Medical billing has gotten significantly more complex this year due in large part to some changes in revenue cycles.
In addition to other factors that are increasingly complicating the industry, such as a rapidly aging population, greater regulation of the healthcare system as a whole and the shift from paper to electronic recordkeeping, there are a few new developments that have had a profound impact on revenue cycle management this year and are poised to continue to do so in the future.
First, and perhaps most wide reaching in its scope, is the implementation of ICD-10, which is slated to occur on October 1. On that day, the entire coding system for the healthcare industry will be upended, forcing medical facilities to prepare ahead of time to ensure smooth operations and avoid any loss of income. As coding will now be based on procedures rather than on revenue, the learning curve for revenue cycle billing and collections personnel will be steep.
Another key factor is the beefing up of HIPAA audits by the Office of Civil Rights. An extremely poor showing in the 2013 audit, which indicated that only 11 percent of audited healthcare organizations were HIPAA-compliant, has resulted in a push for greater compliance this time around. Achieving this will require substantial retraining and likely a review of crucial business partnerships that may compromise HIPAA compliance.
Lastly, due to the expanded availability of healthcare coverage under the Patient Protection and Affordable Care Act, there has been an influx of individuals and families with high-deductible policies into the healthcare system. What this means for healthcare facilities is that these patients, rather than their insurance companies, will now be relied upon for payments to a greater extent than in the past. This will necessitate a more robust system of communication with and information gathering from patients to ensure payments are received.
With all these changes afoot, the key approach for medical facilities is to prioritize making plans for how to deal with the transformation of the healthcare industry. Through a combination of improved training, stronger communication and, if necessary, healthcare consulting, facilities can avoid unnecessary risks and better manage their costs during this transitional period.
About Howell Consulting Group
Howell Consulting Group provides healthcare consulting services to hospital and physician practices nationwide. Our key focus areas are revenue cycle management, health information technology, and revenue cycle billing and collections.
HCGs consultants are highly experienced in all aspects of healthcare financial management. We implement revenue cycle best practices to optimize your receivables performance and maximize your cash flow.
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