The main issue that needs to be considered regarding offshore vs. onshore coding is not where the support comes from, but the technology, training, and expertise of the coders. With high-speed connectivity, security, and coding workflow software, the location of the coder is not as important as the expertise of the coder. Facing lower reimbursements …
The Medicaid Dilemma
Posted in Best PracticesBy Nitin Thakor, GeBBS President & CEO There is much discussion today on what is going to happen to the Medicaid program. Congressional Republicans and President Trump are seeking to repeal and replace the Affordable Care Act (ACA) and Medicaid is a large part of that program. Medicaid has been a pillar of our healthcare …
Two Couples Break-Up on Valentine’s Day
Posted in Best Practices, RCM Solutions, Revenue Cycle SolutionsBy Nitin Thakor, GeBBS President & CEO Cigna ended its merger agreement with Anthem on Valentine’s Day and said it will seek $13 billion in damages from Anthem on top of the $1.85 billion break-up fee outlined in the deal. The planned $54 billion merger was blocked by a federal district court last week on …
What Will Be the Effects of Merger Mania on the Delivery of Healthcare?
Posted in Best Practices, RCM Solutions, Revenue Cycle SolutionsBy Nitin Thakor, GeBBS President & CEO A Healthcare Finance News article last year quoted a New Jersey hospital executive as saying: “Big is going to be better; small is not going to survive.” Time will tell if he is right, but most industry analysts agree that the coming year will be full of acquisitions …
AHA President and CEO Asks President-Elect Trump For “Steady as She Goes” Effort on Healthcare
Posted in Best Practices, Healthcare Revenue Billing, Insurance Billing Solutions, Medical Billing BPO, RCM Solutions, Revenue Cycle Management (RCM), Revenue Cycle SolutionsBy Nitin Thakor, GeBBS President & CEO AHA President and CEO Rick Pollack recently sent a congratulatory letter to President-elect Donald Trump and asking him to go slowly on changes to our healthcare delivery system, particularly when it comes to the Affordable Care Act (ACA). This is good advice since healthcare represents a significant portion …
MACRA Final Rules Released
Posted in Best PracticesBy Nitin Thakor, GeBBS President & CEO In a recent blog we asked that CMS go slowly with the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA), a landmark payment system for Medicare physician fees that replaces the sustainable growth rate formula. After a listening tour and nearly 4,000 public comments, CMS released …
Be Careful of the Solutions You Create – They May Be Worse than the Problems You Were Trying to Solve!
Posted in Best PracticesBy Nitin Thakor, GeBBS President & CEO Some lawmakers are warning the CMS that its Medicare Access and CHIP Reauthorization Act (MACRA) draft rule on new physician payments could significantly harm small physician practices. When MACRA goes live in 2019, it is supposed to improve healthcare delivery by giving bonuses to top-performing doctors and clinicians …
“Thinking Outside of the Box” Pays off for Kaiser Permanente
Posted in Best Practices, Offshore Revenue Cycle ManagementBy Nitin Thakor, GeBBS President & CEO I was struck by recent article in the New England Journal of Medicine Catalyst entitled: “How Multi-Specialty Hubs Fill a Major Gap in the Care Continuum.” The article brings out a fact that all of us in the healthcare industry need to take to heart, and that is: …
Will Free-Standing Emergency Departments Negatively Impact Hospitals?
Posted in Best PracticesBy Nitin Thakor, GeBBS President & CEO A relatively new phenomenon in healthcare has the potential to negatively impact hospitals’ revenue stream. This new phenomenon is called the freestanding emergency department (FSED). We know that market share in any hospital marketing area is critical to the facility’s success. If a competing FSED opens in a …
Sobering Statistics about Growing Patient Self-Pay Amounts
Posted in Accounts Receivable (A/R), Best Practices, Business Process Outsourcing (BPO), Knowledge Process Outsourcing (KPO), Offshore Medical Billing, Self-Pay CollectionsWith the growing number of high deductible insurance plans and the Affordable Care Act (ACA), patients are now responsible for up to 35 percent of their healthcare delivery costs. Here are some staggering facts from MGMA and McKinsey & Company: – Patient A/R growing to $660 billion in 2015 – $65 billion in bad debt …