Compared to other industries, the healthcare industry is heavily regulated. The professional care that is provided to patients nationwide can impact millions of lives, so it can be argued that these regulations are required to ensure quality services. However, many within the healthcare industry have argued that in many ways, the regulations that have been handed down in recent years might be impacting the ability of practices to provide quality care. New rules, processes, technology, coding requirements, and regulations can either positively or negatively affect the millions of patients and healthcare professionals, depending on how they are enforced.
Struggling to Meet Industry Requirements
Following the aftermath of the ICD-9 to ICD-10 transition, there were thousands of medical practices and clinics that were unable to keep up with clinical coding optimization, comprehensive record-keeping, and other changed elements of ENT account management. As a result, many turned to outsourcing services to keep up with billing and coding requirements, as well as to healthcare consultants to ensure training and support for in-house billing staff. Studies have been conducted as well that indicate there may be some level of over-regulation, due to increased levels of stress and errors exhibited by healthcare workers.
The constant changes coming down through the industry increase the layers of bureaucracy, which can result in frustrations for billing employees. Without the proper training and support, they may feel that they are unable to do their jobs well. During the learning phase, as claims are denied or rejected, this can compound the problem and increase the feelings of inadequacy and frustration throughout the entire department. ENT account management is vital to the success of any practice or clinic. The more administration and management can do to provide training for comprehensive record-keeping and keep employees current on the latest billing and coding requirements, the more successful everyone will be.
Why ICD-10 Was So Significant
While the healthcare industry has undergone many changes to help streamline or expand clinical coding optimization, the biggest issue to date has been the transition between ICD-9 and ICD-10. When the change occurred in October 2015, the new coding system effectively quadrupled the number of diagnostic codes used for medical billing. It jumped from 4,000 codes to 87,000 codes, providing the means for more specific coding. Unfortunately, wading through all of the extra codes has caused nearly a 70 percent increase in the amount of time that it takes on average to process medical bills.
Other problems, such as misunderstandings of terms used for billing and coding requirements, mistakes, overwork of staff, and not enough time available in a week to stay current with billing procedures, have been seen across the board. This has affected nearly every type of practice, clinic, and specialty regardless of its size, resulting in a decline in reimbursements, overtime costs for employees, and a steep reduction in patient care quality. Healthcare consultants are working overtime as well, providing advice, training, and support to medical offices, clinics, hospitals, surgical and treatment centers. Instead of the streamlined processing that ICD-10 implementation promised, it has had the opposite effect for many medical professionals nationwide.
Prevent Mistakes & Employee Stress
The best way to overcome all of these issues relating to changes with billing and coding requirements is to provide your staff with professional support and education. Comprehensive record-keeping is just the start. ENT account management requires knowledge and understanding of clinical coding optimization, or a great deal of money could be lost in reimbursements. Mistakes and employee stress can lead to loss of time, money, and quality care opportunities, all of which can directly impact patients. MD Pro Solutions provides ENT practices and clinics with the valuable services and support that they require to get their billing and coding requirements up-to-date. Professional training, office analysis and auditing, online support, and outsourcing options can all be used to make marked improvements that will yield positive results.
If you are interested in learning more about the services available through MD Pro Solutions, give us a call at 508-946-1665. Our team can answer any questions that you might have about our ENT account management solutions and set you up for a FREE evaluation of your existing practices and procedures. We have over 45 years of experience working specifically with Ear, Nose and Throat specialists and we can help you provide your staff with the tools they need for successful clinical coding optimization and claims submission.