What Should Healthcare Organizations Do to Ensure Medical Data Safety

Health is wealth. This old adage proves to be true every single time. The same is true with data in modern times. It is the new fuel and the new form of wealth. In the medical field, the private and secret data of the patients and professionals can be prone to hackers. They employ every tactic to get access to these precious data sets to be used in unethical and immoral ways. So it is the utmost responsibility of the medical professionals to cure the patient and keep their medical data safe and secure. Here are some of the things medical professionals can do to ensure the medical data safety: - 

1- Train the Medical Staff

The human element in data handling is the single biggest threat to the data. If the healthcare staff is not trained properly, they can unintentionally give access to unauthorized people. So proper training should be given to them to ensure that they handle the data sets according to the standard operating procedures. 

2- Restrictions on Applications of Data

Medical professionals should deploy extreme care and precautions in sharing medical data. They should employ restrictions on the access to the data so that any unauthorized and unwanted person has no access to it. Medical data should not be shared with Rick, Dick, or Harry. It is recommended to use multi-factor authentication methods to prevent any fraud and tomfoolery. These authentication methods could be biometric, cards, or keys.

3- Log and Monitor Use

It should be known to the top officials every time what is going on with the data? How many people have access to it? Who has logged in to analyze medical records, etc? These things can be known easily with the help of certain log and monitor software. This enables a system of checks and balances, and in case of any fraud, it will help transfer the responsibility as well. This method also improves transparency, accountability, and responsibility in the administration.

4- Encryption of Medical Records

All the important medical records should be encrypted with proper standards like 128-bit encryption. This helps to secure the data, and it also gives relief in the case the data is leaked by mistake. So even if the data is in the wrong hands, they cannot access it without proper decryption codes. 

5- Backup the Data  

One should be ready for any condition, which is the same with medical records. All the medical data should be backed to a remote, secure backup site to prevent any unforeseen possibilities. This is to prevent any data damage in the case of acts of God like natural calamities or disasters. Data recovery becomes easy with the help of these data backup sites. 

So these are some of the most important steps that the medical professionals and authorities can take, along with taking regular risk assessments to ensure the safety and security of the data. Also, it should be noted that laws like HIPAA are also enacted, which explains these methods more deliberately. So it is a compulsion on the Medical Organizations to follow these useful guidelines.

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by SANTOSH GUPTHA

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8 Benefits of a Medical Billing Service

Medical billing services are highly valued and considered an essential part of the healthcare system since the services are reliable, economical, and controllable. Following are the advantages of medical billing services

Minimum or No Errors

Outsourcing medical billing ensures error-free billing, profiling, and coding. As insurance companies help minimize payouts, a trustable and competent billing /coding team helps achieve majority revenue recovery by minimizing mistakes. Medical billing services save the time and cost of healthcare organizations in terms of office infrastructure, salaries, maintenance, and upgrading of billing software. Outsourcing these services helps in the timely submission of claims and increases reimbursement.

Data Certification of Patient

Outsourcing medical billing enables a team of experienced medical billers who evaluate the patient's eligibility for healthcare insurance. Medical billing helps conduct a watertight check on insurance coverage, pre-authorization, and patient deductibles. Outsourcing medical billing helps in maintaining transparency in the billing process. Medical billing service includes desired infrastructure and security to offer better safety to patients. Medical billing service providers are HIPAA compliant and ensure the security of patient data. 

Revenue Recovery

Insurance companies try to detect a flaw in the billing process to deduct the payouts. This is why experienced and knowledgeable medical billers are hired by medical billing solutions so that they can eliminate errors that take place during coding, billing, and processing. These error-free medical billing services help in maximizing cash flow.

Error-Free Billing and Claims Processing

The insurance policies of the healthcare sector have to be updated frequently. The medical billing companies stay updated regarding each revenue cycle management insurance policy. A reliable medical billing expert makes sure about error-free data certification, claims processing, and billing of every patient.

Maintaining Compliance with Rules and Regulations

One major concern in healthcare billing is compliance. A small compliance problem in the patient billing/privacy/profiling can lead to a huge loss of payout. If a compliance issue is related to patient data breaching, this may lead to the cancellation of a medical license. Therefore medical billing helps to ensure compliance with the recent healthcare insurance rules and regulations.

Great Workspace and Better Services

Medical billing services help reduce the workload of the healthcare staff and ultimately result in better delivery of medical services. Medical billing helps businesses keep control over their bill since dedicated and highly qualified medical billers handle the work. It manages the better investigation of claims-related details and insurance eligibility of patients.

High Productivity

Outsourcing medical billing helps differentiate between patient consultation doubts and patient billing doubts. Medical billing services handle all the queries related to a patient better and allow medical staff to deal with patient consultation queries only. This enhances the productivity of the workforce.

Satisfied Patients

Medical billing ensures data security and efficiency in the billing process of all patients. This makes patients stress-free and satisfied. Medical billing allows accessibility of patient records on cloud-based software as well. Healthcare professionals can give more time and attention to patients if they opt for outsourcing medical billing to third parties. This frees them from the additional task of spending time in the billing process. In this way, medical billing facilitates quality patient care.

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by SANTOSH GUPTHA

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Medical Billing Services: Percentage Vs. Flat Fee Pricing Structures

Nowadays, running a medical practice business has become more competitive as most practices are ultimately turning to 3rd party healthcare billing services to ensure more profitability and generate cost-effective solutions. Many factors are considered when you want to evaluate medical billing agreement, and the pricing of the billing service is one such factor. There are two common pricing methods included in medical billing services.

Percentage-Based Agreements

The most common method in medical billing service is percentage-based agreement. It is an agreement where the fees of medical billing services to the practice are made on a percentage basis. To get a good reimbursement, billing companies work hard and follow all secondary claims and insurance claim denials. In this approach to medical billing, the fee structure is made based on the provider's net revenue. So collections are tied directly to the net compensation for billing services providers. It is based on the following forms-

% of collection

%of the total collection for the overall practicing

% of the gross claims as submitted by billing service

Advantages of Percentage Based Agreements:

It directly ties the success and favorable outcome of the billing company to the success of billing practice if it’s based on the collections.

Billing practice services are needed for potential short-term savings.

The Disadvantage of Percentage Based Agreements: 

The short-term savings collected by keeping certain billing activities within billing practice can cause long-term costs in case of additional staffing.

This method doesn’t address smaller claims vigorously. For instance, a patient invoice of $5 and medical billing practice can lose money while pursuing a claim. When you add the cost of paper postage, envelopes, and staff time spent on mailing, printing, and stuffing, the cost will be somewhere $0.40. 

Flat Fee per Claim:

This is another method of pricing that is provided by the medical billing services. The billing company charges a certain fixed rate of the dollar in flat-free pricing for every claim that has been submitted instead of considering the size of the claim. Flat fee per claim pricing varies from percentage-based agreement based on the extent of services and volume of claims provided. Fee per claim medical billing service in its basic form may offer submission services and claim generation for as low as one dollar or two per claim. It can also involve other services such as patient invoicing, follow-up, carriers, etc. Such additional services can increase the cost ranging from$4-$7 on per claim. Compared to the percentage method, the flat fee per claim is more cost-effective.

Advantages of Flat Fee per Claim:

This pricing approach is more cost-effective, especially in the case of highly-priced claims of individuals.

The Disadvantage of Flat Fee per Claim: 

When carrier follow-up is included within this service, there are chances of little incentives to be earned by the medical billing company on submission of initial claims. It is also not possible to evaluate whether the medical billing service is rigorously following up or not.

The billing practice should manage and solve in-house when the payer and carrier follow-up is not involved within this service. The process of training or hiring new individuals can increase the overhead cost.

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by SANTOSH GUPTHA

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Why Are Medical Billing Jobs In High Demand?

Medical coding and billing jobs are the fastest growing profession within the healthcare sector because the demand for medical services is gradually increasing. People often think that medical billing jobs are administrative, but there’s more than that. Medical billing jobs involve a wide variety of services like posting payments, assisting customers in calls, solving their queries, filing insurance claims, entering all medical codes for medical procedures, and implementing electronic health records. People employed in medical billing are in great demand within the healthcare industry. This demand will gradually grow over the years, as estimated by the US Bureau of Labor Statistics. If you wish to pursue a career in medical coding and billing, it may land you your dream job since careers in medical billing are in great demand. The following aspects cover why medical billing is in such great demand.

The growth rate of Jobs is Strong.

Medical billing and coding services are in huge demand, resulting in many more jobs every year, as reported by the US Bureau of Labor Statistics. This need is ultimately making healthcare facilities seek out professional and skilled billers. As people earn more experience in medical coding and billing, they increase their salaries. The median salary of people working in medical billing services is $41599 per year, excluding the potential bonus that most medical billing experts earn. The accurate compensation of a medical biller varies according to their experience, job location, and the setting where they are employed.

Introduction of the ICD 10 Coding standard has led to a shortage of skilled medical billers 

A new standard for medical billing and coding has been implemented since October 2015. This new coding standard is called ICS 10, which provides great details related to patient treatment, diagnosis, etc. It also contains lab result details. This coding standard has 6times the codes of the earlier measure. Due to this change, healthcare facilities seek professional medical billets who are trained according to this newly developed coding system. These medical billers trained properly with ICD 10 coding standards are in huge demand. If you are experienced in both new and traditional platforms, you can transfer data from the previous ICD 9 database to the new ICD 10 database. Such modern skills of medical billers make their job valuable and demanding.

Elderly population group has a huge demand for healthcare services

The elderly population worldwide will be growing at an unprecedented scale by 2034. This increase in the growth of the elderly population has resulted in huge demand for medical services within the healthcare sector. There will be great demand for medical treatment, testing, procedures, and reimbursement claims. Skilled medical billing service providers will have a huge role in serving this growing number of aging citizens. The most demanding medical billing jobs will be geriatrics, orthopedic, and oncology. Medical billets employed in these specialties will enjoy high earning potential and increased job security. However, the elderly population is not the only factor that will create more demand for medical billing jobs. The population will grow, and so the well-trained billers will be growing in demand.

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 by SANTOSH GUPTHA

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