How will Advanced Medical Billing Services in Texas Help to Facilitate Physicians Texas is deeply embedded in autonomous physician practices. It has the highest number of independent medical practices in the US (29.2% as against 17.2% across US) with another 32% in a practice of 10 or fewer doctors, at par with other states in US). However, as it is the era of integration. It is becoming feasible option to join/merge with a larger healthcare facility. This merging saw an increase from 4 to 7% doctors joining a hospital in 2014. It is also becoming increasingly difficult for many to remain autonomous. This is chiefly due to lower and decreasing reimbursement rates and the unwillingness of many insurance payers to negotiate with independent practitioners, along with new regulations under the Affordable Care Act which requires additions of new staff and costly technology leaving the independent medical practice daunting. Nonetheless, some physicians apply a different approach. With the purpose of saving their clinics/practice, they leave Medicare completely. Those who continue tend to get a little underpaid; mainly due to the Medicare's program, namely the Medicare SGR (Sustainable Growth Rate) payment model. As per experts, there should be a serious consideration to alter the SGR model. It will aid in giving incentives/reasons to stay with the Medicare's program (small incentives such as guaranteed payments or making the reimbursements procedures easier and flexible). Many a times though, Texas providers turn to outsourcing their billing and coding requirements. This is useful as the outsourcing team is more aware of Medicare's complex guidelines, and their compliance with billing and coding rules and regulations. As all these are taken care by the outsourcing team, the billing and coding inefficiencies are eliminated, facilitates physicians in gaining the maximum possible reimbursements for their services, and assists the physician in concentrating on patient care. Outsourcing agencies are also well versed with the new medical procedures, rules and legislations that influence Texas providers. Along with the above mentioned facilities, outsourcing seems a viable option as they eliminate employee costs and human resources issues of a private practice/healthcare facility. Also, a new player in Texas has emerged; private equity firms investing in private medical practices. Though they cannot buy the practice, this value based care model aids independent physicians in setting up management companies and imparts them with more cash for expansion but for a fee. This was previously looked at highly in cardiology, but is now moving towards general medicine/primary doctor. This seems to be a better model as these private equity firms do not interfere on the medical front and doctors remain being their own boss. However, as per a study in the Journal of American Medical Association, spending per patient was 10.3% higher and costs 20% higher for larger healthcare facilities than independent physician owned organizations. Nevertheless, it is getting difficult for practices to work entirely alone and bigger seems to be getting better with independent practices becoming a remnant of the past. Hence, physicians can look towards joining larger healthcare organizations which can facilitate in increasing their compensation.
Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com
1
www.medicalbillersandcoders.com Copyright Š-2016 MBC. All Rights Reserved