Many of us recently updated our billing software to meet the requirements of the HIPAA 5010 standards that took effect this year. If you don’t update your software every year, you may be in for a big surprise. It’s not just the changes — it’s the conversion.
First of all, I want to mention that there are many billers who do not understand how the 5010 implementation affects them and are not prepared for it.
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If you’re consistently getting remittance on your submitted claims, you may think your billing system is working just fine. But how accurate are your reimbursements? The Medical Group Management Association (MGMA) estimates that payers underpay practices in the U.S. by an average of 7%-11%.
The main cause of underpayment is the complexity of all the contracts a medical practice has signed. If you’re not using software that manages those contracts, you’re almost certainly losing money.
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According the Medical Group Management Association, on average, U.S. medical practices are failing to collect 25% of the money they’re owed for treating patients. That means $125 billion is left on the table every year.
The convoluted processes of revenue cycle management and accounts receivable allow too many underpayments, denials and ignored claims to fall through the cracks.
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American hospitals, medical practices, government health agencies and insurers spend around $360 billion per year on administrative expenses. That exorbitant amount is made up in large part by the costs of billing-related functions.
High administrative costs make it more difficult than ever to sustain a private medical office, yet are commonly written off as a necessary, compulsory part of the typical practice budget.
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When you’re consistently collecting on your submitted claims, it can be easy to trust that your routine is working perfectly. What you might not realize, though, is that certain procedures you have in place could be causing you to lose time and incur hidden costs.
To get your practice paid in the most efficient manner possible, it’s important to know what may be slowing you down. With a few changes and a little extra foresight, you can avoid delays and quickly collect on every pending claim.
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The Centers for Medicare & Medicaid Services recently released an update on its Medicare Fee-for-Service Recovery Audit Program, which revealed $684.8 million in improper payments since fiscal year 2010.
The overpayments collected in FY 2011 have already been more than three times greater than overpayments collected in FY 2010. The CMS collected $75.4 million in FY 2010 and has collected $233.4 million through three quarters of FY 2011.
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