I was recently contacted by Michael Sculley from Practice Suite to discuss obstacles faced by medical offices.
He wanted to get my input on the billing challenges physician practices experience day to day.
Tell us your story. How did you get into revenue cycle management?
I was the founder and CEO of a medical billing service company in Florida in 1997, back when the typical physician’s office did not have computers. After 16 years and selling the business, I decided to find and work for the Medical Billing Company that was doing it right. During the search, I found M-Scribe. It was a perfect match.
Can you talk a little bit about the landscape and complexity of your billing?
As providers of Medical Billing Services to physician’s offices, we work with over 200 providers in almost all specialties. By using certified coders and working in any practice management software, we are easily able to help any physician with all aspects of Revenue Cycle Management (RCM).
What do you feel differentiates your service and sets you apart?
Unlike our competition, we can work with all Practice Management/EHR software, thereby eliminating the need for practices to make time consuming and costly changes to their current systems. If the practice is not happy with their current system, we can help them with the selection and with discounted pricing with many of the popular systems available on the market.
Additionally, M-Scribe provides many other cost-saving options to practices from our strategic relationships with key vendors in this space. One such example is our partnership with one of the largest GPOs (Group Purchasing Organizations) to offer immediate savings with deep discounts for medical and office supplies. M-Scribe also provides provider credentialing, payer contract negotiations, Patient Collection Programs, MIPS Consulting and many more such ancillary services to improve the financial health of the practices we work with.
What are some of the challenges facing practices with specialty specific billing?
The greatest challenge a specialist faces when looking for help with billing, is finding billers and coders who are trained in the specialty of the doctors. Bundling of CPT codes due to a lack of training and understanding specialty specific coding can have a long-term financial impact on the practice.
How do you help practices with specialty specific billing?
By having specialty specific certified coders dedicated to each client’s account, the certified coders use the medical record to determine CPT, HCPS and ICD-10 coding.
What’s your plan to stay competitive with major players like Athenahealth, eClinicalWorks and McKesson?
Unlike our competitors that require the practice to use their PM system, like Athenahealth, eClinicalWorks etc., our clients can continue to use their current PM with our team of billers and coders here at M-Scribe.
How has the Affordable Care Act affected your business? What about patient pay?
The affordable care act has affected all of us. The most profound change for both patients and physicians is that the patient is required to pay more money out of pocket for medical service. This creates a consumer that becomes much more educated in understanding the value of services they receive from their physicians, since the services come with a heavy price tag. For the physician’s office, it requires the front desk to be more aggressive and accurate at the time of service with collection of co-pays and deductibles.
M-Scribe has a solution to this dilemma, we are able to greatly improve patient collections by training front office staff on utilizing the insurance verification systems as well as our “collection call process” provided by M-Scribe staff to create payment plans and easy pay processing.
What headlines or trends in the world of revenue cycle management are you following today? Why do they interest you?
We work with our clients in successfully meeting Meaningful Use and PQRS measures, and in 2017, the MIPS Reporting. Privately owned physician’s practices require the owners to be more involved in the RCM process than ever before. They need to measure using benchmarks and key performance indicators. We believe in helping our clients with every aspect of revenue cycle management as well as cost cutting systems like using GPO’s as well as labor reduction by outsourcing staff and other providers.
How should practices be using Healthcare Business Intelligence today?
Healthcare providers are increasingly applying Healthcare Business Intelligence solutions to the collection, integration and analysis of healthcare information. Business Intelligence is used to organize clinical, business and operational data.
What are the benefits of HBI? What do you think is the future for how practices use HBI?
Few businesses have as much at stake as healthcare providers when it comes to BI. Volume-driven care based on fee-for-service models are giving way to value-driven reimbursement based on outcomes. Providers will increasingly rely on advanced BI and analytics solutions to gain insight into patient, financial and other data to achieve quality of care and cost efficiency objectives.
Here is the complete interview –