Challenges & Solutions to Emergency Room Medical Billing Services
Emergency Room - ER services are helping the patients with medical conditions that require quick attention, say an injury or sudden illness. Comprehensive charting is important for emergency medical billing as it can make the whole process less likely to be exposed to critical challenges and risks. However, according to an article published in HFMA, at most ERs across the country, a huge opportunity is seen in improving care, minimize risks, and improve the revenue cycle by focusing on documentation practices.
The
emergency room documentation serves many purposes. Along with being used to
justify reimbursement from insurance companies, ER documentation is helpful for
providers of what was done for the patient. The details may consist of
diagnostic tests, medical decision making and treatments, communication with
patients and relevant families, consultant recommendations, patient follow-ups,
and many other details of the encounter. The emergency documentation record
also helps as a defence in cases of a lawsuit. Moreover, ED charts are referred
for quality improvement, research purposes, and utilization/risk management. In
short, the ED chart should be complete, accurate, concise, and organized.
If
you are handling your emergency room medical billing services, you must be aware that medical claims are so important and
how they can put financial constraints in your revenue cycle when rejected. The
administrative work of an emergency room is different from other common
healthcare facilities as clinical treatment is always shorter and prone to
emergency procedures, starting from a patient's appointment to account closure.
Here are top challenges and solutions in emergency room medical billing
services
Compliance Standards
Privacy
breaches are the main threats to patients' critical information. It needs to be
protected. The revenue cycle management systems of the emergency room need to
work along with the Healthcare Information Portability and Accountability Act
1996 (HIPAA). Frauds in healthcare and abuse of laws may result in penalties
and severely affect your medical practice. HIPAA mandates -
·
Standardization of the medical codes
·
A regular compliance audit of the facility
·
Electronic filing of medical claims
·
Foolproof workstations
·
Restricted access control to medical records and access only
on a needed basis
·
Password Protected Access to the Software and Online Coding
Software
Solution: Complying with the HIPAA and honestly sticking to the mandated protocols
and guidelines can safeguard the privacy, security, and confidentiality of
protected health information (PHI).
Coding and Billing
This
is an actual part where emergency room practice needs to thrive. If done
correctly and timely, it can establish a smooth revenue cycle. Emergency medical billing and coding needs extreme caution as
it is directly related to a practice's income. But, the actual events are
different. As per the National health insurer report, about 20% of the claims
are incorrectly paid and the healthcare organizations have to suffer losses for
around 4%-12% of their total entitled money.
Solution: To recover the designated amount, your emergency room practice must use
well-credited medical coders and billers experts in denial resolution, claim
follow-up, claim appeal submission, bill adjustments, etc. You can also work in
sync with an expert agency that has expertise in the ICD-10 & ICD 11 coding
systems. This is a great way to safeguard a positive cash flow in your
organization, which will boost your revenue cycle.
Interoperability
Information
and Communication Technology have helped practices save time and costs by
expediting the exchange of information between multiple healthcare scenarios.
Physicians at the emergency rooms can have access to their patient's data and
integrate this data with other records in no time. Therefore, interoperability,
an ability of IT systems and applications to communicate and exchange
information are still unreached.
These
legacy systems are still functioning in the hospitals because they have
autonomous nature, which has various modules and nomenclature for multiple
processes and procedures make interoperability unapproachable.
Solution: You can easily achieve interoperability if you adopt a standardized
healthcare terminology, strategy, and usable interface of ICT tools. Moreover,
with continuous changes and updates in the medical regulations,
interoperability can serve as a tool to eliminate data exchange problems across
doctors, hospitals, labs, patients, and pharmacies to a large extent.
Maintaining a Consistent Cash Flow
American Medical Association (AMA) says that more than 10% of claims
are paid inaccurately. A consistent cash flow means the good financial health
of an emergency room. And if the accounts receivables are strong, you don't
have to worry. OR, you need quick measures to increase the collections and
boost the cash flow.
Solution: You can identify the important elements of the emergency room revenue
cycle and collaborate with an expert medical billing agency.
Partner
with 24/7 Medical Billing Services - The Best Emergency Room Medical Billing
Agency.
24/7
Medical Billing Services offers end-to-end emergency room billing services. Our
services can help in reducing healthcare operational costs while regulating the
healthcare revenue cycle management at the same time.
About
24/7 Medical Billing Services:
We
are a medical billing company that offers ‘24/7
Medical Billing Services’ and support physicians, hospitals, medical
institutions and group practices with our end to end medical billing solutions.
We help you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow physicians to attract
additional revenue and reduce administrative burden or losses.
Contact:
24/7
Medical Billing Services
Tel:
+1 888-502-0537
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