On July 1, 2016, the changes that CMS implemented to the durable medical equipment and prosthetics, orthotics and supplies (DMEPOS) went into full (100%) effect.
The impact of these fee changes on DME businesses cannot be overstated. While DME businesses are putting in just as much work to serve just as many patients, they are seeing their reimbursement rates drop by up to 50% overnight.
As a business owner, this is the time to look very closely at your business expenses to make sure you have minimized them. Without business process cost reductions, you will very likely end 2016 with a loss, even if it appears that your revenue is increasing.
Now is the time to pay careful attention not just to your gross revenues, but your net revenues based on reimbursement. That is where you will see the significance of CMS’s recent changes.
In an effort to support the DME industry, Bonafide is offering complimentary A/R reviews and advice to support each and every DME operator in maximizing their reimbursement rates this year and beyond to avoid the crippling effects of these fee changes.
Contact the team at Bonafide today to discuss our proven solution in securing years of future business success for your business.
by Michelle Tohill
Many medical offices grapple with the decision to keep medical billing in-house or outsource it to experts. There are positives to both, so how do you find what’s right for you?
First, you should consider the most important factors in any billing solution: cost, service, convenience and reimbursement success. It should go without saying that you deserve low cost, great service, great convenience and high levels of reimbursement success. However, many physicians believe that they can’t possibly get all four of those elements covered, so they suffer with high costs, poor service, terrible convenience and low reimbursement success.
Usually an in-house team provides the highest level of convenience. After all, what could be easier than walking over to your biller and asking for an update? It also makes it easy for patients to ask question about their bills when you have the biller right there on-site. However, many physician practices experience very low rates of reimbursement success with their in-house team. This is usually due to the fact that the biller only has the time and skills to follow up on claims so many times, leaving many claims under-reimbursed. By working with your in-house billing team or bringing in a consultant to train them, you might be able to increase their reimbursement success.
When working with an outsourced team, you may expect that you will receive lower levels of convenience. However, a good outsourced team will be just as available (via phone and email) as your in-house team. Another common problem with outsourced billing service is that they may not deliver great service, mainly because they are outside contractors, and thus you don’t really know what they are doing, when they are doing it, and how well they are performing. One fix for this problem is having billing software, which some medical billing services provide to allow physicians complete transparency into the billing process.
The costs for in-house vs. outsourced medical billing service can vary greatly. If you have a smaller practice and your biller is multi-tasking, conducting multiple jobs, then it may appear that in-house is a cheaper alternative. However, you should consider the reimbursement success rate of your in-house team in this equation. Many times a professional outsource team of expert billers is able to gain higher levels of reimbursement, thus offsetting any costs associated with the service.
Bonafide prides itself on offering medical practices all four elements of a stellar outsource billing service: our costs are directly tied to our reimbursement rates, so we are highly motivated to maximize your reimbursement; we deliver high levels of service and convenience, including free software with a billing dashboard that allows you to constantly monitor your billing data; and we have excellent reimbursement success. Let me know if you are considering an outsourced billing service, and I can provide a free AR review to tell you whether it will be worth your while.
Michelle Tohill is Director of Revenue Cycle Management of Bonafide Management Systems and oversees all billing programs and processes. Her specialty is conducting AR audits to expose inefficient billing practices that fail to fully reimburse physicians for their work. She conducts AR audits and provides Bonafide customers with training and consulting on how to improve every aspect of billing and practice management to maximize revenue.