Building and maintaining a medical practice is the goal, but many doctors are not prepared for the minutiae that can cause the business to struggle: regular payment collections, increasing costs, patient billing, medical coding, and more. It’s not enough for doctors to provide unsurpassed medical care, display a compassionate bedside manner, and rise to the top of their profession—medical practices also need to stay profitable.
As medicine and technology continue advancing hand-in-hand at breakneck speed, it’s a challenge to keep up, much less stay ahead. We know that a physician’s first priority is patient care. Yet, the challenges of dealing with the myriad of complex and ever-changing billing and claims processes often interfere. Our knowledge of the ongoing payment changes that impact medical practices means we have the know-how to solve problems and ensure the viability of your practice.
Profitability Challenges for Doctors and Surgeons
A major obstacle to achieving profitability is getting payment. Due reimbursements are declining for many medical practices because patient payment hurdles have not been adequately addressed. Many doctors and surgeons have not maximized all possible revenue streams, either, while many practices don’t have a consistent, systematic billing method. Operating expenses have increased, as well, due to rising staffing salaries and IT infrastructure requirements in an increasingly digital world.
The Affordable Care Act has impacted medical practices nationwide by adding tens of millions of newly insured Americans. This has resulted in a noticeable uptick in patient volume at hospitals, urgent-care centers, local clinics, and doctor’s offices. On the surface, this increase seems a simple solution to profitability issues; dig deeper, though, and it’s not hard to realize that this is actually troublesome because there is already a shortage of skilled doctors and specialists.
Furthermore, the ACA has also opened up countless choices for patients, yet the consequences are not always positive for everyone. One such option, which is a negative for medical practices, is that many health plans now offer higher deductible options than in the past. For patients, it has lowered their monthly premiums.
However, for medical practices, collecting due monies has become more difficult. Patients cannot always pay this higher deductible quickly, like insurance companies and similar providers can, which puts a strain on the profitability of medical practices everywhere.
Value-Based Payment Models and Profitability
Many people affiliated with the medical industry believe that the value-based payment plan is a viable solution. This system differs from the traditional fee-for-service model (patients pay based on how many doctor’s visits they make, the number of tests they have performed, etc.) in that patients pay based on the quality of care they receive. The idea of a value-based payment system is to allow patients to pay less for medical care without a reduction in quality of the care.
However, this model has shown not to be ideal for every practice. Certain guidelines in the model are difficult for many providers to meet, resulting in reduced profitability due to lower payments and even monetary penalties. However, if a practice can meet the guidelines, a value-based payment system can cause profits to increase.
Coronis for Medical Practices
The medical industry is among the most innovative and rapidly evolving industries in the country. New services, procedures, and upgraded technology become available seemingly every month. Compliance and insurance regulations also change constantly.
This means billing and medical coding headaches for even the most efficient of medical practices. Staying up to speed with it all is exhausting. However, with outsourced billing and medical practice management, Coronis can reduce headaches so our clients can do what they do best – heal people and restore lives.
Our focus is simple: enable medical practices to get paid quickly and without complications with the following cutting-edge technology and services:
- Hand-picked dedicated account executives for personalized service
- Cloud-based software for all aspects of billing
- Assessment of current reimbursement rates
- Reduced expenses and increased revenue and profits
- Detailed reports of and access to patient and account information
- Customizable billing capabilities to simplify the process
- Secure, accurate electronic claims submissions within 48 hours of receipt
- Consistent payment collection and follow-up
- Increase in collected outstanding balances
- Keeping current with coding changes and updates (e.g., ICD-10 or CPT)
- HIPAA compliance
Our services are intended to free up time and resources so the focus of the practice can be where it belongs: on quality patient care.
Our clients have increased revenue by 10%-20% with Coronis due to the following:
- Increased billing and outstanding payment collection
- Reduced administrative and overhead costs
Striking a Delicate Balance
A doctor or surgeon’s first priority is unrivaled patient care. But to stay in business, getting paid for providing services and care is crucial. Many times, the struggle to stay profitable can become less of a hassle with simple tweaks:
- Updating billing and collection methods
- Keeping up with changing rules and fee schedules
- Being more prepared for upcoming transitions, such as ICD-10
- Outsourcing to professionals dedicated to your profitability
Ultimately, medical practices have to deliver the utmost in medical care while also remaining profitable.
Learn more about medical billing at Wikipedia.org.