Why Behavioral Health Practices Need EHR Software: 5 Reasons

 The outdated paper-based methods and generic office software that are still used by behavioral health offices of all sizes in the US today do nothing to keep their work organized and moving smoothly.

In certain circumstances, healthcare providers believe that the expense of adopting electronic health record software is too expensive. Others feel that the EHR programs as they stand do not provide the functionalities they want for their behavioral health practice. But as cloud computing technology has developed, there has been an increase in the adoption of extremely secure cloud-based EHR installations.

Vendors of EHR software are now modifying their products to better suit the requirements of behavioral health practitioners.

They provide software as a service for mental health EHR applications. A SaaS is often a subscription-based service, which lowers the providers' total cost of ownership. SaaS-based EHR programs scale with your needs and let you just pay for the practitioners under your roof who use the service.

We are aware that EHR software may be pricey because we ourselves are an EHR vendor. However, especially in behavioral health procedures, the benefits outweigh the costs by a wide margin.

Try with advancedmd ehr software to streamline your practice efficiently.

The five main justifications for why your behavioral health practice requires EHR software are covered in this article.

1. Productivity Growth

Your staff may now automate calls to patients thanks to the integration of EHR and practice management software, which lowers the incidence of no-show appointments. Because they will be hearing about their appointment from a voice they are already acquainted with, individuals with mental health concerns may find it comforting to have these calls recorded in the voices of your staff members.

Additionally, the EHR software makes it easier to identify which patients require follow-up visits, helping to fill open appointment times sooner rather than later when there are fewer openings.

2. Denial of Claims and Reduced Recoupments

You have probably seen that the documentation requirements of third-party payers for supplied services are becoming increasingly demanding. If your company doesn't supply the required data, claims may be delayed, denied, or money may be recovered by payers after audits.

You can rely on the paperwork to always be full with all relevant facts when you use electronic health record software in your behavioral health clinic, which is one of its key advantages. By doing this, you may enhance the income flow in your clinic and prevent billing and reimbursement problems.

3. Tracking of prescriptions

It is a sad reality of contemporary life that many psychotropic medicine prescriptions intended to benefit patients are open to misuse. Because of this, behavioral health providers are starting to rely on their EHR's prescription tracking features.

Electronic prescription tracking makes ensuring that patients only get their medicine from one practitioner. Otherwise, people may abuse the system by getting several prescriptions from numerous doctors using various pharmacies for the same banned medication

.

Tracking also enables doctors to confirm that their patients are regularly filling their prescriptions.

Government restrictions influencing behavioral health must be complied with by healthcare professionals.

4. Better Service Coordination

Due to the nature of mental health illnesses, patients frequently see several different healthcare professionals and utilize a variety of services.

EHR software can assist behavioral health clinics manage the increased number of moving pieces since it makes provider communication easier and reduces the need for unnecessary duplication of services.

After all, a patient may not be able to determine if they are receiving unnecessary treatment, depending instead on the experts to ensure that services are delivered effectively.

5. Tracking Authorization

How much time does your behavioral practice's employees spend on the phone attempting to confirm a patient's insurance coverage before scheduling services? The procedure of determining how many units a patient has remaining until permission should go without a hitch.

Connect with the experts who can provide the best behavioral health billing services and to take care of your patients retention.

Revenue Cycle Management Trends - Know Them

 Medical practices of all sizes are reviewing their revenue cycles as they start to see more patients return in the wake of the unprecedented COVID-19 infections caused by the global coronavirus epidemic. You may anticipate that more of your patients will come through your doors for appointments they missed or treatments and tests they postponed after years of social withdrawal and shelter-in-place directives.

Making the most of your revenue cycle management system is something to think about when you study the revenue flow.

Because of effective revenue cycle management, your company will continue to succeed. It pays to keep up with new innovations that affect the billing process, whether you utilize your own standalone RCM system at your facilities or you outsource this crucial activity to a third-party organization via cloud computing.

You'll earn more from your firm if you keep an eye on healthcare revenue cycle management trends.

The following are five significant RCM trends to watch:

1. Medical practices will prioritize putting patients first

It will be wise to embrace a patient-centric mindset in order to increase income flow inside your firm, especially as you work to increase sales to pre-pandemic levels.

Medical practitioners will be considering how they might use and integrate best practices with digital delivery systems, as mentioned by Healthcare IT Today. Both in the exam room and online, automation makes it simpler to give each patient greater attention.

It is expected that medical practices would use technology more often than ever before, for example, to engage with patients on social media platforms. Practices will put more of an emphasis on patients by automating workflow procedures like scheduling appointments, processing payments, and handling invoicing, in addition to employing technology to increase interaction.

2. Simplifying Payments for Both Staff and Patients

From a business planning standpoint, patients, who you may also refer to as "clients," frequently show some degree of loyalty to their doctors and nurses. However, they are also knowledgeable users of digital information and used to doing banking and bill-paying activities online. So, one way to assist patients and reward their loyalty may be to provide payment options.

Unfortunately, patients have been skipping medical appointments due to financial strains and an economic slowdown brought on by the high number of people who lost their jobs during the peak of COVID-19. According to Healthcare IT Today, you may give patients a plan where they pay you back for services incrementally if you find that they are able to pay medical costs over time rather than all at once.

3. More Telehealth Possibilities to Free Up Staff and Improve Patient Appointment Convenience

You might want to rethink using this type of software and technology system if you haven't already given your patients access to a telehealth system. Telehealth is a $250 billion industry, according to a recent market analysis, and its use jumped 38 times during the coronavirus epidemic.

You might remember that in 2021, the Centers for Medicare and Medicaid Services changed the physician pay schedule to now include telehealth codes. As individuals wanted to avoid circumstances where COVID may be spread from person to person, virtual meetings became popular.

Giving patients access to telehealth services can be the difference between more cancellations of appointments and higher attendance at appointments. And moving future, this means improvements to your revenue cycle.

4. The Role of Analytics and Other Data Tools Will Increase

You can anticipate that your team will start to use software that makes predictions about patient behavior, such as tracking patterns to see who is taking a long time to pay their bills, as more practices turn to analytics to extract more value out of the data that they gather on each patient being served. One of the more significant developments in healthcare revenue cycle management to watch is analytics.

Analytics also assist you in identifying staff mistakes and determining the kind of claims that are most likely to be rejected. You may enhance the cash flow in your practice by combining this skill with analytics to examine your key performance indicators for the revenue cycle.

5. Using Payer Portals Along With Machine Learning

Healthcare is one of several sectors where artificial intelligence, also known as machine learning, is advancing. If you haven't already used AI and machine learning to support your revenue cycle management, you may start to do so in 2022, especially with payer restrictions becoming more complicated.

For instance, the top medical billing companies pointed out that automated status retrieval and payment posting both help you handle denials better. A payer portal facilitates payer automation as well. Your practice may access this dynamic data from any location using a tablet, smartphone, or laptop because so much data is being saved and processed straight via cloud computing services (also known as SaaS).

If medical companies wish to stay competitive in the healthcare sector, they must use the most recent software and computer technologies. Those that keep an eye on revenue cycle management healthcare will take action to speed up patient payments at their facilities by using cutting-edge RCM software. Anyone who keeps up with revenue cycle management trends will be aware that employing modern software is essential to the success of their business.

Major Difference between Credentialing and Payer Enrollment

Our nation's healthcare system is everything from simple. When you're trying to expand your strategy in a turbulent market, this causes uncertainty. To make sure their strategy is viable and lucrative, emerging businesses who wish to benefit from new technology, a new business model, or a new source of funding must comprehend the growth process.

Everyone involved is on the same page and is aware of what needs to be done in order to start providing treatment when they have a better understanding of the terms and conditions from both sides of the table - both as a practice and as a health plan.

Credentialing: What Is It?

A new doctor or healthcare professional must undergo credentialing to confirm their eligibility to deliver a range of services and medical treatment. This mostly entails giving proof of the person's certification, education, training, and employment.

It's trickier than it seems, though, because the information should preferably come from the place where the certification was earned, such as the medical school, the licensing body, and previous employers or practices.

Credentialing is a significant barrier to hiring a doctor or entering a new market since there are extra applications and demands for information for other situations, such malpractice lawsuits.

The process of re-credentialing practitioners on a regular basis is required by providers in order to make sure they can continue deliver the services they offer.

Due to this load, many practices who lack substantial internal teams to manage these tasks outsource their credentialing to groups that work in several markets on a full-time basis. 

Payer Registration

While payor enrollment operates on an individual level, credentialing doesn't. By enrolling with a payor, a practice can start receiving payments from Medicare, Medicaid, and health insurance companies like BCBS and Aetna.

This is a vital step toward a provider's financial health since timely, competitive reimbursement rates are what keep healthcare providers in business. Because patients are becoming less ready to pay for out-of-network care, contracting with the appropriate payors will open up a large number of new patient lives for you.

This is where market research for the payor enrollment process comes into play. Even if certain private plans could have a sizable patient base in other states or counties, they might not exist in the region or with the target population that you are looking for.

Contracting with and obtaining credentials

The contracting and credentialing procedure is time-consuming and difficult. With payor contracting and healthcare rcm services, let our staff handle the hassles for your practice. Our team of specialists has the understanding of the industry and internal resources to manage these expensive but essential operations successfully, saving you time and money while guaranteeing a sound financial position. To learn more, give us a call or send an online message today.

Provider Enrollment: What Is It?

The procedure for provider enrolment is closely similar to that of provider certification. While provider enrollment entails enrolling a provider with insurance payers so that they are able to request payment from those payers for the services they provide, provider credentialing entails reviewing a new provider's credentials to ensure that they are qualified and a good fit for the new position they are taking on.

Since payers will need all of the data that the provider credentialing process generates before they can enroll a new provider, you must first finish the healthcare credentialing process before beginning the provider enrollment process.

Provider enrollment is frequently a highly time-consuming and tedious procedure, similar to provider certification. The process of enrolling a new provider sometimes entails filling out and submitting dozens, if not hundreds, of different paperwork because each payer has its own distinct criteria.

What's most annoying is that, no matter how small the error may be, most payers will make you start the application process again if there are any mistakes on any of the paperwork you submit.

A Quality Checklist For Verifying Insurance Eligibility

 Verifying insurance eligibility is an essential step in preventing denials brought on by omitted or inaccurate information. There may be a number of reasons for a claim to be denied or rejected, however research has shown that the majority of denials and claim rejections, when compared, are due to insufficient insurance eligibility verification. Let's talk about the whole checklist for insurance eligibility verification so that it may be simplified and made more effective to enhance the overall billing experience.

Frequently omitted insurance eligibility verification denials

• claim rejected because of an error in the required information

• absence of required information

• incorrect or lacking patient demographic information

• Coverage is finished

• Not covered by insurance

• Coverage has ended

• Policy Expired or Terminated

• Prior authorization is required for services, or a referral

• Coverage outside of networks

The identification and prevention of denials such as those mentioned above is substantially aided by insurance eligibility verification, which also helps to submit claims more efficiently and raises the first-pass rate.

Therefore, a comprehensive Insurance Eligibility Verification is necessary for any medical billing and revenue cycle management services. Having a checklist for a quick eligibility verification procedure is the best approach to ensure that your advantages are maximized.

Checklist for verifying insurance eligibility

The lengthy insurance eligibility verification procedure necessitates gathering as much data as you can at once. The secret to efficiency is asking the appropriate questions, therefore having a list of information to be gathered during the verification call will produce better outcomes. The information that must be checked and confirmed during insurance eligibility verification is listed below:

• information about the insurance, such as the name, ID, and group number

• Name of insurer and dependent information

• Policy Start and End Dates

• coverage information Insurance Policy

• The action to be taken is covered

• Services covered by the policy's exclusion list

• Practice and Provider Insurance Network Participation

• Prior Authorization and, if necessary, Referrals

• Patient obligation, including as copays and deductibles.

Verifying insurance also assists in properly communicating the patient's duty to them ahead to the day of services. This not only aids in organizing patient collections, but also strives to improve your company objectives by enhancing patient happiness.

Insurance eligibility verification issues

Verifying and confirming each patient's insurance information at each visit may need a significant amount of time and manpower to get the desired outcomes. However, a medical office that manages patient registration, appointments, and focuses more on uninterrupted patient services may overlook these important billing details.

Additionally, if the front desk or office manager of a medical practice handles several claims on a daily basis instead of a separate medical billing business, this knowledge may be lost. But outsourcing insurance eligibility and benefits verification services might make it easier for you to deal with these difficulties.

Outsourcing the verification of insurance eligibility

The practice of outsource medical billing services is currently popular. A skilled medical billing company has the knowledge to handle each aspect of revenue cycle management and guarantee the best possible outcomes.

They are able to manage any specialty thanks to their exposure, infrastructure, automated tools and software, personnel, competence, and experience.

They also have a committed workforce that has the necessary training and skills to meet the required quality and quantity %.They strive to boost your monthly collections.

Top 10 Considerations: Outsource Your Medical Billing

Perhaps handling invoicing internally made financial sense when you initially started your firm. But as your company has expanded in size and maybe scope, billing has also become more complicated. Many businesses consider it wise to outsource this duty since there are so many moving pieces to keep track of in order to maintain a steady flow of money.

If you've ever questioned if you should outsource medical billing, this article will go through all the benefits it offers you in terms of operations and all the reasons why medical practices should. Make use of it to decide if it's the ideal answer for your business.

1. Reduce the Chance of Medical Billing Errors

Although your personnel has received billing training, how thorough was it? Compare outsourcing this task to an outside team of professionals with doing it in-house. They accrue more billing hours annually than any other employee at your office and receive ongoing training in industry best practices. A speedier revenue flow results from fewer errors.

2. Benefit from the expertise of billing experts

You can't be expected to be an expert in medical billing given the large range of payers present. Each of them will have unique characteristics that third-party billers are well-versed in. You won't have to spend time learning the procedures of each insurance provider, which saves time.

3. Allow staff members to focus on more crucial tasks

You need to keep a careful watch on a number of administrative matters. You may free up some of your back-office workers to focus on other urgent projects by relieving them of some of the billing duties. Of course, you may reallocate the budget to more workers or new equipment for the practice if you had been planned to recruit more billing staff but no longer need to do so due to a third party.

4. Gain Understanding of Your Financial Situation

Your partnership with a third-party billing provider will enable you to increase transparency. According to a research from Medical Economics, they will employ software solutions to provide you statistics regarding how old your accounts receivables are increasing and at what volume, or how patients respond to any changes in how reimbursements are granted.

5. Cut expenses

The quickest route to achieving your aim of cost containment and increased profitability for your clinic may be to outsource medical billing. According to market research, hiring a third party would likely be more expensive than buying the most recent version of specialist billing software and investing in employee training.

6. Integrate Your Electronic Health Records Software With Medical Billing Services

Patient data is a crucial factor to take into account. It is simple and practical to connect your electronic health records, or advancedmd EHR software with the IT infrastructure of the third-party billing team. This guarantees that patient data is correct and that each bill may be processed efficiently by the billers.

7. Greater Patient Contentment

When patients receive clear billing statements with payment instructions, they are grateful. The experts at the outside company to whom you outsource invoicing will handle every little detail consistently. Your own staff could take their time distributing papers, but external billing handles this process considerably more quickly while abiding by the most recent guidelines with each insurance.

8. Upgrade Your Stagnant Accounting System

It could be preferable to upgrade by utilizing a third party if it has been a while since you bought and installed your practice's accounting system. Forget about spending time and money figuring out which new accounting system is suitable for your business. To make the most use of their time, the medical billing services staff will employ the most recent version of their software.

9. Expand Your Company Using Medical Billing Services

Billing was a normal and easy process when your firm was young and just getting started. But as you plan to expand, managing the bills from your numerous specializations and physicians will become increasingly difficult. It would be wise for doctors looking to expand their practice over the coming year to weigh the pros and cons of outsourcing vs doing their own billing.

10. Verify That You Are Compliant

According to EU Today, outsourcing your medical billing services can assist guarantee that you adhere to the requirements of the Health Insurance Portability and Accountability Act (HIPAA), which addresses privacy issues. This is another factor that many people overlook.

You may rest easy knowing that the third-party billing specialists will be educated on the most recent compliance standards, resulting in quicker bill payment.

Conclusion

• Your practice will make fewer errors on patient statements if you rely on a medical billing services provider.
• Since third-party billers will have more experience than anybody on your staff, you should expect higher accuracy and quicker payouts.
• Want to increase the financial openness of your practice? Using third-party billing services can help you understand how income is generated.
• Billing services may simply be integrated with your electronic health record (EHR) software, increasing accuracy.
• When you work with medical billing experts, it will be simpler for your company to adhere to Health Insurance Portability and Accountability Act privacy standards.

Prior Authorizations: Present Issues and Solutions

Prior authorization (PA) is required by health insurance companies as a condition of payment for numerous services. Payers utilise PA to decide whether or not particular medications, products, treatments, or services are medically required before prescribing or providing them to beneficiaries. However, the PA process imposes an administrative burden on physicians' offices and managed care organisations, and often has a negative impact on patients by delaying required therapy.

According to a recent health leaders report, such support is especially important now because payers are requiring prior permission for patient care even while the COVID-19 pandemic persists. Though some payers eased their PA requirements in response to the COVID-19 pandemic, many of them reinstated them as the pandemic progressed.

Prevailing Prior Authorization Issues Revealed

According to a new AMA poll, 94% of physicians indicated that PA requests caused care delays, and 79% claimed patients abandoned treatment due to authorization complications with insurance. The poll, which was performed in December 2020, included 1000 practising physicians. The following are the report's other significant findings:

• PA programmes, according to 90% of physicians, have a detrimental impact on patient clinical outcomes.
• 30% of respondents said that PA requirements resulted in major adverse events for patients under their care.
• The burdens associated with PA were rated as severe or extremely high by 85% of respondents.
• Only 15% of physicians said PA criteria were frequently or always based on evidence-based medicine.

Recommendations of the ACR on Prior Authorizations

The American College of Rheumatology (ACR) issued many proposals in March 2020 to lower PA requirements and increase patient access. Among the suggestions were:

Reducing the number of clinicians who are subject to PA requirements if they use evidence-based practises and achieve performance metrics and other standards.

Reducing the number of treatments and drugs that require PA by assessing and deleting extraneous requirements on a regular basis.

Improving transparency and communication channels among payers, patients, and physicians

maintaining continuity of treatment when coverage, payers, or PA requirements change, and

accelerating the adoption of national electronic PA standards and increasing transparency about formulary decisions and coverage limitations

In January 2021, the Centers for Medicare and Medicaid Services (CMS) issued a new regulation to streamline the PA process and improve data transparency for providers, payers, and patients.

Certain payers, providers, and patients will have electronic access to pending and active prior authorization (PA) decisions under the regulation. The new rule, according to CMS, will:

• Allow providers more time to focus on providing higher-quality care.
• encourage interoperability by promoting secure electronic data access
• empowering individuals, lowering expenses, and easing the stress on the health-care system

The new rule requires authorised payers to establish application programming interfaces (APIs), which will allow providers to access data via integration with their electronic health records. This information will include claims and encounter information, as well as laboratory results and information on any pending or active PA judgments.

APIs will ensure that healthcare providers have more complete information about their care, which is expected to improve the patient experience. APIs will also make it easier for patients to access their health information.

CMS indicated in a statement issued the first week of April that, in recognition of the difficulty faced by payers during the COVID-19 public health emergency, the agency will not implement the new policies and technology standards for interoperability and burden reduction until July 1, 2021.

According to the American Medical Association's 2020 report, the prior permission burden has a major impact on medical practises. Practices complete 40 prior authorizations per physician each week on average, which requires two business days (16 hours) of physician and staff labour.

According to the AMA, these findings highlight the need to streamline or abolish low-value prior-authorization restrictions in order to reduce delays or disruptions in care delivery.

"Delayed and disturbed treatment can have life-or-death repercussions for patients, especially during a public health emergency," stated AMA President Susan R. Bailey, MD. "This painfully acquired lesson from the current crisis must inspire a reexamination of administrative costs imposed by health insurers, which are frequently unjustified," she said.

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How Prior Authorization Outsourcing Can Help

Insurance authorization services can help patients and clinicians deal with the stress of prior authorization. A team of insurance verification specialists from an insurance authorisation business will work with practises to:

• Ensure that claims for PA-eligible treatments or services are submitted on time.
• Before submitting a PA request, ensure that it meets all of the payer's requirements.
• Reduce submission hassles and reduce redundant procedures.

These businesses have a streamlined, centralised approach in place that reduces errors. They have also worked with all government and private insurers. Working with an expert allows practises to save time and resources required for prior authorizations services while also lowering the likelihood of denials, which benefits both physicians and patients.

How to Create a Positive Culture in Your Medical Practice

A company's culture may make or break it. Numerous books and studies have proven that a positive work culture can lead to increased employee engagement.

Employee engagement has an effect on retention, productivity, and how your teams handle their clients, in this case, their patients. A satisfied employee will go above and beyond for patients, identify possible problems early, and is constantly searching for ways to innovate and improve the practice.

We've all heard about the fantastic working cultures at Google, Netflix, and Apple. Giants like Google have the budget to provide amazing incentives, but any expert will tell you that lavish perks are not required to maintain a healthy and high-performing work culture. Without a large budget or a culture officer, you may build an exceptional work culture at your medical practice. Consider the following five steps to developing a successful practice culture:

1. Determine Your Goal 

Defining your practice's purpose or mission, as well as outlining your values, will help you build a healthy work culture. For others to understand where you want to take your medical practice, you must have a common goal. More significantly, connecting your purpose to a specific employee and the position they play has a significant impact on employee engagement levels. 

Working in the medical industry makes it easy to develop a company purpose since the work you do is naturally significant. However, as you are aware, each medical practice has its unique identity and can profit from a specific goal. Define the unique objective of your medical practice as a group. 

2. Recruit With Caution 

Take the time and make the effort to hire the best people for your team, mission, and culture. Make certain that the people you hire share your values. Be conscious of any biases you may have. A recruiting manager may focus his or her judgement on first impressions, which isn't always the ideal technique.

If you are conscious of your prejudices, you can implement mechanisms to overcome them, such as involving another person in the interview process. You can also train yourself not to make a decision on a candidate during the first 10 minutes of an interview. The proper people are critical to your success, but they are also the most expensive aspect of any practice.

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3. Establish an Operational Rhythm and Improve Internal Communication 

A regular meeting schedule and communication flow are essential. Meet with your team on a regular basis. Your staff are concerned about the practice's performance, and receiving feedback from patients and about their own performance is important to them.

A weekly meeting also allows your staff to provide feedback, ask questions, and discuss any problems they may have. You can also solicit suggestions for procedure improvements or discuss the patient experience. It is equally crucial to guarantee that employees receive one-on-one time with their bosses.

According to research, the number one reason people leave firms is because of their management. Schedule regular catch-ups with your personnel to ensure you provide genuine positive feedback to them. 

4. Request Feedback 

Asking questions is the best method to learn where you can promote participation and where cultural reforms are needed. You may use Google Docs to create a basic survey that asks an open question about what might be done to improve the culture and employee experience at your business.

Make certain that the outcomes and any action plans implemented are communicated. Be honest about whatever you can't do something about and explain why. For example, if a request is made to serve daily lunch, you may respond that this is too costly for a small firm, but you can guarantee your kitchen has the necessary facilities for individuals to bring their lunch and eat it peacefully. 

5. Create Reward and Recognition 

Success should be celebrated and rewarded. Recognizing good conduct reinforces it, and celebrating victories is crucial for team building. Instilling appreciation and encouraging celebration in your practice will help everyone comprehend your mission and the progress you're achieving. Meeting a patient satisfaction score, for example, could be cause for celebration.

Individual events like birthdays and work anniversaries are especially important to recognize because they contribute to employee engagement and culture. Any personal celebration, such as an engagement or pregnancy, should also be acknowledged. Small gestures such as saying thank you at the end of the day can also make a significant difference in creating a happy environment. Appreciation is really important, especially if someone has had a bad experience with a patient.

Overall, great culture and positive transformation will begin with strong leadership. Communicate which areas need to be improved and what actions you intend to take. Most essential, act on your words! People will never change if they see you not behaving the way you expect them to.

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