Streamlining Medical Practice Reimbursements

June 27, 2015

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Now that national health care has been postponed for at least another congressional session, physicians can redirect attention to their own practices. In many parts of the United States, health care reform and its potential consequences to physicians have assumed lives of their own. Integrated delivery systems have spontaneously generated as health care providers respond to reform and a changing marketplace.

These changes have caused the physician practice unit to suffer. Many physicians have forgotten that their own medical practices are assets that require daily attention. Like any other business in the United States, the bottom line is a simple combination of maximizing revenue and containing operating costs. Unfortunately, market pressures, such as the expansion of managed care, cause overhead to rise and revenue to decrease. Although market changes may affect revenue, many practices lose money unnecessarily. Potential revenues are lost simply because the billing and reimbursement process is inefficient. Physicians today must pay strict attention to the business aspects of their practices.

The key to revenue enhancement in a medical practice is to streamline the reimbursement process. Four factors are important for practice reimbursement to operate efficiently: 1) hiring a qualified office staff, 2) prompt and accurate billing, 3) capturing and coding services correctly, and 4) monitoring reimbursements.

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