Billing

A new report by Grand View Research examines the growth of medical billing outsourcing. Grand View projects the outsourcing market to grow by more than 150% from 2015 to 2024.

Here are five of the factors that will contribute to the significant growth, according to Grand View:

  1. Current systems in practice for managing revenue are gradually becoming obsolete due to lack of expertise in new payment models and revenue management tools.
  2. Providers are facing increasing challenges in managing claims and reimbursement, resulting in losses.
  3. Outsourced billing companies are developing new, advanced technological solutions that allow them to provide more efficient and cost-effective services.
  4. Providers are struggling to keep up with ever-changing, ever-growing regulatory billing requirements.
  5. Growth in bad debt and uncollectable accounts (likely due to in-house billing shortcomings) have cut into providers' revenue and profitability.

PGM Billing, a leading provider of outsourced medical billing, has experienced significant growth in the use of its revenue cycle management (RCM) services.

As Grand View notes, "Large medical groups with high claim volume are experiencing significant revenue growth due to outsourcing. ... Implementation of RCM by medical providers has improved their cash flow, reduced claim denials, and helped them gain an analytical approach to allocate resources and ensure effective revenue management."

The Centers for Medicare & Medicaid Services has published its latest Medicare Quarterly Provider Compliance Newsletter, which provides guidance to address medical billing errors.

The newsletter is designed to identify common billing errors and other erroneous activities when dealing with the Medicare Fee-For- Service (FFS) Program.

Topics discussed in the October 2016 issue include the following:

  • Transluminal Balloon Angioplasty, Venous
  • Endovenous Ablation Therapy of Incompetent Vein
  • Blepharoplasty
  • Transurethral Resection of the Prostate

CMS provides background on the procedure, the cause(s) of the most improper payments, examples of how providers fail to bill properly, recommendations on how healthcare professionals can avoid improper payments and resources.

To access the October 2016 issue, click here.

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