I can show some quick example so you can get a clear idea about changes, see below for the difference between the updated and old rates. (Region I and Region II are not identical on old Fee Schedule but they are Identical on the New Fee Schedule)

Old and New Fee Schedule
Region I:

99204: $114.20 (Old)

99204: $163.85 (New) Difference: $49.65

99214: $71.40 (Old)

99214: $102.45 (New) Difference: $31.05

99244: $181.96 (Old)

99244: $261.10 (New) Difference: $79.14

·         Region II:

99204: $119.60 (Old)

99204 : $163.85 (New) Difference : $44.25

99214: $74.89 (Old)

99214 : $102.45 (New) Difference : $27.56

99244: $190.60 (Old)

99244 : $261.10 (New) Difference : $70.50

·         Region III

99204: $136.78 (Old)

99204: $187.39 (New) Difference: $50.61

99214: $85.53 (Old)

99214: $117.17 (New) Difference: $31.64

99244: $217.97 (Old)

99244: $298.60 (New) Difference: $80.63

·            Region IV

99204: $148.69 (Old)

99204: $203.76 (New) Difference: $55.07

99214: $92.97 (Old)

99214: $127.40 (New) Difference: $34.43

99244: $236.94 (Old)

99244: $324.69 (New) Difference: $87.75

I have mentioned only 3 very commonly use CPTs by most of the medical providers, this new fee schedule is applicable on all billable codes, again DME fee schedule depends on invoice cost. Medical Testimony and Phone DEPO Refer to Rules (as per my suggestion don’t change old fee schedule on these two)

Many Medical Biller’s and medical billing companies don’t know about this update go ahead and ask them about this update. Some doctors are happy with their current medical billers because biller just shows the things which they want to show medical doctor and medical providers are too busy to check data of reimbursement and open items.

Most of the time medical biller’s are unable to reach any worker comp case manager or Customer care department and they keep leaving voicemails and notes into the system, this leads to nowhere, old claims still sitting down in system for years and eventually they adjust/write-off the claims after 2 years and medical doctor don’t even know about these loss. I can understand that there are few Govt. carrier are really tough to deal with, I can show you many examples. To deal with these Govt. carriers there are many easy ways to reach them and get claims paid in no time, but people are not creative any more they just want to finish the work and go home, that’s it.

After this new fee schedule, I guess medical provider should not lose more money because this new fee schedule is equivalent to Commercial fee schedule.

I hope this information would help many medical doctors to improve cash flow and may increase revenue after 04/01/2019 would very help full for all people in the Healthcare industry especially in New York. One more important thing, This new fee schedule is also applicable on No-fault claims.

And Please, don’t criticize this article just send feedback and ask any question if you may have I will try to resolve everything you ask, send me email or drop me a message in the box.

Also, please share if you like this article.

Blog Written By: Raman

My Email: Raman@monarchrcm.com

Credit: http://www.wcb.ny.gov and https://www.optum360.com/

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