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Difficulty in Adapting to the Fee-for-value Billing Model

Jan 24th 2014 at 10:58 PM

Lowering costs, enhancing patient care, and providing insurance to the uninsured are some of the salient features of the fee-for-value model that has created a great hype in the US health care system over the past few years. Many US healthcare providers and facilities have already transitioned from the traditional fee-for-service model to this outcome-based payment model. However, the question here is whether they have accomplished it successfully? In most cases, the answer is ’maybe’. The simple fact is that adapting to this new payment model is quite difficult, which makes medical claims management hard enough to handle. Outsourcing physician medical billing services is considered the prudent solution to this problem. Before that, let’s discuss the difficulties involved in adapting to the fee-for-value billing model:

Training Time: It is the most crucial time for a healthcare facility’s medical coding specialists, as they will have busy time getting accustomed to the new billing model. Training and documentation will cost a considerable amount. Therefore, providers must be prepared for such temporary economical downs in the interim while they get adapted to the fee-for-value billing model.

Lack of Transition time: Any US healthcare provider or facility which has implemented the fee-for-value billing model will definitely require some time to adapt to it. They very well know that the normal workflow of medical billing and collections will get affected in the interim, but has to be minimized to protect cash flow. It is because of the fact that medical coding specialists will find it hard to devote equal time to processing medical billing & collections and adapting to the new payment model. The lack of transition time is their prime difficulty.

Collaboration with Multiple Providers: The main aim of the fee-for-value model is to provide better patient care services at low cost. Providers are expected to accomplish this goal while they collaborate successfully with other providers, including super-specialists like surgeons and radiologists. They can share savings only on attaining certain quality metric scores. It requires a lot of time to dedicate, so providers will find it hard to focus on the medical billing and collections. The right solution would be outsourcing physician medical billing services.

Administrative Challenges: Implementation of the fee-for-value model will require a lot of administrative work that involves data collection and reporting. It basically consumes a huge amount of time, which affects the normal medical claims management. Besides, many changes will occur in terms of budgeting, performance reporting, productivity management, and outcomes. Therefore, adapting to this payment model while carrying out physician medical billing services would be a challenging task.

About MGSI:

The best solution to overcome the difficulties of adapting to the fee-for-value billing model would be outsourcing to a reliable medical billing company like MGSI. Based in Florida, this national outsourced medical billing company has more than 22 years of experience in providing quality physician medical billing services to its clients. For more details, log on to

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