News
Medical Business Resources Improves Fiscal Health
Posted on Wednesday, June 15th, 2011 at 5:16 am.
MBR assists healthcare providers in managing, as well as improving accounts receivable performance and improving the overall fiscal health of medical facilities. Our medical auditing tools are a great asset. Please give us a call at 303-409-7722 and learn more by visiting us online at www.mbrus.com .
Washington — The Dept. of Health and Human Services plans to assess how long patients typically must wait to see primary care physicians by secretly surveying practices using so-called mystery shoppers.
The department has proposed using people posing as potential new patients to help gauge the availability of primary care physicians, according to an April 28 notice in the Federal Register. HHS hopes the effort will help determine whether primary care doctors accept new privately insured patients more or less readily than they take on new Medicare or Medicaid patients. The department also wants to gauge the timeliness of available primary care services, and find out why certain availability may be limited.
If the department moves forward with the plan, it would use mystery shoppers to contact more than 4,000 physician offices in nine states. Shoppers would call on each practice twice — once posing as a patient with private coverage and then as a patient in a public plan.
More than 450 of the practices would be contacted a third time. The office would be informed of the study and then asked again if it accepts new patients and how long it would take for one to see the doctor. “The purpose of this additional data collection component is to evaluate the validity of the mystery shopper approach in generating accurate estimates of physician availability and timeliness of services,” the proposal said.
Data Integration & Management Software Auditing Tools
Posted on Monday, June 13th, 2011 at 5:27 am.
Since 1996 Medical Business Resources has been recovering hundreds of millions of dollars for it’s clients. MBR has designed software (ATB+, AnswerData), that provides data integration and management, analytical forecasting and cash recovery strategies to help assure financial success. Learn more by going to www.mbrus.com or by calling 303-409-7722 .
Amednews, Washington — Physicians who see Medicare patients would have more opportunities to avoid being penalized for failing to prescribe medications electronically by a June 30 deadline under a proposed rule from the Centers for Medicare & Medicaid Services.
The proposed revisions would provide relief to eligible physicians who do not expect to report at least 10 paperless drug orders to CMS by June 30. Medicare will penalize doctors for failing to meet 2011 e-prescribing requirements by reducing payments by 1% in 2012. On May 26, the Medicare agency said it would give doctors a second chance to avoid the penalty after the deadline. It would allow physicians who did not meet the minimum reporting requirements to claim one of several hardship exemptions through a special website by Oct. 1.
The proposed rule also would apply to physician practices that already have adopted certified electronic medical record systems in an effort to earn Medicare or Medicaid meaningful use bonuses. Those practices could use those systems to satisfy the e-prescribing requirements as well. Under the current program, practices that use certified EMRs to send paperless drug orders will satisfy the e-prescribing requirement as long as the system meets four specific functionalities. If the proposed rule is finalized later this year, certified EMRs will be acceptable for e-prescribing in future reporting years even if they don’t technically meet the four specific functionalities.
Healthcare Services, Data Management & Data Integration
Posted on Friday, June 10th, 2011 at 4:23 am.
MBR has recognized the growing demand for data management and data integration. This began the evolution of MBR’s analytical software product, AnswerData and ATB+. It identifies the compelling factors that would have hospital executives eagerly embracing a software product which could provide data integration and management, analytical forecasting and cash recovery strategies to help assure financial success. Call Medical Business Resources today at 303-409-7722 and learn more by logging onto www.mbrus.com .
Amednews/Washington — The House Energy and Commerce Committee on May 11 approved a medical liability reform bill that would cap both noneconomic and punitive damages, among other changes. Rep. Phil Gingrey, MD (R, Ga.), the primary sponsor, said the measure would refocus health care spending on patients and physicians by limiting the potential payout for pursuing frivolous lawsuits against physicians.
“Democrats, Republicans and even President Obama all agree that this country needs real, meaningful medical liability reform,” Dr. Gingrey said. The American Medical Association supports the bill, said AMA President Cecil B. Wilson, MD. Many physicians pay $150,000 or more in annual medical liability insurance premiums, which has led to reduced access to care, especially for higher-risk specialties, he said. On May 10, the AMA launched a print advertisement campaign in support of the bill that ran in two Washington, D.C., political trade publications. The ad cites statistics supporting the need for liability reform, including that doctors need to defend themselves against all medical liability actions even though 64% of claims in 2009 were dropped, withdrawn or dismissed.
Rep. Henry Waxman (D, Calif.), the committee’s highest-ranking Democrat, said the bill would unfairly cap damage awards for people with disfiguring injuries or lifelong pain from medical injuries. Also, it would trump state medical liability reform laws, which is why the National Conference of State Legislatures opposes the bill.
A Suite Of Medical Auditing Tools, Medical Business Resources
Posted on Wednesday, June 8th, 2011 at 5:03 am.
Medical Business Resources has a suite of products which includes ARMS™, 3DATB™, and QDAR™. Eric Whitrock President of MBR, co-developed MBR’s Extended Business Office (EBO), a technologically advanced remote patient accounts processing facility which operates in real-time with existing hospital and clinical patient accounting systems. He has served as Committee Chair for the HFMA, and is the recipient of the Folmer Award of Merit. Call MBR today for help with Healthcare Financial Services at 303-409-7722 and learn more at www.mbrus.com .
Amednews: Vermont Gov. Peter Shumlin has pledged to sign a bill that paves the way for the state to launch a health system approaching a single-payer model later in the decade and to create a state health insurance exchange within the next several years.
The measure creates a powerful five-member Green Mountain Care Board, members of which will determine the benefits and craft a funding plan for Green Mountain Care, a state universal health plan. The board would have wide authority over state health spending and health system reform. The bill requires the governor to nominate Green Mountain board members by Oct. 1 and the Vermont Senate to confirm them.
The measure will set up a health insurance exchange in which Vermonters will shop for private health plans and enroll in public coverage. The exchange is to begin enrolling residents in November 2013 and be fully operational by January 2014. The bill calls for at least two private health insurance plans to participate in the exchange.
The Democratic-controlled Vermont Legislature approved the bill along party lines, with the state Senate voting 21-9 to pass it on May 3 and the House adopting it on May 5 with a 94-49 vote. Shumlin scheduled a bill-signing ceremony for May 26.
He had pledged to enact a single-payer health system during his Jan. 6 inaugural address. “Let Vermont be the first state in the nation to treat health care as a right and not a privilege.”
Medical Pre Bill & Post Bill Account Resolution
Posted on Monday, June 6th, 2011 at 5:46 am.
Healthcare Financial Services is a main tool in medical pre-bill and post bill account resolution. Medical Business Resources is your asset for cash recovery. Call MBR at 303-409-7722 and learn more at www.mbrus.com .
Hospitals reported $167 million worth of claims denied by Medicare Recovery Audit Contractors between the first quarter of 2010 and the first quarter of this year, although in many instances the facilities eventually prevail, reports AHA News Now. Among the 1,960 hospitals participating in the quarterly RACTrac survey, 84 percent of those that received complex denials cited the questioning of medical necessity as the reason for the denial. Syncope and collapse DRGs–treatment for fainting–was the most-questioned of the medically necessary RACs, followed by brief cardiac episodes. Most of the denials involved hospital stays lasting less than one day, and most had to do with an inappropriate care setting triggering the denial, not that the care itself was completely unnecessary. Altogether, nearly a quarter of all RAC denials were appealed by hospitals, and they won most of the time. Seventy-one percent of denials were overturned. Moreover, 57 percent of the participating hospitals reported receiving underpayment determinations, meaning they were entitled to more money. Altogether, the underpayments totaled $17.4 million between the first quarter of 2010 and this year
AnswerData, Strategy for Improving Revenue Cycle
Posted on Friday, May 27th, 2011 at 5:33 am.
AnswerData is a division of Medical Business Resources, Inc. with a new software product that is unparalleled in its ability to provide answers and strategies for dealing with a healthcare provider’s revenue cycle and accounts receivable.
We can quickly show you how to improve and accelerate your revenue cycle and transform your healthcare organization within 90 days. Call our Health Capital Constultants at 303-409-7722 and learn more at www.mbrus.com .
Significant Cash Flow, Healthcare Financial Services
Posted on Wednesday, May 25th, 2011 at 5:29 am.
Medical Business Resources revenue cycle approach allows for rapid and effective accounts receivable cash recovery. Precise analytical tools coupled with meticulous staff permits significant cash flow and prosperity for our clients. Learn more at www.mbrus.com or call MBR at 303-409-7722
Medical Business Resources A Great Asset
Posted on Monday, May 23rd, 2011 at 5:59 am.
Medical Business Resourcesmedical Revenue Cycle Analysis is a great asset for cash recovery. Our Healthcare Financial Management services are unsurpassed in improving the fiscal healthof medical facilities. In this ever changing world of healthcare you need someone on your side that analyzes reports on healthcare so the outcome benefits you! Call us at 303-409-7722 and learn more about MBR at www.mbrus.com .
Amednews:It’s easy to see why the Food City grocery store in west Phoenix would be an attractive location for an in-store clinic. The store, serving a largely Hispanic population, markets itself as a community gathering place, attracting the large walk-in audience such a clinic needs. In the parking lot, street vendors sell homemade tamales out of their carts. On weekends, a mariachi band plays in front of the CareToday clinic.
The company that found Food City so attractive isn’t a typical retail clinic operator. It’s Cigna, one of many health plans moving aggressively to expand its operations into treating patients — not just paying their insurance claims.
Like Cigna, many insurers, dating back to the traditional HMO days, have owned and operated patient clinics through subsidiaries, while some hospitals have run their own health plans.
Recently, many of those insurers have expanded that branch of business, with a focus on care provided by nurse practitioners or physician assistants. Some are targeting plan members within a specific demographic, such as Medicare or chronically ill patients. Others are targeting communities where they believe members have few options, outside of emergency departments, for urgent care.
What’s in it for the plans? Analysts say insurers believe they can get more direct control of medical costs by actually providing care. Also, they have an opportunity to market their names to the millions who will be shopping for individual insurance, required under the Patient Protection and Affordable Care Act by 2014. And the insurers can keep for themselves some of the 80% to 85% (depending on the health plan) they are required to spend on patient care.
“It’s a tangled web of reasons why it’s happening,” said John Gorman, CEO of Gorman Health Group, a managed care consultant who recently advised several insurers that opened clinics. Right now, Gorman said, plans are worrying not so much about making money but about controlling the spending of money.
“This is almost two-to-one driven by the cost side of the equation and not the revenue side.” He said the cost issue isn’t just about current spending on care. It’s also about where millions of newly insured patients go in an environment in which primary care physicians are already considered to be in short supply. Namely, the plans don’t want those patients to go to emergency departments.
Answer Data Strategy Chart, Healthcare Financial Services
Posted on Friday, May 20th, 2011 at 6:55 am.
Medical Business Resources’ internally designed “AnswerData Strategy Chart” has become the analytical blue print to achieving predetermined levels of cash recovery. The strategy focuses on specific inventories of hospital third party payer claims and systematically progresses through selected account portfolios, both actively and retroactively. Each portfolio is identified along with the specific actions to be taken in sequential order. Call our Health Capital Consultants today at 303-409-7722. For more information on our services go to www.mbrus.com .
Amednews: One of the perceived advantages of electronic medical records is that physicians will have a wealth of information that can help them gain greater insight about patients. The process of gathering and examining this information is called data analytics. For practices that are applying for federal bonuses for meaningful use of technology, or planning to work with accountable care organizations, analytics will be critical for proving that a practice is doing well enough to earn a bonus.
But even a practice that isn’t participating in these programs can use analytics to get a solid, fact-based snapshot of how it is performing. Analytics can show physicians how similar chronic-care patients are faring, or show common threads among patients, or even help a practice identify expansion opportunities. And with more health plans offering performance-based pay, being able to collect data can help a practice prove its case for a better bonus.
“Apart from the moral and ethical imperative to do what is the best and the safest and the most effective treatments for patients … physicians are also businessmen,” said Ahmed F. Ghouri, MD, co-founder and chief medical officer of Anvita Health, a health care analytics firm based in San Diego. Clients include health plans, pharmacy benefit managers, disease management companies and physicians. “They’re going to need analytics to be more successful, because they’re going to need tools to keep patients from coming back to the hospital and to keep them healthy. They’ll make more money by doing that,” Dr. Ghouri said
A practice could pore through paper charts, but you need an EMR system to provide ways to search and organize patient data. The easier it is to collect and analyze data, the easier to use that data, whether by reaching out to at-risk patients or instituting changes to make a practice more efficient and financially sound.
The ultimate goal: seeing the forest of your patient population through the trees of your individual appointments.
Help With Cash Recovery For Health Care Facilities
Posted on Wednesday, May 18th, 2011 at 5:39 am.
Medical Business Resources can help you in Recovery utilizing these things: A/R Backlog, Rollover / Aging Prevention, Zero Balance (Discovery of Hidden Cash), Pre-Bill and Post-Bill Account Resolution, Follow-Up, Reimbursement (Short Pay), Denial Management, Self-Pay Review for Third Party Liability and Credit Balance Review. MBR has so many services to help you improve the fiscal health of your facility. Please go go www.mbrus.comso see all our services including our medical auditing software. Our clients include nearly every hospital in the greater Denver area and many healthcare providers throughout Colorado, Arizona, California, Florida, Illinois, Kansas, Mississippi, Missouri and Nebraska. Give us a call today at 303-409-7722.
WASHINGTON – Federal officials announced Friday they will launch a $25 million project expected to be the largest-ever federal investment connecting patient safety and medical liability.
The demonstration and planning grants are part of the patient safety and medical liability initiative President Barack Obama announced last year.
Under the initiative, Obama directed the Department of Health and Human Services (HHS) and the Agency for Healthcare Research and Quality (AHRQ) to help states and healthcare systems test models that put patient safety first and work to reduce preventable injuries.
According to HHS, the initiative will also foster better communication between doctors and patients, and help to ensure that patients are compensated fairly and quickly for medical injuries, while reducing the incidence of medical malpractice lawsuits and reducing liability premiums.
HHS Secretary Kathleen Sebelius said $23 million of the funding will be allocated to new grants, with $2 million reserved for final evaluation of the project.
According to Sebelius, the $23 million will be used for grants to jump-start the project with three-year grants of up to $3 million for states and health systems. In addition, HHS will offer one-year planning grants of up to $300,000 to states and health systems to help them implement and evaluate the patient safety and medical liability demonstrations.
“This new research is the largest government investment connecting medical liability to quality and aims to improve the overall quality of healthcare,” Sebelius said.
