Category: Blog

To achieve Meaningful Use, increase patient satisfaction, and encourage higher usage of data, patient engagement becomes critical for any healthcare provider.

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For healthcare providers, one of their primary focuses is to provide quality care to their patients. Consumers rely on healthcare providers to do anything they can to improve their care, and a lot of times, do to not turn away patients in need.

 

Unfortunately, a lot of time can be spent to maintain a steady stream of cash flow for your practice or hospital or chasing down payers. Healthcare providers used to count on payers (private and public) to provide a vast majority of their revenue, but that is no longer the case.

 

With the increase reimbursement issues, and as high-deductible plans become more widespread, healthcare providers are finding it more and more difficult to collect payments.  

 

Favorably for providers, automating revenue cycle processes with electronic transactions can save you both time and money.

 

Healthcare providers can implement these strategies for improving healthcare revenue cycle management:



  • Easily tracked healthcare revenue

 

For the purpose of improving your revenue cycle management, it is important to track data in order to measure performance. The data collected will tell healthcare organizations if their staff is efficiently performing in order to get a fast and accurate reimbursement.

 

Sandra Wolfskill, Director of Healthcare Finance Policy and Revenue Cycle MAP at the Healthcare Financial Management Association (HFMA) recommended that “using financial and clinical date, organizations should develop and track key performance indicators (KPIs).”

 

These indicators should be able to tell you the average time taken to submit a claim, the average reimbursement rate, etc.



  • Implementation of Electronic Remittance Advice (ERA) & Explanation of Benefits (EOB) posting

 

To implement ERA and EOB your organization will improve the reimbursement cycle and streamline workflow.

 

According to the Electronic Remittance Advice Toolkit by the American Medical
Association (AMA) by adopting ERA you can expect to increase practice automation, reduce manual tasks, ease coordination of benefits processing, receive faster payment, and free up staff time by replacing paper remittance statements with efficient payment processes.

 

You will be able to process your claims much faster and reduce the number of days your receivables are outstanding. These features will turn into cost savings for your practice and free up staff time for patient care by reducing any manual processes.



  • Make it easy for patients to pay

 

To make it easy for patients to pay, not only will you achieve patient satisfaction but you will also make it easy for your practice to collect payment from patients.

 

Consider collecting payment through a patient portal, send reminders on what bills they are expected to pay prior to their upcoming visit, use of automated statements, keep credit cards on file if allowed by the patient, and offer payment plans.

 

 

  • Automated prior authorizations and eligibility

 

A recent MGMA report stated that about 86 percent of healthcare organization leaders reported an increase in prior authorization requirements in 2017.

 

The demand for prior health plan approval for certain medical tests or medical procedures can take up a lot of time resulting in the delay of treatment and driving up administrative costs.

 

For that reason, payers are increasing prior authorization as well as coverage eligibility requirements in an effort to reduce unnecessary administrative costs.

 

Healthcare providers can ensure a smooth revenue cycle management by switching to automated processes. Staff will reduce the time it takes for them to get prior authorization and eligibility requirements and focus their time on other high-priority tasks.

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The market of medical and healthcare robotics is increasingly growing and it promises to revolutionize the industry even further.

 

According to a report by Grand View Research, Inc., the market growth of robotics in healthcare is expected to reach 17.8 million in 2022.

 

The report included the leading factors for this market growth which include: Increasing demand for robotic surgeries, continual advancement in healthcare infrastructure, developing reimbursement policies, and increasing awareness levels amongst healthcare organizations and practitioners.

 

The report also found that the integration of multiple systems is expected to boost demand over the estimated period. For instance, new generation robotics systems integrated with advanced data recorders, remote navigation systems, HD microscopic cameras, data analytic systems, motion sensors; 3D-Imaging and robotic controlled catheter.

 

In the article “Vitality of Robotics in Healthcare Industry: An Internet of Things (IoT) Perspective,” published in 2017, the authors argue that a combination of Robotics and Machine Learning leads in robots with the capability to do those jobs on their own.

 

The increasing demand for information technology in healthcare leads to robotics into it. In addition, the advanced applications of robotics in healthcare boost the market growth in the upcoming years.

 

The article also states that “as the world population increases the use of minimally invasive robotic surgeries increases which will provide sustainability to the disorders such as neurological, orthopaedics and others.”

 

Application of robotics in healthcare

 

In the healthcare industry, robots perform integrated duties using mechanics and electronics such as force or movement measurement or sensor system technologies. Robots are expected to care for patients, rehabilitation, e-health, monitoring patients, and medical interventions if needed.  

 

Robotics applications are currently mainly used in rehabilitation and in surgery.

 

In terms of rehabilitation, the goal is to serve patients who have permanently or temporarily (in some cases) lost part of their physical or mental abilities. It serves as a tool to compensate their disabilities. The rehabilitation robotics consists of prosthetic, orthotic, therapeutic and exoskeleton robotic systems.

 

In surgery, the option for using robotic systems arises when physicians are not able to perform because of “precision, repeatability, and endurance.”

 

Robots are able to perform well in small spaces inside the human body, and it is for that reason that they have become popular in the following field: precision and microsurgery; minimally invasive surgery, nanobots, remote surgery via IoT based platforms, and surgery assistant.

 

It is also important to note that robotic surgery market is isolated based on the components and services. It includes robotic surgical systems, instruments and accessories, and services.

 

 

Outcomes

 

It is critical to understand that the outcomes of robotics applications in healthcare are extremely valuable in the industry. Robotics in medicine gives technical solutions to different procedures across the field.

 

For instance, in surgery, robotics has proved that it reduces timing and risks. Today, due to its results and popularity, prostate and cardiac procedures are performed by medical robotics.

 

Robotics play a vital role in the medical field. In the surgical field, scientists are trying to overcome any limitations of actual robotic systems. In the near future, robotic systems will lower overall costs, and shorten set-up time with the help of a well trained medical staff and even remote telementoring could become available. 

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You have finally decided to implement telemedicine into your practice, or you already have but your patients are not too sure about the use of it. What can you do?

In this case, knowledge is power and you will have to empower your patients with the right information. After all, telemedicine will only benefit your patients.

You have finally decided to implement telemedicine into your practice, or you already have but your patients are not too sure about the use of it. What can you do?

 

In this case, knowledge is power and you will have to empower your patients with the right information. After all, telemedicine will only benefit your patients.

 

It is important to remind your patients that real-time video encounters between patients and their physicians are a powerful tool that supports their health.

 

And that full integration of telemedicine into your practice means that your patients have a greater access to on-demand care with the touch of a button.

 

But getting your patients to transition and adopt telemedicine will ultimately come down to doing marketing. By just offering a real-time video visit is not enough. Telemedicine options need to be offered in a way that feels integrated and smooth to their health.

 

There are clearly so many more reasons as to why the use of telemedicine will benefit your patients, that it is critical to provide them with the right information.

 

Thanks to the convenience, ease, and affordability of these services, providers and patients could no longer be concerned with office hours or travel times to and from your practice. Telemedicine certainly gives healthcare systems the chance to achieve a more flexible infrastructure. Now it is up to you and your staff to encourage its usage.  

 

We have listed a few tips on how to prepare your patients for a telemedicine transition:

 

Increase awareness of Telemedicine services

 

You might offer telemedicine services but there is a possibility that your patients are not aware of that or if they do know about them, they are not quite sure what that means.

 

It is important to create awareness of the telemedicine capabilities through broad messaging to a wide audience. You can create educational materials that encourage the use of telemedicine by patients. You should tailor this according to the patient’s needs or for those patients with particular medical conditions. Consider designing some that are tailored to caregivers who assist patients with their care.

 

Encourage nurses and staff make use of the services

 

In a perfect world everyone will be using telemedicine services, but sometimes even our staff can be afraid of using the new systems. If we encourage our staff to use them, they will be more likely to recommend the use to your patients.

 

Remind them that by using these services they are providing better healthcare services to your community. It will also retain revenues in your practice, instead of having to refer patients to other providers. That means more work and more money for your practice and staff.

 

Drive utilization of services by patients and referring providers

 

The opportunity of having access to specialists with telemedicine services at your practice reduces the long wait times to see specialists who are far away from your patients.

 

It is critical to remind your patients that even though these specialists are in their community, they can still address their concern and issues. It will also avoid costs of having to travel to see specialists, or take time off from work or away from family, etc.



Ensure your patient that these services are HIPAA compliant

 

Privacy is a big issue at the moment, and patients can be concerned about engaging in a face-to-face visit.

 

Ensure that your practice is using HIPAA compliant systems so you are able to reassure your patients that their information is tightly secured and that it is safe to engage in these types of visits.

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     With any new technology, there is also a challenge. In this case, our current licensing and reimbursement policies can be viewed as a threat to the adoption of telemedicine. Unfortunately, to complicate things even further, regulations and requirements vary among federal, state and private payers.

Telemedicine is making a huge impact in the healthcare industry. As technology continues to move forward, so does the affordability and accessibility of telemedicine in the industry.

 

According to The American Telemedicine Association (ATA), over half of all U.S. hospitals now use some form of telemedicine. Telemedicine offers many benefits including improved access to patients, as well as allowing physicians to expand their reach beyond their offices.

 

But with any new technology, there is also a challenge. In this case, our current licensing and reimbursement policies can be viewed as a threat to the adoption of telemedicine. Unfortunately, to complicate things even further, regulations and requirements vary among federal, state and private payers. None of these are alike when it comes to how telemedicine services are covered and reimbursed.

 

In terms of licensing and credentialing there is also a challenge because they vary depending on the state, and providers are required to be licensed in every state they work. There isn’t a “universal license” when it comes to telemedicine.

 

Thankfully, there has been an implementation of procedures that facilitate the licensing process for providers. It is important for providers to always be vigilant and aware of new policies and regulations since these are constantly changing.

 

We know that it can be difficult for providers to try and figure out licensing and how to charge for telemedicine services. Fortunately, we have broken down some steps you can take that will facilitate your research and will allow you to understand how licensing and reimbursement works in the telemedicine industry.

 

Payor type

 

The best thing you can do to figure out which type of reimbursements you will be getting will be to track your enrolled patients by payer type. It will also help in terms of what regulations are applicable to you telemedicine practice.

 

This will assure that you are in compliance with applicable regulations, and also that you will receive the appropriate reimbursement for provided services.

 

 

  • Medicare

 

When it comes to Medicare, it only reimburses telemedicine if it pertains to certain types of care, provider, locations, and technology.

 

In terms of providers, the following are the only ones eligible for telemedicine reimbursement: physician, nurse practitioner, physician assistant, nurse midwives, clinical nurse specialists, clinical psychologists, social workers and registered dietitians or nutrition professionals.

 

There are only four types of telemedicine applications allowed by Medicare for reimbursement: video conferencing, store-and-forward, remote patient monitoring, and mHealth.

 

There a couple more categories not listed, but it is best to consult the Centers for Medicare and Medicaid Services (CMS) Telehealth fact sheet.  

 

  • Medicaid

 

Even though states are beginning to expand reimbursement policies, many others continue to restrict and place limitations on telemedicine services. Currently, there are 48 states including the District of Columbia that have some form of reimbursement.  

 

According to The Center for Connected Health Policy (CCHP), 9 states and Washington, DC provide reimbursement for some form of video conferencing, 15 states provide it for store-and-forward, 20 states provide it for remote patient monitoring, 23 states limit the type of facility that can serve as an originating site, 32 states offer a transmission fee when telemedicine is used, and 38 states and the District of Columbia have a law that governs private payer reimbursement policy.

 

It is best to consult each state’s Medicaid website to learn more about the reimbursement policy for telemedicine in each state.

 

We also recommend visiting the CCHP’s interactive map with state telehealth laws and reimbursement policies




  • Private payers

 

Private payers reimbursement policies for telemedicine also vary from state to state. There are 29 states including the District of Columbia that have enacted parity laws that mandate private payers to cover for telemedicine services. Even though under parity laws, coverage and restrictions still vary by state, video conferencing is always covered to some extent by private payers.

 

In this case, it is best to check the provider’s individual or practice payer contract. This contract should list the terms relating to telemedicine services reimbursement.

 

Licensing and credentialing  

 

In terms of licensing, it only becomes an issue when the physician has to treat a patient out-of-state, in this case, the physician must be licensed in the state where the patient is located.

 

Fortunately, the Federation of State Medical Boards (FSMB) offers an expedited licensing for physicians that allows them to practice across states through the Interstate Medical Licensure Compact.

 

Currently, 22 states credit the compact making it easier for physicians to practice in multiple states.

 

For those physicians who practice out of a hospital, the organization is required to credentialing all physicians. The process can definitely be more tedious for hospitals since physicians need to be credentialed at the facility from which they provide services as well the originating site.

 

The CMS recognizes the process of credentialing by proxy, which means that the originating site can usethe credentialing completed at the distant site to establish privileges for physicians at the originating site.

In order to successfully implement telemedicine services to your organization, it is critical to have an understanding of all federal and state requirements and policies.

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