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News, Information and Updates on Hardware and IT Tools to help improve your Medical practice
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Health Care Providers Face More Direct Billing, More and Tougher Collections

Health Care Providers Face More Direct Billing, More and Tougher Collections | IT Support and Hardware for Clinics | Scoop.it

Opponents figure that they pretty much killed the Affordable Care Act in December when they ended the individual mandate. They may be right. The mandate – the part of the ACA that required Americans to buy health insurance or face a minor penalty – was a key to trying to broaden and deepen the insurance pool, mitigate payers’ risk and, not least, keep premiums at least remotely tethered to people’s ability to pay.

 

Another part of the ACA is also under threat. The law allowed states to agree to an expansion of Medicaid that was meant to help people who couldn’t afford to meet the mandate on their own.  Still another: it also offered subsidies to help payers meet the expenses of covering all the previously untreated people they’d have to insure and of covering everyone’s pre-existing conditions. 

Premiums in fact did not grow as fast in states that accepted the Medicaid expansion during the past three years and as an estimated 40 million more people gained some form of health insurance.

The end of the individual mandate, the junking of one of the subsidies for health insurers and last year’s drastically truncated open enrollment period for the remaining Exchange plans, however, have again started to reduce the number of Americans with health insurance.

 

These changes affect more than practice volume. They impact operations for practices that retain patients, too.

For without increased attention to “revenue cycle,” all health care providers can expect to be doing more direct billing of patients, doing more collections work and assuming more bad debt from people with higher, tougher-to-pay deductibles in the coming months and years.

 

Here’s why: No one yet knows how many people who bought insurance only because they were required to. There’s reason to believe the end of the individual mandate will start making them drop out of all kinds of plans during the next open enrollment period.

A federally truncated open enrollment period October-December, 2017 has already reduced the number of insured people in the nation.  A number of forces are leading fewer people – and fewer younger, healthy people – to buy plans, and some predictions have premiums rising an extra 10 percent this coming year.

 

More shrinkage is coming. Newly permitted work requirements for Medicaid coverage promise to push still more people into the ranks of the uninsured. Kentucky’s new rules, for example, will drive an estimated 40,000 people out of Medicaid coverage during the next five years. As of this writing, nine other states are considering imposing new restrictions on who can qualify for Medicaid coverage.

 

The increase in the numbers of the uninsured obviously has disturbing implications for the nation’s health as a whole. It will also force payers to raise premiums to make up for the rising costs of being able to spread their risk across smaller, riskier customer pools.

 

The uninsured aren’t the only ones threatening practice finances.

Rising premiums, in turn, are leading employers to offer employees more high-deductible health plans. These HDHPs have lower premiums but higher risk for patients, who in addition to their premiums must pay an average of the first $2,400 of their families’ medical bills out of their own pockets. Some plans have deductibles as high as $10,000.

 

The lower premium costs, however, are attracting more and more people.

 

They are also higher risks for physician practices, which have a harder time collecting from patients with HDHPs. Thirty-seven percent of the people working for employers who offered plans in 2017 chose high-deductible plans. That’s up from 28 percent in 2016. The same year, that accounted for 39.3 percent of all Americans on employer-based health plans. All told, up to 37 percent of insured Americans, regardless of where they bought it, were using HDHPs.

 

But there have been dire unintended consequences. With the costs of care so high, 64 percent of those with high-deductible plans say they’ve put off care because they didn’t want to or couldn’t pay the deductible. And 62 percent said that, despite the lower premiums, they end up spending more on health care than under their previous plan.

 

People with the high-deductible plans thus tend to be bigger financial risks for providers.

Of HDHP customers, 15.5 percent reported having trouble paying medical bills in 2016 (versus 10.3 percent of those with “traditional” plans).

 

In sum, this means everyone in health care – providers, hospitals, practices – are going to chance offending more patients by billing them directly and, at minimum, going to have to devote more resources to revenue cycle and collecting what patients owe them.

Technical Dr. Inc.'s insight:
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Professional Development Advice from Technology Leaders

Professional Development Advice from Technology Leaders | IT Support and Hardware for Clinics | Scoop.it

This edition of AppointmentPlus Radio brings together two industry leaders within the tech sector. Raymond Wiley, a general manager with Sun-Tec America, shares the story of how he landed his current position, as well as the philosophy that shapes his professional interactions. Dhruv Bhate, a senior technologist who works in 3D printing, offers insight into how reflection on your true values can lead to a meaningful work life. The two also discuss:

 

  • The importance of finding your professional “sweet spot”
  • How to understand, and communicate your professional value
  • Why defining what you do also mean defining what you don’t do
  • Plus: 5 must-have personal technology recommendations and 2 must-read books to overhaul your professional mindset

 

 

About Raymond and Dhruv: 

Raymond Wiley is the general manager at Sun-Tec America, LLC where he is responsible for the go-to-market strategies for Sun-Tec’s high precision lamination, labeling, and taping equipment portfolio for the Americas and European markets. He is the primary interface between the customer and the Sun-Tec design engineers located in Japan and is charged with overseeing the entire sales process through every phase of the project. Previously, Raymond spent 21 years at Motorola in the Semiconductor Products Sector serving in a variety of increasingly responsible positions including operations manager for the Small Signal and MEMS Sensor Businesses in Japan.

 

Dhruv Bhate is a Senior Technologist at Phoenix Analysis & Design Technologies, Inc. (PADT) where he leads R&D efforts in Additive Manufacturing, with a focus on high-performance polymers and metals. Prior to joining PADT, Dhruv spent 7 years at Intel Corporation developing laser-based manufacturing processes. Dhruv has a Ph.D. in Mechanical Engineering from Purdue University and a Master’s from the University of Colorado at Boulder, where he developed fracture models for ductile metal alloys and to simulate adhesion in MEMS.

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Online Scheduling Software Is Revolutionizing the Wellness Industry

Online Scheduling Software Is Revolutionizing the Wellness Industry | IT Support and Hardware for Clinics | Scoop.it

Appointment-Plus, the industry leader in online customer self-scheduling software, announced several major additions to its growing wellness and health screening client base. Major program providers such as Lifecare, Inc., which serves more than 4.5 million individuals, have quickly implemented Appointment-Plus web-based scheduling software to solve many of the thorny scheduling issues often associated with corporate wellness and health screening programs. Appointment-Plus seamlessly manages these large appointment volumes by allowing corporate employees and healthcare members to self-schedule via a secure Internet portal.

 

In addition to Lifecare, Appointment-Plus was also recently selected to be the online scheduling solution utilized by Self-Insured Schools of California (SISC), a health insurance group of over 300 school districts in the California education system. SISC will use Appointment-Plus software to allow thousands of school district employees and dependents to schedule health screenings across the State of California. With the integration of both the online self-scheduling software and the call center services offered by Appointment-Plus, SISC will maintain a comprehensive scheduling solution that meets all aspects of the employee and dependent scheduling process.

 

The appointment-plus software offers wellness providers the ability to customize the system to meet very specific scheduling needs, including the option to private label both the member scheduling view and the administrative view of the system. In addition, Appointment-Plus offers an enterprise solution if required for large projects. The enterprise solution allows wellness providers a web services toolkit to interface Appointment-Plus information with other systems.

 

Because Appointment-Plus operates on a software as a service (SaaS) model, wellness providers can implement the system with virtually no up-front or capital costs. In addition, because the member self-scheduling process eliminates much of the traditional manual scheduling process, using Appointment-Plus is a cost-saving measure for programs. Appointment-Plus accounts are scalable to allow scheduling across multiple client-companies and client-locations. With its robust reporting functionality, Appointment-Plus also effectively manages wellness project information needs.

 

“The flexibility and functionality of the Appointment-Plus system have been a key factor in its success for wellness providers,” said Jeff Fleming, Director of Business Development for Appointment-Plus, “Wellness providers, their clients, and their members really appreciate the simplicity of member self-scheduling and the corresponding business efficiency.”

 

Appointment-Plus is a technology firm that specializes in the development of web-based scheduling and appointment software for a wide variety of applications and industries. Appointment-Plus software clients include Fortune 500 companies such as Pepsi and Comcast, federal and local government, universities and schools, and small/medium sized businesses worldwide. In 2007, Microsoft Corp. selected Appointment-Plus software as its referral source for all appointment manager software clients.

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4 Industries That Find Blockchain Technology Useful

4 Industries That Find Blockchain Technology Useful | IT Support and Hardware for Clinics | Scoop.it

 

By 2024, the global blockchain market is expected to be worth $20 billion, and according to a recent study by IBM, one-third of C-level executives are considering adopting these technologies. Does that surprise you? Is your organization exploring blockchain or distributed ledger solutions?

 

Recent reports indicate that blockchain has the potential to reduce certain industries’ infrastructure costs by 30 percent. Additionally, there’s a $8-12 billion annual savings for certain industries that use blockchain technology. Let that sink in.

 

Companies of all industry types are using blockchain technology to help them improve transparency, traceability and trust; but here are four industry-specific benefits.

 

  1. Healthcare: Hospitals are now able to seamlessly access patient data shared between member hospitals and participating hospitals.
  2. Banking: Financial institutions are able to simplify and speed up the transfer of funds, while ensuring the identity of the user.
  3. Supply chain: Manufacturers can ensure the authenticity of goods and products with better transparency and accountability.
  4. Insurance: Companies can eliminate common sources of fraud, and use smart contracts to improve efficiency and improve customer experience.

 

With all of these sample use cases, blockchain helps companies increase efficiency and reduce friction. Sirius offers various services to help organizations define and develop their blockchain solution.

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Keep Your Appointments Afloat! 

Keep Your Appointments Afloat!  | IT Support and Hardware for Clinics | Scoop.it

Summer can be a busy time for sailing and boating businesses as people flock to the beach, bays, rivers and lakes for a fun day on the water. Online scheduling software from Appointment-Plus can be the perfect partner for operators looking to spend less time booking reservations and more time on the water with their customers.

 

Used by businesses coast to coast for scheduling sailing lessons and booking boat rental reservations, Appointment-Plus helps these operations automate and streamline their appointment-setting procedures with such functionality as online self-scheduling, which allows customers to view availability and book their lessons and reservations online, 24 hours a day; automated e-mail and text message reminders, which inform customers of their upcoming appointments and reservations; accurate recordkeeping and report-generating features; and e-marketing capabilities for sending current and past customers information on specials, discounts and other news.

 

“Sailing and boating businesses provide fantastic recreational opportunities for individuals and families throughout the nation,” says Jeff Fleming, marketing director at Appointment-Plus. “Our software helps automate and streamline the entire appointment- and reservation-scheduling process, allowing them to spend more time focused on their operations and their customers.”

 

A Software as a Service (SaaS) application, Appointment-Plus is Web-based and accessible from any Internet connection. This gives operators the ability to access their scheduling calendar from outside of their home or office. Additionally, Appointment-Plus does not require a Web site, expensive hardware or time-consuming installations to use. Pricing starts at $39 per month with no long-term contracts and free set-up assistance with a dedicated coach.

 

Businesses that utilize the online self-scheduling feature can expect a significant drop in the number of phone calls from customers looking to book appointments and check availability. This functionality is especially beneficial if the operator does not have an office or receptionist and routinely takes phone calls at the dock or on the water while giving lessons.

 

“Just think of the convenience of allowing your customers to schedule their lessons or reserve their watercraft at any hour of the day and at their own convenience,” Fleming adds. “Plus, you’ll spend less time answering the phone call and returning messages.”

 

Appointment-Plus supplies almost 4,000 clients throughout the United States, Canada and 10 other countries the tools they need to schedule customer and patient appointment times, book rooms, accept registrations and many other services. Geared primarily toward small businesses such as doctors’ offices, spas, health clubs and massage therapists, users of the service also include Fortune 500 companies; colleges and universities; healthcare agencies and facilities; federal and local government; and freight and delivery companies.

Technical Dr. Inc.'s insight:
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