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Medical Billing Concerns Of Groups With 2 To 15 Providers

Mar 19th 2014 at 5:45 AM

The constant changes in the healthcare space have created a huge impact on Healthcare groups regardless of their size. Right from large groups that have more than 50 Providers to small groups that handle 2 to 15 Providers, everyone including the solo Providers face great challenges surrounding medical billing and collections. In this scenario, large practice groups and solo Providers endure the impact to a passable level, while small groups struggle badly. The reason is that large groups utilize the best resources and have the revenue to balance the loss. Even solo practitioners have the liberty of making their own decisions, be it right or wrong. However, small groups are the ones that miss either of these advantages and get struck in the interim. Let us take a look at the concerns of such small groups and the possible revenue cycle solutions:

Reimbursement Payment Cuts: The major concern of groups with 2 to 15 Providers is the reimbursement payment cuts introduced by the Affordable Care Act in the past few years. The HHS sequestration cut, which came into effect on April 11, 2013, is deducting 2% from all physician services. If Providers do not report PQRS in the proper format, then they will be subjected to an additional 1.5% payment cut in 2015. Above all, the 24% SGR-mandated cut that was postponed from January 1st to April 1st has become the most concerning factor in recent times. Outsourced medical billing can help small groups balance such revenue losses.

HIPAA 5010 Migration and ICD-10 Implementation: The 5010 version of the HIPAA transactions came into effect on January 1st, 2012. As per this transition, Providers were expected to carry out all kinds of transactions, including ERAs complying with the 5010 platform. Small groups found it highly challenging to upgrade to the translation and mapping techniques to present standards. Before they could break-even from the costs of implementing these changes, the obligation of ICD-10 implementation added to the burden, affecting the normal workflow of physician billing services. With 200,000 new codes, the new code set has to be implemented by October 1st, 2014. The best way to keep medical billing and collection processes of small groups running smoothly is by outsourcing medical billing.

Managing Overheads: Implementing these healthcare changes will cost all practices including small groups with 2 to 15 Providers quite a lot of time and money. Large practices find it easy to overcome these expenses, but it is those small groups that struggle spending for software and technology up-gradation, staff recruitment, and high-end training and infrastructure overheads for their in-house billing staff. The right revenue cycle solution to balance this loss will be to outsource a part of physician billing services to a reputed medical billing and collections company like MGSI.

About MGSI:

Based in Florida, MGSI is a renowned outsourced medical billing company that has been guiding small and medium sized groups through their physician billing services. With more than 20 years of experience, this national company renders quality medical billing and collection services to its clients across the US. To learn more details, log on to

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