How Medcare MSO can help you achieve you goals for 2013

Are you a healthcare provider that is looking to bring the latest technology and efficiencies to your practice? At Medcare MSO, we are helping medical groups achieve performance standards that result in increased practice revenues.

Pay for performance is a term used to describe a health care payment system that rewards health care providers, medical doctors and hospitals when they provide high quality service with minimal cost.

As part of the Health Care Reform Act, the federal government has now been implementing pay for performance in the Medicare program. At this preliminary stage, it is not yet clear how effective the program has been at maintaining and reducing healthcare costs.

There is a new system in place that rewards providers for focusing on preventive care rather than treatment. It will reward doctors for practicing and implementing care treatment that has been proven to improve health outcomes and provides incentives for doing so.

  • The biggest challenge in implementing pay for performance is to get a consensus on quality standards. For example, one of the measures under consideration is the minimal time of treatment received by the patient. Observation and care co-ordination is not always dependent upon the service delivery by the provider.  Other factors can be the type of facility where the patient is admitted and in what condition the patient was in. Moreover, achieving pay for performance is not possible without the help of a professional billing service like Medcare MSO where our teams work behind the scene and monitor all of your quality measures. We make sure that your practice is in compliance with all of the requirements to ensure you receive the performance incentives.

Medcare MSO is a complete revenue cycle management company that provides EMR, PMS and medical billing services. We are experienced in over 25 medical specialties and institutional practices. We have clients across the U.S., and we strive to provide innovative solutions to your practice.

 

Are you up to date with your timely filings?

One of the most critical issues for providers is the timely filling limits of insurance companies, which have been constantly shortened in recent years.p>

Payers seem to be looking for ways to make the payment process more difficult. Medicare has changed their policy to not allow any claims over 12 months to be eligible for submission. In response to this problem, many practice management systems have developed a timely filing monitoring function. These solutions provide an automatic alert to follow up on the claim and even bill/re-bill in advance of filing deadlines.

The best practice for any medical billing service is to follow up on completed practice claims within 45 days and to make sure no claims are un-paid in 30+ aging. While following up on the claims, payers with low timely filing and slow payment history should be followed up first.

Ideally, all practices should be aware of their practice payer mix and the number of days left for critical filing. Some insurance company rates vary according to the dates of submission.

There are several payers which offer the opportunity for providers to submit claims after the timely filing period. Such payers require a special timely filing indicator that justifies the late filing. An appropriate delay reason code helps to prevent a payment reduction on the claim.

To find out how our experts can help with late claims from filing issues, please call 800-640-6409 xt 1 and schedule an appointment with one of our technical support specialists.