Tag Archives: HIPAA

Top Tips To Avoid Healthcare Compliance Risks In 2011

In 2010, the Obama Administration specially focused on regulatory measures in the healthcare sector, and 2011 is perhaps slated to be the breakthrough year for healthcare compliance. So the healthcare industry should prepare itself to face numerous challenges lurking in the compliance scene. Doctors, dentists, chiropractors, psychologists, and other medical practitioners have to abide by the regulations set forth in the HIPAA and HITECH Acts. With new reforms in place healthcare entities need to be proactive in abiding by compliance standards and changing regulations. Here are some tips that can help healthcare organizations avoid compliance risks:

Establish an appropriate policy and procedure framework. An unclear set of policies or compliance framework could go against the organization. Hence it is essential that medical practitioners and healthcare organizations dedicate efforts towards being HIPAA and HITECH compliant. They should ensure that the right policy framework and guidelines are in place to help the implementation of systems and practices that can keep patients health records safe.

Select a compliance solution that offers centralized up-to-date services. They should ensure that the compliance solution adopted is future proof: A healthcare compliance management system is most effective if it can work anytime, anywhere. Therefore it is important to opt for a solution delivered on the cloud. This also means that the solution is capable of sending timely alerts and updates regarding new versions of security monitoring/compliance management software and techniques. More importantly, it should provide complete in-built HIPAA & HITECH support which can be easily extended if the need arises. Also, the healthcare compliance solution chosen should be easy to deploy and manage.

Select a compliance solution that automates audit processes. Healthcare regulatory compliance is essential even if medical practitioners and organizations are not using technology in their medical practice. Small medical practitioners should proactively deploy a healthcare compliance solution that can automate audit processes and provide tangible evidence of compliance. Therefore, they should opt for a solution that has the ability to build a repository of all HIPAA Compliance related documentation and provide automatic updates on revised policies and procedures.

It is well known that ever since HITECH was enacted as part of the American recovery and Reinvestment Act of 2009, organizations abiding by the Act were offered incentives for Electronic Medical Recordkeeping (EMR). However from 2015, non-compliance with these standards would attract criminal penalties. So medical practitioners and healthcare entities which abide by HITECH and HIPAA are likely to face fines that can amount to a formidable sum of $1.5 million per year or more along with criminal prosecution. So being healthcare compliant is certainly a safer bet!

Healthcare It Solutions Ensure Uptime, Security And Scalability

A high quality data center’s medical and healthcare IT solutions offer a secure, regulatory compliant environment to manage critical medical data. Downtime is not an option when clinicians need access to Electronic Medical Records (EMRs), Picture Archiving and Communication Systems (PACS), or Telemedicine in order to make life or death decisions.

Your medical and healthcare IT infrastructure must be designed to deliver continuous uptime, solid security, reliable connectivity and scalability to ensure high quality patient care.

Get 100% Guaranteed Uptime
You shouldn’t have to worry about your critical healthcare IT infrastructure experiencing issues or downtime. That’s quality data centers build in redundancy and reliability into all data center operating systems, including critical power and cooling infrastructure. Additionally, a high quality data center will provide a 100% Data Center Uptime Service Level Agreement (SLA). The SLA covers key elements and service metrics like power, temperature, and network availability.

Ensure Medical Data Security
The Health Insurance and Portability Accountability Act (HIPAA) mandates the safeguarding of Protected Health Information (PHI). Information breaches can result in millions of dollars of lost business, penalties and fines. Compromised security can significantly interfere with your ability to care for patients. A top priority in all quality data centers is rock solid physical and network security.

Physical Security
A high quality data center’s SAS 70 Type II audited processes ensure operational procedures, security, and controls are working effectively to safeguard and protect your data and equipment. These data centers deliver up to 5 levels of physical and electronic systems working 24/7 to protect your equipment. These systems include around-the-clock monitored closed circuit televisions, onsite support and security teams, biometrics security systems and/or military-grade key cards, and various alarms and sensors tied to fire and police departments.

Network Security
Healthcare IT threats are everywhere. Computer viruses, hackers, human error and disaffected employees can be a significant threat to mission critical applications and patient data. A safe and secure healthcare IT network can work to enable quality patient care, enhance productivity, increase mobile point of care access to information, and reduce costs.

Enjoy Flexible & Scalable Solutions
Your business requires scalable infrastructures to keep pace with changing technology needs. A high quality data center enables you to easily scale-up with guaranteed space and power. Their managed hosting solutions should include a number of data storage options: cabinets, cages, and private suites.

Disaster Recovery Preparation
Healthcare providers must ensure high availability and maintain uptime even in the event of a disaster. High quality data centers can provide hospitals, physicians and other healthcare providers with cost efficient disaster recovery facilities, systems and infrastructure. These data centers can also help healthcare organizations in meeting their IT infrastructure needs by delivering cost-effective, secure, reliable and scalable data center hosting and managed services solutions.

Healthcare IT service solutions from a high quality data center:
Data Center Hosting Solutions- Flexible space, power, cooling, and network connectivity solutions to host your healthcare IT infrastructure in our top tier, SAS70 Type II and HIPAA compliant data center facilities.
-Managed Security Solutions – Select from several managed security offerings, including Firewall Protection services, Intrusion Detection and Prevention services, Virtual Private Network services and PCI Compliance services to safeguard your data and servers from the threat of on-going cyber attacks.
-Managed Data Solutions – Choose from physical or virtual data storage and back-up solutions to help manage your ever-growing electronic medical records (EMR), digital imaging, and communication data handling needs.
-Business Continuity Solutions – For primary and back-up hosting that includes multiple data centers and redundant network connectivity to ensure continuous availability and fast response times.
-Disaster Recovery Solutions – Enabling physical and virtual disaster recovery activities through multiple data center connectivity so you can easily back-up or store data in secondary locations.

Contact your local data center today for more information about medical and healthcare IT solutions.

How Can Streamlined Medical Billing Help You Deal With Annual Medicare Cuts

As a result of Medicare Sustainable Growth Rate (SGR), physicians face Medicare payment cuts annually. Even though the Congress often steps in to stop the reductions, it has been reported that Medicare reimbursement for physicians will be slashed by 24.4% in 2014.

Physicians and senior citizens to bear the brunt:
Even though annual Medicare cuts are done when Medicare spending outpaces economic growth, it has affected patients as well as senior citizens in the US-

Seniors relying on Medicare Advantage Program might lose doctors, benefits, plans and financial protection they currently enjoy

Doctors will start turning away Medicare patients For instance, in 2012, Medicare patients looking for new primary care physicians had trouble finding doctors

Impact of annual Medicare cuts is also being felt by physicians, especially private practices. They are finding it difficult to strike a balance between the treatment and keeping their practice open. The uncertainty is taking a toll on their practice. Since private insurers consider Medicare rates as the basis for their reimbursement rates, it is getting difficult for them to determine if they can afford to stay in business

Access to care has also been affected due to annual Medicare cuts as practices are deciding to discontinue certain in-house tests. Cuts have also resulted in costly, unnecessary procedures

Medicare payment cuts will also impact hospitals, forcing the management to bring necessary changes in staffing and services to increase efficiency. Due to reductions, growth of operating expenses and total revenue will slow down

To bring down unnecessary hospital admission, more resources will have to be assigned for primary care. Since hospitals will gain or lose 1% of Medicare funding on the basis of 20 factors that gauge quality of care, necessary measures will have to be taken to avoid disruption in cash flow

Till Congress doesnt fix this problem, necessary preparations will have to be done by practices to sail through the impending Medicare crisis. Approximately, 10,000 people gain eligibility for Medicare every day and with the current shortage of primary care physicians in the US, a dangerous situation will arise if doctors start limiting the type of patient they want to treat due to payment cuts.

Streamlined medical billing services- the key to dealing with Medicare cuts

Amidst challenges generated by Medicare cuts, other vitals tasks related to ICD-10, PQRS, HIPAA, and medical billing coding will also get affected due to lack of time and resources. In order to ensure efficiency in billing procedures and to maintain a smooth cash flow, practices are outsourcing their billing services.

Billing partners like Medicalbillersandcoders.com has been helping practices balance billing and Medicare cuts along with other ongoing healthcare changes. MBC has the largest consortium of billers and coders in the US and the latest technology is used to handle medical billing, HIPAA compliance and other vital processes. The aim is to maximize revenue and minimize claim denials for providers who are getting bogged down due to annual cuts in Medicare payments.

Preparing Your Practice For The Medicare Rac Audits

Due to the success of the Recovery Audit Contractor (RAC) demonstration, CMS rolled out the Medicare RAC audits to all states in the year 2010 with the anticipation of recouping more monies and returning the improperly paid claims to the Medicare Trust Fund.

The program has been such a success that Medicaid has jumped on the band wagon and has mandated a similar program known as the Medicaid Integrity Contractor (MIC), which will be implemented in all 50 states by the year 2011

Now is the time to prepare for increased scrutiny of your claims by governmental agencies as its no longer a matter of will you be audited but when you will be audited.

The Department of Health and Human Services and Office of Inspector General provides a model formal compliance program to provide healthcare providers with guidance to on how to be compliant with CMS rules and regulations and to reduce a healthcare organizations risk exposure if they were subjected to an insurance audit. The seven elements of a model compliance program per the OIG are as follows:
Designation of a compliance officer and compliance committee
Development of compliance policies and procedures
Establishment of open lines of communication
Appropriate training and education
Internal monitoring and auditing of claims
Response and corrective action to detected deficiencies
Enforcement of disciplinary actions

In today’s health care environment most entities are already burdened with the everyday challenge of accurate billing and coding, compliant documentation, HIPAA regulations, physician managed care contracts, Stark laws, vendor contracts, and most importantly, patient service.

This leaves most health care entities with minimal resources to focus on compliance and audit risk issues.

With that being said, how does a healthcare organization, regardless of size, go about dealing with the increased burden of potential insurance audit scrutiny from both governmental and commercial payer?

The first step should be to perform an independent internal audit review of your organization’s documentation and compliance procedures. We know that during CMSs three year RAC Audit Demonstration Project, their findings indicated that somewhere between 70% – 75% of the overpayments identified were from coding errors and lack of documentation to support medical necessity. It would make sense that a healthcare organizations focus should be on ensuring that their providers are utilizing proper coding and supporting it with the correct documentation and that medical necessity is clearly documented for each patient encounter that supports the services rendered and billed.

To determine the accuracy of your providers coding and documentation and proper medical decision making, it is critical that your organization conduct on-going internal audits to determine any deficiencies that may exist within your organization. The review will help you identify deficiencies and allow you to correct them through proper education and training for your providers, which in turn will reduce your audit risk significantly if you are faced with an insurance audit. Implementing an education and training program based on your findings for your staff and medical providers is an absolute as you will notice that once implemented, your error rates due to coding and documentation deficiencies will drop significantly.

If such deficiencies are not identified and addressed by your organization, you may find Medicare or Medicaid knocking at your front door to inform you of your lack of compliance. At this point, the cost of disputing or paying for the findings of a governmental audit will far outweigh the cost of your organization identifying these issues first and putting a corrective action plan in place to fix them.

In terms of your internal review, there are many things to consider. Does your organization have the internal expertise to conduct proper audits and decide what areas to focus on? Will you base your efforts on the Medicare RAC findings which consist of validating that medical necessity is properly documented and that the coding that was billed is supported by proper documentation in the patient encounter notes? There are many variables that need to be pre-determined if your organization opts to do an internal audit review.

One thing every facility should think about that is considering conducting internal audits is that you must be confident that your audits are being performed by individuals who are “independent” of the documentation they are reviewing. It is also critical that your audit team have the appropriate skill set, credentials and clear understanding of the compliance rules and regulations per the Centers for Medicare and Medicaid Services (CMS) to be conducting the audits. If your organization lacks these resources, serious consideration should be given to hiring a third party audit firm that has the experience and credentials to assist your organization with the internal audit function. When selecting a vendor, make sure you are engaging a firm that has governmental audit experience and that they can identify any compliance deficiencies and more importantly, provide your personnel with the proper training and education to eliminate such deficiencies. The cost of utilizing a third party to assist your organization
will dramatically reduce your potential audit risk and your return on your investment will be tenfold compared to what the financial consequences could potentially be if you sit back and do nothing and let Medicare be the messenger.

Revenue Management & Being Vigilant Amidst The Impending Medicare Backlash

Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their Medical Billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix.

Dispelling all the speculation of a permanent solution to the impending Sustainable Growth Rate (SGR) fix, the Federal Government has deferred Medicare cuts till 2013, and with that it is pretty sure that the issue will meander for another year or so. Despite its possible impact on the Federal Budget, the Federal Government seems to be in no mood to stir hornets nest as it could possibly have demoralized physicians morale and motivation, resulting in deterioration of the quality of medical services which remains the uttermost concern across the nations healthcare industry.

Strangely, the Sustainable Growth Rate (SGR), which was promulgated to limit the Medicare expenditure within the permissible limit, has contributed to an alarming escalation of Medicare expenditure, which now stands cumulatively at 27.4%. The Federal Government, in a desperate attempt to keep the figure from swelling further, is diverting $11.6 billion from the Patient Protection and Affordable Care Act, including $5 billion from the prevention fund, and $2.5 billion from Medicaid funds earmarked for Louisiana. Although physicians can heave a temporary sigh of relief for having escaped the backlash of Medicare cuts, they would always carry the apprehension of the impending possibility.

Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their medical billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix. When you consider the ominous task of being vigilant with medical billing practices along with the imminent healthcare reforms mandatory EHR implementation, Accountable Care Organization (ACO) model, ICD-10 and HIPAA 5010 compliant coding & reporting amongst others it is sure going to tell on the physicians ability to keep their quality of medical services unblemished.

Therefore, amidst all these realignments, outsourcing the medical billing Revenue Cycle Management (RCM) from credible and competent vendors seems to be more viable. Apart from easing the possible workload on physicians, the outsourced model of Medical Billing Revenue Cycle Management (RCM) can prove financially vindicated as it can offer the advantages of voluminous operations from being source to many medical practices, clinics, and multi-specialty hospitals.

But, like in case of decision involving trusting the credentials of a vendor, physicians need to be doubly sure of their service providers integrity so as to avoid falling prey to unscrupulous intentions.

Medicalbillersandcoders.com (www. medicalbillersnadcoders.com) the largest consortium of medical billing services with over a decade of proven credibility and competence has become a premier source of medical billing and operational management solutions for a majority of medical practices across the length and breadth of the U.S. Compliant with the best practices in the industry, its medical billing solutions being ICD and HIPAA compliant, processed on the latest automated EHR platform traverse the comprehensive Revenue Cycle Management comprising Patient Scheduling and Reminders, Patient enrollment, Insurance Enrollment, Insurance verification, Insurance Authorizations, Coding and audits, Billing and Reconciling of Accounts, Account Analysis and Denial Management, AR Management, and Financial Management Reporting is built for clinical, operational and revenue augmentation.

Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their Medical Billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix.

Dispelling all the speculation of a permanent solution to the impending Sustainable Growth Rate (SGR) fix, the Federal Government has deferred Medicare cuts till 2013, and with that it is pretty sure that the issue will meander for another year or so. Despite its possible impact on the Federal Budget, the Federal Government seems to be in no mood to stir hornets nest as it could possibly have demoralized physicians morale and motivation, resulting in deterioration of the quality of medical services which remains the uttermost concern across the nations healthcare industry.

Strangely, the Sustainable Growth Rate (SGR), which was promulgated to limit the Medicare expenditure within the permissible limit, has contributed to an alarming escalation of Medicare expenditure, which now stands cumulatively at 27.4%. The Federal Government, in a desperate attempt to keep the figure from swelling further, is diverting $11.6 billion from the Patient Protection and Affordable Care Act, including $5 billion from the prevention fund, and $2.5 billion from Medicaid funds earmarked for Louisiana. Although physicians can heave a temporary sigh of relief for having escaped the backlash of Medicare cuts, they would always carry the apprehension of the impending possibility.

Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their medical billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix. When you consider the ominous task of being vigilant with medical billing practices along with the imminent healthcare reforms mandatory EHR implementation, Accountable Care Organization(ACO) model, ICD-10 and HIPAA 5010 compliant coding & reporting amongst others it is sure going to tell on the physicians ability to keep their quality of medical services unblemished.

Therefore, amidst all these realignments, outsourcing the medical billing Revenue Cycle Management (RCM) from credible and competent vendors seems to be more viable. Apart from easing the possible workload on physicians, the outsourced model of Medical BillingRevenue Cycle Management (RCM) can prove financially vindicated as it can offer the advantages of voluminous operations from being source to many medical practices, clinics, and multi-specialty hospitals.

But, like in case of decision involving trusting the credentials of a vendor, physicians need to be doubly sure of their service providers integrity so as to avoid falling prey to unscrupulous intentions.

Medicalbillersandcoders.com (www. medicalbillersnadcoders.com) the largest consortium of medical billing services with over a decade of proven credibility and competence has become a premier source of medical billing and operational management solutions for a majority of medical practices across the length and breadth of the U.S. Compliant with the best practices in the industry, its medical billing solutions being ICD and HIPAA compliant, processed on the latest automated EHR platform traverse the comprehensive Revenue Cycle Management comprising Patient Scheduling and Reminders, Patient enrollment, Insurance Enrollment, Insurance verification, Insurance Authorizations, Coding and audits, Billing and Reconciling of Accounts, Account Analysis and Denial Management, AR Management, and Financial Management Reporting is built for clinical, operational and revenue augmentation.

Medical Coding and Billing for Healthcare Professionals

Professional medical coding and billing services are crucial for successfully running a medical facility.Healthcare professionals can concentrate on their core treatment activities by assigning the task of collecting reimbursements of their medical claims to specialists.

Medical Coding and Billing Services to Minimize Claim Denials

Tedious paper work involved in making insurance claims and performing medical coding gets in the way of healthcare professionals who want to concentrate on activities related to patient care. These billing and coding tasks can take a good part of your time and expenses that may lower the performance of clinics and health practices. Outsourcing these tasks to professional medical coding and billing company is the best solution. Outsourcing firms involved in these medical coding and billing tasks will be well-versed in medical terminology, diagnostic terminology, claim processing, insurance forms and the related. Professional outsourcing firms keep themselves updated about the latest procedural and diagnostic coding techniques, and generate error-free results for the healthcare professionals

Benefits of Outsourcing Medical Coding Tasks

When it comes to coding, medical coding outsourcing firms ensure that the healthcare professionals receive timely reimbursement from insurance companies for their services. They help insurance providers get a clear idea about the medical history of your patients, medical insurance claims and the health services received. These firms employ the latest technology and tools to deliver effective medical coding and billing solutions. They ensure complete security of the sensitive medical records and documents as they strictly adhere to HIPAA regulations. By outsourcing all your medical billing and coding functions to a professional firm you can: Focus on your core medical activities Reduce account receivables in minimum turnaround time Increase the accuracy of your billing process and decrease billing denials Reduce administrative costs. The services of medical coding and billing firms are very much in demand. Healthcare professionals should take care to select a firm that meets most of their requirements and make a real difference to their revenue.

Paperless Dental Practice Records By 2014

Have you heard that there is a new government regulation that requires dentists to have electronic records by the year 2014? I have heard or read a number of variations on this theme in the last month along with various rants and dire warnings regarding the alleged new rules.

Lets get the really important information out there right now; at this time there is no federal requirement for dentists to be using paperless or electronic records by 2014 or any other date. What there is is a lot of confusion, speculation and scare tactics the same as we saw when OSHA and then HIPAA first plagued the dental profession.

However, as a dental practice consultant, setting up an electronic dental record (EDR) or what is commonly called paperless dental records makes sense for many reasons even if the law does not yet require it. Paperless records are: faster, more accurate and less expensive than traditional paper records.

EDR are in essence part of the complete electronic medical record or EMR. This is good as dental health is of course part of overall health and many general medical conditions are important to dentistry and dental conditions affect general health. On the other hand, it is bad as dentistry has become lost in the much larger battle over creation of an EMR which has many more players and much more money involved than we have in dentistry.

In 2004, President Bush set a ten year goal for most Americans to be using an EMR by 2014. The current administration through the dept of Health and Humans Services (HHS) has made stimulus money available to health care providers to help them get paperless by 2014. I assume dentists could get in on this federal stimulus give-away although it is obviously designed for hospitals and physicians.

All of this is made more complicated by the political circus that has become healthcare reform. Bureaucrats are meeting to come up with the actual rules and the speculation is that some deadline will be imposed. When that will be and what the rules will be is anyones guess. In the meantime dont wait around for some bureaucrat to tell you what to do, develop EDR for your office just because it is the right thing to do.

Healthcare Compliance Understanding Hipaahitech Regulatory Controls

Security is a major cause of concern in today”s techno savvy global corporate environment. With organizations and healthcare facilities going towards a paperless environment, most of the information transfer and storage is in digital formats. Organizations, healthcare institutions and hospitals are faced with security challenges of their records and personnel. The need to protect the privacy of employees or patients involves a critical issue of the access to the electronic information.

Through a forward looking approach with view to address the current problems of IT compliance and security requirements of the healthcare industry and corporate sectors, various regulatory controls were put in place. This includes healthcare compliance in the form of Health Information Technology for Economic and Clinical Health (HITECH) Act, signed as a part of the American Recovery and Reinvestment Act of 2009. The Act, besides adding requirements for security breaches, has also laid down security standards for maintaining electronic health records. This Act also expands the privacy provisions beyond the Health Insurance Portability and Accountability (HIPAA) Act.

Tthe HIPAA act was enacted in 1996 in the United States among other things to protect the health insurance coverage for employees and their next of kin in case of change of workplace or retrenchment. With the widespread use of electronic data exchange, HIPAA also made provisions for health care providers, insurance companies and employers to confirm to national standards in electronic health care transactions, so as to maintain high level of security. However, since the integrity of data is at risk by technological enhancements, the HIPAA healthcare act has transaction and code rules besides a number of standards and guidelines for the organizations to maintain the privacy and security of sensitive health information.

Though considered a boon to the security of healthcare information, these regulatory systems offer the entities a number of challenges too. The use of compliance management software developed by experts in the field will help organizations streamline and automate compliance initiatives. Further organizations have also made use of smart cards to identify access to the electronic documents. Such holistic enterprise-wide approach is needed for effective controls

Conformance to HIPPA/HITECH regulatory controls ensure Information security and healthcare regulatory compliance. These Acts address the security and privacy issues in healthcare industry. HITECH applies to the business associates too. Under such provisions, the business associates are also accountable for any data breaches and face penalties for non-compliance.

A Healthcare Answering Service Confronts Present Day Challenges

To say a healthcare answering service is a blessing for doctors would be an understatement. In fact, these days, medical answering services are a dire necessity for any medical profession.

Without a virtual office at its disposal, a doctor”s office, a hospital or a clinic cannot operate its business 24 x7 efficiently and effectively.

However, all professional answering services for doctors do not provide the same level of services. Doctors and caller patients, being a demanding lot, expect first-rate responses from call agents.

An answering service that provides top-quality experience is not easy to come by.

Doctors deal with many such individuals who call clinics at odd hours asking for urgent assistance. If the right responses are not forthcoming, even the life of a patient can be at stake.

Admittedly, any answering service will look for call agents who are the best in business. The best services hire call agents who understand their role as the first vital link between a patient and a doctor.

Healthcare professionals who are sensitive to the needs of patients do their best to offer first-rate treatment. This function also encompasses flawless performance by the answering service they hire.

Here are three of the key features a good healthcare answering service must have:

Recording calls

The ability to record calls must be an indispensable feature in the kitty of all physician answering services.

As a rule, a good call center for doctors will have a state-of-the-art voice recording system that stores all patient calls in digital archives for at least a couple of years.

Some of the stored transcripts may be needed at a later date for insurance information, legal cases, or reviews.

Safety and security of the record storage facility is also important. Prior to hiring a healthcare answering service, doctors must ask how the company stores data, how often the data is backed-up, and how secure is the data.

Creating the most appropriate call management scripts

Commencing business with a new client requires developing custom-made scripts for the given hospital, clinic or doctor with a specific specialty.

This is the only way an answering service can create a close liaison between the patients and doctors.

A live answer protocol plays a critical function when an answering service operates. The staff must be able to differentiate the answering needs for a diverse set of clients. To achieve expertise in this regard, blending of advanced technology, call scripting, and training are essential.

Being multi-lingual

In the medical profession, communication with the patients must be precise and to the point. For call agents, this can be a challenging task if the callers are not proficient in English.

Today, more than 30 million people live in America. This has made the need for bilingual proficiency greater than ever before.

Ideally, it is preferable if the answering service provides live and real-time assistance to non-English speaking people for incoming and outgoing calls.

Though this article stresses on only three features, there are, of course, more attributes an answering service for doctors must have, such as proven experience, HIPAA compliance, and more.

To get the best results, a medical service must know what their needs are prior to hiring a healthcare answering service.

A Guide To Healthcare Insurance Software

The basic purpose of a health insurance software is to make insurance shopping a pleasurable and easier experience for the customers. For the agents and health insurance professionals, it should help them serve their clients better and faster.

The basic functions of health insurance software are:

-Simplify insurance claims
-Frees up resources that are then used for serving the clients better
-Develop new products and solutions

There are various insurance softwares that cater to varied insurance needs such as basic record keeping, plan comparisons, claims processing, etc.

All health insurance software, though, have the following basic features:

-They speed up the claim process by reducing the paperwork
-Computerized records ensure that medical billing and insurance errors are almost nil
-Productivity and efficiency is improved that leads to increased customer satisfaction

Some of the basic softwares that an insurance company should incorporate in its web portal are:

1.Quote Engine: A quote engine will help a potential customer to find out all the health plans of the insurance company that are in accordance with the needs of the customer. A quote engine provides the insurance company an opportunity to showcase their products and services.
2.Comparison tool: Quote comparison is one the basic step before a customer decides on a plan. A comparison tool is a good way to advertise that if they shop from that particular portal, they will get the best value for money.
3.A basic record maintaining software that stores the administrative data of every client of the insurance company and every application that the company receives.
4.An Electronic Health Record (EHR) software that maintains the medical history of every client and which can be used as reference when deciding claims

It is not just about accessing the software, but a health insurance company should have careful considerations in mind before its decides to go in for any software on its internet platform.

“Make sure that the insurance software is HIPAA compliant. Health Insurance Portability and Accountability Act sets certain regulations and all insurance softwares should be HIPAA compatible.
“With the new Patient Protection and Affordable Care Act getting enforced, the new softwares also have to be in accordance with the new federal reforms.
“It should be easy to update the healthcare insurance software according to the latest premium rates and insurance regulations.

Healthcare insurance softwares are an important tool for insurance professionals to serve their clients efficiently. They help a great deal in knowing and purchasing of health plans and faster processing of applications and claims making the lives of consumers, brokers and insurance companies easier.