Joseph Tessler CPC is the CEO and Founder of Bills Right Inc. He recently answered a few questions about the evolution of revenue cycle management. Here’s what he shared:
What’s your approach to medical billing today?
My approach to medical billing is simple. Submit the claims as timely as possible and follow up should be done as soon as there is a remit from the payer. In simple terms, the billing side of things needs to run on a perfect cycle, and even then there will be denials.
What do you feel differentiates your service and sets you apart?
What differentiates us is the experience dealing with different specialties and knowing what the issues are and how to avoid and/or resolve them. I work with the billers to review and correct any denials so that I am personally involved in the day-to-day operations.
Can you talk a little bit about the landscape and complexity of your billing?
As far as landscape goes, we specialize in FQHC billing. FQHC stands for Federally Qualified Health Center and is a major part of our business but we do a lot of other specialties as well. The hardest part of billing is the ever changing rules and regulations that the industry has between Medicare and Obamacare and ICD-10 to name a few more common ones. The need to keep up with these changes are what makes it much more difficult do be ahead of the curve.
What are some of the common billing challenges you run into on a day-to-day basis? What do you do to overcome these challenges?
One of the most common billing challenges are the front desk errors that can easily be avoided on a day-to-day basis, like patient ineligibility and missing prior authorization to name a couple. I think most practices don’t realize how important it is to have an experienced front desk so that you avoid all these issues in the first place. I always tell my clients that it all starts with a great from desk because that’s your first line of defense and can reduce your number of denials by almost 50 percent.
What do you wish more of your clients would be doing with respect to revenue cycle management? What advice do you find yourself repeating over and over?
All the providers that are in a particular practice have to be on board with all the changes, as well as getting their clinical duties complete in a timely manner. This is a direct result in the timely filling process for the claims. So I tell all my clients that they need to discuss this with their providers in order to have a great revenue cycle.
What’s your plan to stay competitive with major players like Athenahealth, eClinicalWorks and McKesson?
I think in order to compete with the major players that you mentioned you have to be more personal as opposed to corporate, meaning that we provide a service that is more in tune with the practices’ needs — working for the practice and keeping their best interests at heart.
How has the Affordable Care Act affected your business? What about patient pay. What has been the impact on your work?
The Affordable Care Act has been anything but affordable. Most of the plans have very high deductibles and are not accepted by a lot of providers. This has caused major issues within the healthcare industry where the patients don’t understand what’s their responsibility and what is the health plan’s. We hope the new administration will figure out a way for it to work because currently it’s not.
What headlines or trends in the world of revenue cycle management are you following today? Why do they interest you?
I follow mainly CMS which is Medicare, the reason I follow them is because in the healthcare industry they are the trendsetters. Basically, everyone follows what they release and bases everything off that.
What predictions do you have for the future of revenue cycle management? How will the field evolve?
I do believe we are moving over to a value-based system where the payments will be based off the value of the care not just by the type or the time spent with a patient. I do believe some practices have already switched over to this model and I believe more will follow. I also believe that wearable technology in healthcare will be the next big thing and I hope it will help save lives.
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Last Updated on May 15, 2016