Marketing Medical Billing Services to Physician Practices

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Marketing Medical Billing Services to Physician Practices

Marketing Medical Billing Services to Physician Practices

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  • 1. Marketing Medical Billing Services to Physician Practices Presented By: John R. Mazza, President & CEO Financial Healthcare Management, Inc. 1400 Johnson Ave., Suite 4-S Bridgeport, WV 26330 E-mail: jrmazza@fhcm.net Web: www.fhcm.net
  • 2. REMEMBER “IF A PERSON DOES NOT MAKE NEW ACQUAINTANCES AS THEY ADVANCE THROUGH LIFE, THEY WILL SOON FIND THEMSELVES ALONE.” -Samuel Johnson
  • 3. WHY DO I NEED TO MARKET  CLIENTS ARE SWITCHING BILLING COMPANIES JUST FOR THE SAKE OF CHANGING OR COULD IT BE….. + PRICE (We are their 2nd largest expense) + UNREALISTIC EXPECTATIONS + MERGERS AND ACQUISITIONS
  • 4. Industry Environment (Change Driven by External Forces)  American Recovery and Reinvestment Act of 2009: As it relates to: Health Information Technology (Health IT). Provides approximately $19 billion for Medicare and Medicaid Health IT incentives over five years.  Electronic Medical Record Implementation Provides financial incentives through the Medicare program to encourage physicians and hospitals to adopt and use certified electronic health records (EHR) in a meaningful way (as defined by the Secretary and may include reporting quality measures). Authorizes ONCHIT to provide competitive grants to states for loans to providers. Medicare incentive payments would be based on an amount equal to 75% of the Secretary’s estimate of allowable charges, up to $15,000 for the first payment year. Incentive payments would be reduced in subsequent years: $12,000, $8,000, $4,000, and $2000, after 2015. Physicians who report using an EHR that is also capable of e-prescribing would be eligible for EHR incentives only. Early adopters, whose first payment year is 2011 or 2012, would be eligible for an initial incentive payment up to $18,000. In 2014, the payment limit would equal $12,000. Adopters, whose first payment year is 2015, would receive $0 payment for 2015 and any subsequent year.    
  • 5. Industry Environment (Change Driven by External Forces)  Electronic Medical Record Implementation: (continued) For eligible professionals in a rural health professional shortage area, the incentive payment amounts would be increased by 10 percent. Incentives under the Medicaid program are also available for physicians, hospitals, federally-qualified health centers, rural health clinics, and other providers; however, physicians cannot take advantage of the incentive payment programs under both the Medicare and Medicaid programs. Eligible pediatricians (non-hospital based), with at least 20 percent Medicaid patient volume, could receive up to $42,500, and other physicians (non-hospital based), with at least 30 percent Medicaid patient volume, could receive up to $63,750, over a six-year period. Physicians who do not adopt/use a certified Health IT system would face reduction in their Medicare fee schedule of -1% in 2015, -2% in 2016, and -3% in 2017 and beyond. E-prescribing penalties would sunset after 2014.
  • 6. Industry Environment (Change Driven by External Forces -continued)  Transition from ICD-9 to ICD-10 October 1, 2013: ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on and after October 1, 2013. Otherwise, your claims and other transactions may be rejected, and you will need to resubmit them with the ICD-10 codes. This could result in delays and may impact your reimbursements, so it is important to start now to prepare for the changeover to ICD-10 codes.  About the Version 5010 Transition on January 1, 2012: On January 1, 2012, standards for electronic health care transactions change from Version 4010/4010A1 to Version 5010. These electronic health care transactions include functions like claims, eligibility inquiries, and remittance advices. Unlike the current Version 4010/4010A1, Version 5010 accommodates the ICD-10 codes, and must be in place first before the changeover to ICD-10. The Version 5010 change occurs well before the ICD-10 implementation date to allow adequate Version 5010 testing and implementation time. If providers do not conduct electronic health transactions using Version 5010 as of January 1, 2012, delays in claim reimbursement may result. If health plans cannot accept Version 5010 transactions from providers, they may experience a large increase in provider customer service inquiries affecting their operations. Preparing for ICD-10 and Version 5010 – including potential updated software installation, staff training, changes to business operations and workflows, internal and external testing, reprinting of manuals and other materials, and more – will take time.
  • 7. Marketing The Fear      Experts predict a practice will spend over 80K per Physician to Implement ICD -10 and 5010. Reimbursements on average will continue to decline. Operating costs (malpractice, benefits, ect.) will continue to rise. Third party payers will ramp up claim denial patterns and enforce regulatory compliance. On-going trend of increasing self pay patient outstanding accounts.
  • 8. Strategy For Consistent Lead Generation   Build referral relationships Educate yourself on the entire Revenue Cycle Management process. Revenue Cycle Management is defined as the Administrative duties, clinical and financial, that facilitate the collection of all revenues for the provision of care.
  • 9. Sales Goals (what are they)  Two to three physicians or healthcare providers signed per calendar quarter, with each generating approximate $2,500-$3,500 per month in contracted revenue. Example: Billing company collects 50K for Doctor X client in a month. $50,000 * 6% (contracted rate) = $3,000 (monthly revenue to billing company)
  • 10. Key Actions      Define your target market by specialty, size, and location of physician prospect. Defining your prospects will allow you to concentrate your marketing efforts in the right directions. Establish a dynamic web presence easily found through multiple search engines. Write article for various trade journals that are targeted to prospects. Volunteer to speak at various trade events.
  • 11. Key Actions (continued)      Attend prospect trade events as vendor/sponsor. Direct mail solicitation to target markets. Institute an aggressive telemarketing campaign. NETWORK, NETWORK, NETWORK If you are not Networking, then you are Notworking
  • 12. Open Discussion    Current obstacles encountered: Questions: Role Play: