Posted By Amanda Guerrero
January 31, 2013

EHR Health Information ExchangeWith the help of the United States’ first cancer reporting model, which sends patients’ electronic health record (EHR) data to the Kentucky Cancer Registry in real time, researchers now have access to timely medical data and statistics that can help spot cancer-related trends more quickly than ever before. According to a statement by Eric Durbin, the director of Cancer Informatics at the Kentucky Cancer Registry, “[The] project is laying the groundwork for electronic reporting not only in Kentucky but across the United States.”

The reporting module, which officially launched in October of last year, is a collaboration between the Kentucky Health Information Exchange, Regional Extension Center and Cancer Registry, and the Centers for Disease Control and Prevention (CDC). It was funded through the CDC as part of the American Recovery and Reinvestment Act (ARRA) Comparative Effectiveness Research activity, due to its ability to improve population health through disease surveillance efforts.

The database is made possible through the use of health information exchange (HIE), which allows for the secure transfer of clinical data between EHR systems and government databases. Many states are working on developing standard health information exchanges that allow providers to share data with government agencies at all levels, as well as other physicians using different EHRs. The ultimate goal is to have a national interoperable network facilitating health information exchange between providers and agencies in different states.

HIE is likely be an important tool for healthcare providers looking to participate in Meaningful Use stage 2 next year.

Posted By Amanda Guerrero
December 12, 2012

Doctor using EMR softwarePrimary care providers (PCP) have implemented electronic medical record software at a higher rate than many other physician specialties, with 69 percent of providers using EMR software in 2012 compared with just 46 percent in 2009. The fact that EMR adoption rates have doubled in a three year period shows that PCPs understand the value of the software in improving care delivery and reducing costs. However, there are still improvements to be made. According to a Commonwealth Fund survey of primary care doctors in ten different countries, many providers still complain about not getting patient data on time from hospitals and specialists, hindering their ability to provide comprehensive care.

For the survey, researchers polled general internists, family practice physicians and pediatricians in the following countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the United Kingdom, and the United States.

Results were then compared to data collected from a similar survey in 2009. What researchers found is that, despite more doctors using EMR software, most physicians do not receive timely access to patient data after they are seen by a specialist, nor are they informed by a hospital when a patient of theirs is discharged.

Physicians in Switzerland were most likely to receive information from specialists when needed (27 percent), while those in the Netherlands were least likely to (1 percent). The U.S. landed in the middle of the spectrum and tied with Canada with 11 percent of doctors receiving timely access to patient information. “Lack of integration between primary care, specialty care, and hospitals can put patients at risk and result in duplicative care, particularly for patients with complex chronic illnesses,” said the paper published about the study in the journal Health Affairs.

As far as receiving notification from a hospital following a patient’s discharge, the average for the ten countries was 36 percent. The U.S. fell below the international average, with only 26 percent of physicians reporting that they always receive notification of discharge from hospitals.

This shows that there is still a lot of progress to be made with regards to the U.S. healthcare industry’s goal toward greater care coordination and patient-centered care. While EMR software can help physicians meet this goal, there are still some barriers, such as a lack of interoperability between electronic medical record systems. Vendors and health IT technicians will need to continue working on this flaw to ensure that the electronic exchange of patient information becomes an everyday occurrence.

Posted By Amanda Guerrero
December 6, 2012

Brad Pitt medical collections TV seriesThe debt collection industry isn’t necessarily glamorous – yet, it caught the interest of Hollywood megastar Brad Pitt. Pitt’s production company, Plan B, is reportedly developing a TV series for HBO, tentatively called “Paper.” The show will center on the life of a single dad and ex-cocaine dealer trying to change his life around and stay out of prison by going into the debt collection business.

It likely won’t be medical collections the drama centers on, however, as a description of the show on Variety.com says that the main character will find that debt collection is just as cutthroat of a business as the one he’s trying to get away from.

The idea for the hour-long series comes from “Pay Up,” an essay by Jake Halpern that was featured in the New Yorker in 2010. The essay provides a glimpse into the life of an ex-con in Buffalo, NY who owns a small debt collection agency and works to recovers payday loans in order to provide for his five children.

The name for the TV series also comes from Halpern’s essay, which talks about “paper” – a term used in the collection industry to refer to debt that loan agencies and credit card companies have failed to collect on. These debts, ranging from medical collections to loans, are sold to collection agencies for cheap – and they are not usually easy to recover.

There is no official start date for the TV show yet, but it is known that Wells Tower is writing the project, and Pitt will be co-executive producing.

Catergories : Accounting, Business, Health Care IT tags : , ,
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Posted By Marie
October 2, 2012

Though the lack of a free universal healthcare system in the United States is a cause for criticism for some, for others it’s a fair and justifiable way to save hardworking American taxpayers from being indirectly strapped with other peoples’ medical debt.  Opponents of universal healthcare often argue that there IS a way to receive free care with a guarantee not to be turned away: visiting a hospital emergency room.Emergency roomas and healthcare debt

While there’s a high degree of truth the widely-held idea that a person cannot legally be denied care at an emergency room facility, there’s also a high degree of misinterpretation.  There are a number of factors at play in determining whether a person can receive care at an emergency department without being able to pay – and the fact that they were unable to pay does not mean that they’re not going to wind up dealing with healthcare debt collection.

What is really means to be “guaranteed” emergency care

Yes, it’s true that legally – in certain situations – a person cannot be turned away from an emergency room because of an inability to pay.  However, there are restrictions on what conditions can be treated by an ER doctor as well as which conditions are allowed to be turned away due to the patient’s lack of financial resources.  Conditions that cannot be turned away include only

  1. Acute medical conditions that would cause death, serious harm, or serious organ damage if not treated immediately.
  2. Labor in pregnant women.

For example, a person with a severe bowel-obstructing colonic tumor can’t be turned away to have the tumor removed as an emergency procedure after it has become a life-threatening problem.  However, the care necessary to cure their cancer would never be covered – and by the time the tumor is at this serious a stage, the patient is not likely to survive cancer treatment anyway.

Someone IS paying – even if it’s not the patient

The healthcare provided for patients with emergency conditions DOES cost something, and hospitals need to rely on medical collections in order to keep financing patient care.  According to a study by the American Hospital Association, hospitals in the United States lost over forty billion dollars in 2012 due to unpaid patient medical debt.  Hospitals, just like any other company or organization, need financing to run – and since United States taxes don’t cover their expenses (the way taxes and government money fund hospitals in countries with universal healthcare systems), they need to get money from patients in order to run.  A law covering emergency care doesn’t erase hospital debt or offer security for patients; it simply transfers debt.

Posted By Marie
September 17, 2012

Electronic medical record systems provider Cyramedx parters with HSTSeptember 17, 2012 (Miami, FL) – Electronic health record systems provider Mountain Medical Technologies, Inc. – developer of CyramedX™, one of the country’s leading ASC EHR systems – is announcing a new partnership with practice management software company HST.  By integrating CyramedX™ EHR with HSTpathways™, the new union is able to produce the most advanced enterprise solution for ASCs currently on the market.

CyramedX™ ASC EHR (formerly offered through SourceMedical as SourcePlus EHR) is a highly functional and extremely successful EHR system designed for implementation at ambulatory surgery centers.  HIPAA-compliant for 2011/2012, it is known as one of the easiest and quickest systems to deploy with regards to implementation and training.

“[The HST] product is easy-to-use,” says Philip Keane, CEO of Mountain Medical Technologies, Inc.  “It’s cutting-edge, and the deployment and training that we provide give excellent support where the client is key.  Our companies are almost identical in their respective business styles and philosophies and have a similar level of commitment.”

New products provided by Mountain Medical Technologies, Inc. and HST will be available as either a true cloud or a client-server solution.  The union looks to provide the ASC market with a range of new, highly customizable options for practices interested in implementing EHR as well as improving business management and office functions with a high-end practice management system.


About CyramedX
CyramedX is a 2011/2012 HIPAA-compliant and ONC-ATCB certified EHR system.   Developed by Mountain Medical Technologies, Inc., its unique 3D graphic user interface replicates the look and feel of a traditional paper system – allowing practices to preserve their current workflows without disruption to staff or patient throughput.  Claiming that “if you can use an ATM, you can use CyramedX,” users appreciate its easy implementation and training process resulting in an extremely higher than average user retention rate of over 90%.  Combined with HST Pathways Practice Management System, CyramedX™ provides all of the management tools required to improve office functionality, increase practice revenue, and decrease overhead.  Visit http://www.cyramedx.com/ for more information.

About HST
HSTpathways™, the flagship practice management software system offered by healthcare IT developer HST, is recognized for its ability to enable ambulatory surgery centers streamline and improve the business aspects of their medical clinics.  Solutions offered by HSTpathways™ include patient accounting and collections, accounts receivable (A/R) control, workflow management, claims and statement processing, scheduling, supply chain and informatics management, and a range of other functional tools. HST is well respected for its strong and complete management reports and data mining features.  Visit http://www.hstpathways.com/ for more information.

Posted By Amanda Guerrero
September 11, 2012

From software upgrades to revenue cycle management woes, healthcare professionals worry about how ICD-10 will affect their organizations.

ICD-10 logoOn August 24, the Department of Health and Human Services (HHS) announced a one-year delay for ICD-10 compliance, meaning that physicians don’t have to worry about using the new codes until October 1, 2014. The announcement came as a relief for medical professionals who feared that rushed implementation of the latest ICD codes could wreak havoc on revenue cycle management processes at healthcare facilities across the U.S.

Physicians are already working hard to adopt electronic medical record software, and the pressure to comply with ICD-10 so soon would have been too much to handle. As it is, according to a recent Nuesoft Technologies survey, 73 percent of respondents fear that ICD-10 will affect their practice, and not in a good way.

Though some physicians are hung up on the number of new codes that are added under ICD-10 – there are approximately 138,000 more procedure and diagnoses codes than in ICD-9 – what makes the new system so complicated is the complexity of the codes. They are a lot more detailed, meaning that doctors, coders and billing staff will require extensive training before the new system goes into effect.

Another concern for medical organizations is that many of their software systems will need to be upgraded in order to meet ICD-10 demands. This is an extra cost for healthcare professionals, many of whom recently invested in EMR technology.

The biggest concern, however, is whether the new system will affect facilities’ revenue cycles. If a physician chooses an incorrect code – for example, “accident with motorized mobility scooter” instead of “fall from motorized mobility scooter,” it could cause a claim to get denied, creating a delay in payment. Physicians will need to make sure they’ve planned appropriately for ICD-10 in order to prevent delayed payments from payers or lapses in medical collections.

Posted By Marie
September 4, 2012

Healthcare revenue cycle management tipsWe may be approaching the final quarter of 2012, but there’s still time to review your hospital or practice’s finances thus far this year and begin to formulate a plan for improving your income.  Managing your healthcare revenue cycle the right way can help you maximize collections, increase revenue, and save time spent managing patient accounts in the office.

Increasing healthcare debt collection and boosting revenue is often much simpler than you may expect, and working with consultants or a healthcare accounts receivable partner can help organize your efforts more than any other tactic.  The following tips are some of the most common and broad-reaching strategies for improving your hospital collections.

  1. Set up a policy of insurance authorization.  Insurers will often reject claims for tests and services scheduled before the pre-certification/authorization for it was confirmed.  Set up a system – such as assigning a number to a procedure once it has been authorized as a prerequisite for having that procedure scheduled.
  2. Verify claims submission.  Most insurance carriers send two levels of confirmation reports – an initial report to confirm that the report was received electronically, and a second report that will require verification from the physician.  Check for this second report and handle all verifications immediately to avoid losing out on revenue from claims submitted online.
  3. Encourage eligible patients to enroll in a care compensation program.  Often, the number of patients eligible for Medicaid but not enrolled eats a significant hole into healthcare debt collections.  Their bills may remain on the ledger unpaid when they could easily be handled by Medicaid in a reasonable amount of time.  Though it takes up staff time to audit such cases (and patients are often wary of the stigma attached to collecting Medicaid), it’s a very direct way to handle certain unpaid bills from clients not in a position to pay.
  4. Dig deep.  What you’ve read above are a number of small issues that arise, but they’re often part of a larger problem: an entire revenue cycle management system gone wrong.  Working with an expert can help your healthcare organization rethink its whole structure and uncover systemic problems leading to inefficiencies in the way your hospital or practice collects debt.
Posted By Tim Ruben
August 28, 2012

revenue cycle partnersA bad car crash can not only wreck your vehicle, it can also cause long-term damage to your credit. The majority of accident victims wind up with medical bill collections agencies knocking on their doors as they wait for insurance companies to sort out endless piles of paperwork and payments.

For many, this process can be confusing. Different kinds of insurance coverage may come into play in the case of an auto accident, including Personal Injury Protection, which is mandatory coverage on auto insurance in some states and optional in others; Medical Payments coverage, which may be optional on auto insurance policies; private health insurance; supplemental accident coverage; or Medicare. But it’s not always clear who has primary responsibility to pay in the case of an accident.

Below are some tips from credit.com that can help you protect your credit and minimize the aftermath damage of a car accident.

Read and save all mail: Start a folder to save all the correspondence and bills you receive about the accident. You can also use it to store handwritten notes you take if you talk with anyone over the phone about the accident. When you receive a bill, don’t just assume that the insurance company will take care of it.

Balance billing: If your health care provider is in-network, then there’s a good chance that it is required to follow certain billing procedures. If the provider fails to bill in a timely manner, for example, it may not be allowed to bill the patient for that claim.

If something is wrong, make it known: Most claims adjusters are overworked, and sometimes it’s the customer who is persistent whose claim gets processed first. While you want to remain polite and calm, letting them know you are staying on top of your claim can help. If an insurance company is taking forever to process a claim, then don’t be afraid to escalate things.

Ask your insurance agent for help: Use an online insurance comparison websites. Even if the insurer you’re having trouble with is not your own, your independent agent may have relationships with other insurance companies or revenue cycle partners that can help.

Provide complete insurance information to all your providers: Don’t assume one insurance company will or won’t pay. If you have auto and health insurance, for example, provide complete information about both policies to all the providers involved.

Challenge a denial: Don’t assume that a denial by an insurance company is the final word. If insurance coverage has been denied or the decision by an insurance company has been delayed, an attorney may be able to help.

Negotiate: If it turns out you are responsible for some of the medical bills that result from an accident, you may be able to negotiate a reduction in the amount you owe. If you are working with lawyer, they may be able to negotiate this with the medical provider.

Posted By Marie
August 24, 2012

Medical collections agency AccretiveAccretive Health, one of the largest healthcare debt collection companies in the United States, has been at the center of a torrid legal battle during most of 2012 over questionable collections practices.  The company will be required to pay 2.5 million as a settlement to the Attorney General’s office of Minnesota and will be forbidden from doing business with any hospital within the state during the next two years.  This includes accounts with three hospitals that they currently have as clients.

A report released by Minnesota State Attorney General Lori Swanson this April on Accretive’s medical collections techniques listed a number of extreme tactics, including:

  • Setting patients up with “financial counselors” who were actually third-party Accretive debt collectors without financial counseling licenses.
  • Placing debt collectors in hospital emergency rooms.
  • Pushing patients to pay for their treatment before even receiving it.
  • Discouraging patients from accepting medical care if they weren’t sure that they could pay.
  • Focusing their efforts on patients in cancer treatment units and labor/delivery wards.

In January, news broke that an unencrypted laptop belonging to an Accretive employee had been stolen the previous July.  The laptop was later revealed to have contained sensitive personal information and medical records for 23,500 people, and the employee reportedly was not authorized to have access to this information.  The state took Accretive to court on this issue as well, claiming that the company should reveal what precise information the laptop contained and how Accretive was using it.  Accretive insisted that the suit was baseless, as no patients have been defrauded or harmed as a result of the missing information.

A medical collection agency has a financial responsibility to its clients, but this line of work also comes with a social responsibility to patients.  It’s important to balance performing one’s job efficiently and correctly with treating other people involved with the respect they deserve – a mainstay of healthcare work that Accretive failed to comply with.  The Accretive lawsuits serve as an excellent example of the importance of choosing a healthcare debt collection agency whose policies and strategies fall in line with the goals of the healthcare facility that hires them.

Posted By Tim Ruben
August 21, 2012

patient account management trainingIn the healthcare industry, nothing is more important than a well-managed revenue cycle to insure patients are keeping up with their bills and doctors are getting the money they work hard to earn. The following article provides five easy steps to creating a more efficient revenue cycle for healthcare providers and medical collections agencies.

1. Cross-train all staff members: It is important to make sure everyone in the office know how to  post payments, schedule payments, perform follow-up consultations and work the front desk. Every business staff members should be trained to perform revenue cycle management and duties outside their main job description. Ideally, each staff member should spend some office hours every month performing another job function, to make sure they maintain their skills in other areas.

2. Technology makes life easier: Medical experts are frequently hesitant to add information technology to their offices because of costs, time constraints and employee push-back, but choosing the right technology can significantly improve business office functions if implemented correctly.

For instance, a quality desktop scanner can reduce paper use, save money and better organize the billing and collections process. Modern billing software is also available to health professionals and can greatly improve the efficiency and accuracy of business operations. Then there’s the dual monitor option. Purchasing two computer monitors per staff member, may seem like a luxury, but screen cost about $100 these days and the efficiency they provide makes up for the small expenditure in little time.

3. Communication is the key and so are regular staff meetings: Some of the best suggestions for improving a business office can be born out of meetings and everyday exchanges between come staff members. With this in mind, company managers should meet regularly with business office staff and ask for suggestions on improvements. ”

4. Arrange for payment from patients before appointment: Patients should be contact prior to their visit to review their insurance coverage, benefits and payment options.

Before  calling the patient, the front desk coordinator should determine how much the patient owes the facility, so the center can present a clear, understandable financial responsibility with an explanation according to the patient’s insurance. This can be made easier by giving callers the proper patient account management training so they can manage various problems that may arise when talking to negligent clients.

5. Monitor Performance and lay out expectations in advance: A good boss makes sure their staff members understand the main goals of their monthly performance. Once you’ve established your expectations, perform weekly and monthly audits of staff members.

For a collector, the supervisor should go through the accounts and make sure the collector is completing their task thoroughly and not simply making cold calls to answering machines.

Industry experts also recommend setting collection goals for the office team every month. Collection goals can be calculated by taking the average of the last three months’ net revenue, minus two percent for bad debt. Once the system is up and running, the team should receive tangible awards for meeting collection goals, such as a chocolate cake Fridays or gift cards.

The mission of New Wave Enterprises has and will always be very simple: deliver a quality custom solution to every client within budget. Founded in 2003 by John Deutsch the company was originally known as New Wave Marketing.
We then incorporated under New Wave Enterprises LLC. Around this same time we founded Medical Web Experts and Legal Web Experts as subsidiaries. We pride ourselves on staying true to our ethics by being honest and fair to our clients.
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