Healthcare Provider Solutions Make Providing Quality Care Better

The introduction of the comprehensive health care reform law in March of 2010 was a great milestone of this generation. Popularly known as “Obamacare”, it has become the very foundation of making affordable health insurance available to millions of people.

The expansion of health care’s coverage means more patients, and more paperwork. Many medical practitioners have already reported having difficulties focusing on providing quality health care while running their clinics. Good thing there is now a system for healthcare and medical practice reimbursement which makes your job as a medical practitioner a lot easier.

The Difficulty in Receiving Healthcare Payments

Typically, paying for a service or product is simple. In upfront industries, you only need to know the price and so you can pay right away. For the services sector, you may either pay half now, half later or pay for the job in full after it’s been completed.

Payment via healthcare insurance, also called reimbursement, is somehow related to paying for services except it’s a bit more complicated. Reimbursements require multiple procedures which often take a month or more to process. That’s if there are no hitches in between that could result in further delay of the payment to the healthcare provider.

Delay in payments and administrative burdens are the main reasons why some independent healthcare providers choose not to accept insurance. They want to avoid the complex structure of healthcare reimbursement by simply billing the patients directly.

doctor looking at the chart

The Complexity of Acquiring Patients Thru Insurance

It is true that some healthcare providers are afraid that the quality of their service might dwindle if they receive more patients through insurance. And who wouldn’t? Before getting paid for the healthcare service rendered, there are lots of complex procedures to undertake.

Of course, you will need a detailed record of the patient’s history, medical history, and past examinations, along with diagnoses and plans on how to treat the patient. Documenting, assigning medical records, the list of attending physicians, the paper trail complicates things even more. And these are just some of the standard administrative procedures.

When it comes to payment of fees, every physician is paid differently depending on practice, specialty, and contract. Plus, there are some instances when the patient’s medical plan does not provide full coverage. Take for instance the 80/20 insurance wherein the insurance provider shoulders 80% of the total allowable amount and the patient pays the rest.

The buck does not stop after the payment is received. Post-payment audit and documentation is another important aspect of the transaction. Based on normal practices, insurance providers request complete documentation to ensure claims are paid correctly. Sometimes, even patients will request their own copy.

Indeed, deciding to get more patients through healthcare insurance is a tedious process. And more often, it’s one of the main reasons clinics and healthcare providers refuse healthcare accreditation.

Healthcare Reimbursement Made Easy

However, the number of clinics getting more patients by tapping into insurance patient pools is increasing by the days. That’s because they have learned the benefits of getting a complete healthcare solutions system. This allows medical practitioners and healthcare providers to focus on taking care of patients rather than getting tied with administrative burdens and the complex structure of reimbursing the payments.

Tapping an experienced partner that offers comprehensive practice management services enables you, as a healthcare provider, to concentrate on patient care. Having a partner with a trusted system that handles all areas of the health care and billing industry will surely bring exceptional results for you and your clinic.

About the Author

Scroll to Top