Healthcare

Denial Management in the Time of Pandemic

Health crises such as COVID-19 pandemic are putting a strain in the healthcare system. In the lens of health insurance, policy cancellations add a different level of burden. While the government has support implementations such as Coronavirus Aid, Relief and Economic Security Act funding in helping businesses retain employees, there is still an expected increase in policy cancellations as a result of unemployment and the overall economic downturn.  It is also uncertain as to whether the government will provide relief to the insurance industry.

Despite the increased insurance cancellations, health insurance companies are taking the toll on paying for expensive tests and treatments for those policyholders that have COVID-19 coverage. According to American Academy of Actuaries, insurance companies without large cash reserves could have problems because of expenses related to COVID-19 care and the widespread waiving of cost sharing, including for treatment. It is then very important for insurers to have accurate medical coding and billing processes to avoid mistagging insurance coverage and making sure that cash flow is managed correctly.

Although the US administration declared a national emergency by granting HHS authority to waive certain Medicare, Medicaid and CHIP policies, pandemics are a phenomenon that not all health insurance companies have prepared for. There will be confusions over what the blanket waivers do insurance policies cover in an attempt to manage health crises with a finite amount of resources.

To track the spread of coronavirus and get paid for testing and treating, having accurate billing and coding processes are the key in helping providers in overcoming the challenges of a pandemic now and in the future. Also, having accurately coded medical procedures streamlines communication across the health system and reduces administrative rework decreasing costs at a time especially with the scarcity of resources. Prior to the pandemic, health insurance companies are already facing high volume of claims and billing errors. When the economy reopens, there will be a definit surge in medical claims and billing.

But since this is a new health crisis that health insurance companies are facing, some treatments and procedures will fall under the denial management system.

How, then, can you effectively manage denial claims in times of crisis?

Understand how and why claims are denied at the first place

Knowing why claims were denied is important in streamlining your process to maximize your collections revenue and preventing future denied claims from happening. Since most if not all of the patients are knowledgeable about the insurance denial system, it is your job to educate them on how they can solve the issue. But you can only do so if you and your team members are aware of the reasons for denied claims. This will also give you an avenue to create action plans on organizing and creating a system in place to keep track of your denials. 

Many health insurance companies and hospitals are adopting tools and technologies in assisting them in tracking the ‘when’ and ‘why’ the claims are being lost in the shuffle. This will help your company in managing denials and keeping an eye on which ones still need attention in the best way to maximize denial collections revenue. Keeping track of denied claims will help you see which areas in your denial management process are working and which need further support. Documenting both wins and losses, in regards to your unpaid claims helps in improving the efficiency of your organization and sticking close to the analytics in your strategy in denial management.

Identifying common denial trends and updates in medical codes

Being aware of the common denials is a crucial component of establishing an effective denial management process. Although each health organization may have a unique list, there are top causes for coding and billing denials common to every health insurance company which are; Coordination of Benefits, PIP Applications, Accident Details, Pre-existing Conditions, Name Misspellings and new emerging illness and diseases.

These denials may seem like a small problem initially but with continued tracking and analysis it may reveal larger issues within your health insurance company. Creating a system in the denial management strategy of your organization helps ensure that these problems are addressed on the set and also creates foresight for trends five years from now. Plan ahead, and you may see your list of common denials start to lessen. 

Being updated with the new codes in enabling COVID-19 tracking and billing can help in capturing testing and treatment claims. CDC announced in March that it has added the new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) emergency code created by the World Health Organization earlier this year. According to official guidance from the CDC, health insurance providers should only use U07.1 to document a confirmed diagnosis of COVID-19 as documented by the provider, per documentation of a positive COVID-19 test result, or a presumptive positive COVID-19 test result. Being aware of these updates and codes also helps in decreasing denied claims.

Outsourcing denial management process and team

It is then very crucial for health insurance companies to minimize their operational cost and secure accurate medical coding and billing processes to avoid mistagging of insurance coverage and making sure that cash flow is managed correctly especially in the midst of the recovery phase caused by the pandemic. Having a team of reliable and experienced medical coders, billers and claims processors who are crucial to accurately translate patient data into alphanumeric codes and properly tag which treatment and tests are covered by the insurance plan to make sure that the medical expenses are accounted for correctly and accurately. 

Partnering with a reputable & trusted outsourcing company that specializes in Revenue Cycle Management services and has expertise in denial management. Top denial management providers build great teams of highly trained billers and coders that are working with, negotiating and navigating the complexities of the insurance system. By outsourcing your denial management tasks, you’ll have more time to focus on the core areas of your business that require your attention. When choosing which outsourced company to partner with, there are two questions you should ask:

  1. Will they ensure exceeding customer satisfaction?
  2. Will their claims management assistance refute denied claims and increase cash flow?

Expanding other non-clinical related concerns such as medical billing, coding, claims and health insurance processing by partnering with an outsourcing company that is an expert in the Revenue Cycle Management (RCM) process who can provide these extended services virtually can be one of your key weapons in keeping your healthcare business afloat. This team can help in accounts receivable management including follow-ups of unpaid claims and resolution of denials. They can also take care of filing claims to health insurance carriers, post payments received, send patient statements and stay updated with the trends and changes that may affect client’s reimbursements. This results in >95% claims accuracy, 1 hour turnaround time and minimal to none denied claims by getting it right the first time.

At Infinit-O Global, we build great teams of medical billers, medical coders, clinical and medical abstractors that resolve claims denied by medical insurance carriers, stay up-to-date with the changes that affect client’s reimbursements and understand how the medical insurance industry works. Our aim is to create long lasting partnerships and endless opportunities for your business to grow on top of saving at least 70% on operational cost. We render a strong combination of business consultancy, process optimization, and outsourced services; all utilizing the latest technology to provide excellent value for our clients. We are ISO-certified, HIPAA– and GDPR-compliant, so your company and data are safe with us.

Infinit-O Global’s aim is to create long lasting partnerships and endless opportunities for your institution to grow while managing the sudden demand for healthcare. We render a strong understanding in medical review and analyzing clinical abstractors for health institution consultancy, process optimization, Revenue Cycle Management (RCM) process and outsourced healthcare services; all utilizing the latest technology to provide excellent value for our clients.

Let’s work together to Build a Great Denials Management Team.

7 days ago No Comments
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Flatten The COVID-19 Curve Through Telehealth

Historically, healthcare is immune to business vulnerability during a recession because there will always be a constant need for care and treatment as illness and diseases happen with or without crisis. Hence, the demand for healthcare is relatively constant across a business cycle. However, some crises such as a pandemic have a different tale to tell. Implementations such as physical distancing and lockdowns to reduce the risk of virus spread has affected the mobilization of healthcare across the country and across the globe and health care offices are feeling the pinch.

Not a single company in healthcare is not at risk for business vulnerability in any type of crisis. Especially with a health-related crisis, the bulk of the responsibility is carried by the providers of clinical care. If this won’t be contained and the curve of spread doesn’t decrease through time, the effect of a crisis upon the health and care system poses a vulnerability in the industry and goes beyond economic concerns.

telehealth

As of this writing, the COVID-19 pandemic has reached 3.51 millions cases with over 248,310 deaths and 1,156,991 recovered individuals. The US is now top one in terms of number of infected people, higher than China where the virus first spread. In only 2 months, China was able to flatten the curve of infection through aggressive testing and quarantine efforts. Another country that successfully flattened the curve of the pandemic is South Korea by preventing and delaying the spread of virus so that large portions of the population do not get sick at the same time. These countries were able to stamp out COVID-19 as soon as possible through:

  • Quarantining
  • Encouraging physical distancing
  • Encouraging working from home
  • Closing schools and other institutions
  • Placing hard limits on the size of crowds at events

Without treatment and vaccines available, physical distancing is about the only key to limit the spread of the virus. Reopening businesses and other non-essential commodities when physical distancing measures are in place throughout the country can halt in flattening the infection curve. Yet, enhancing and mobilizing the healthcare industry through telehealth into adapting to the new normal is one key measure to control and limit the pandemic. Now, what is telehealth and how does it help in flattening the curve? 

Telehealth is a virtual platform that allows healthcare interactions such as promoting long-distance clinical health care, patient and professional health-related education, and public health and health administration. The number one job for everyone is to avoid being a carrier or a distributor of the virus. Therefore, virtual healthcare such as telehealth can free up medical staff and equipment needed for those who become seriously ill from COVID-19 especially the people with greater risks like 60 years old and over, children, individuals with underlying health conditions and those with compromised immune systems. Keeping people apart and not congregating in small spaces such as clinics and hospitals can thwart the virus to roam from one person to another or as we all know as physical distancing. But keeping healthcare professionals apart from patients is called medical distancing and can be accomplished through telehealth.

How then can it flatten the curve?

Think of it this way, suspected and probable patients can stay at home and treat the flu-like symptoms instead of going to the hospital. Aside from the influx of patients in and out the hospital, staying at home can limit the spread of virus that can possibly  infect medical frontliners. But of course, these people still need ample treatment from professionals. This is where telehealth comes in. Through the use of video chat or phone call, medical providers can call in to assess and gather information to find out whether care is urgently needed, or self-monitor of symptoms at home is more advisable. It can also be used for regular check-ins during recovery, as needed. 

Sad but true, there are more than 100 healthcare professionals per institution under quarantine because they face head on and are exposed to infected people which in return raises concern on workforce capacity. If the spread will not be managed sooner, it will come to a point that supply of healthcare professionals will not meet the overwhelming demand. 

Another beauty of telehealth is balancing the load through disseminating the needed care to thousands of online clinicians. This helps medical facilities struggling to better serve patients during peak periods of the outbreak. Through telehealth, those under quarantine may still extend a helping hand through virtual check ups and consultations freeing up clinicians in performing in-person care.

While the number of outbreaks is spiralling, the need for healthcare does not exempt those people with high risk non-COVID-19 related illnesses such as cardiovascular diseases, hypertension, diabetes mellitus and cancer. Telehealth can come in handy beyond treating COVID-19 related cases by providing options to other routine care to the elderly and other high-risk patients. This is a calculated strategy to protect non-covid related patients from exposure while not limiting routine care. Limiting their exposure in the waiting room, emergency room or at the doctor’s office promotes decreasing their risk in contracting the virus especially since these people are more often than not immunocompromised.

Now if there will be an increased use of telehealth, what’s next?

If most health institutions use telehealth there will be a significant surge for online waiting queue and virtual healthcare providers may get overburdened. Streamlining up-front screening questionnaires, chatbots, and AI tools aid in making health processes and patient encounters more efficient for clinicians. The strategy of getting patient information while on hold helps practitioners by having already available data about medical history, symptoms, and other information needed to accurately diagnose.

It is also important to partner with an outsourcing company that can provide a team of healthcare professionals who can help manage the patient influx from this outbreak with the best healthcare practices at hand. The right outsourcing company can catapult the healthcare industry amidst the crisis by helping get clinicians working as quickly as possible where they’re needed most and at the same time targeting key metrics such as quality improvements in telehealth, decreased turnaround time for claims management, savings operation cost and most importantly access to the right pool of talents in the telehealth field – all while adhering in keeping health risks low through the beauty of being able to perform administrative tasks and support despite geographical distance.

Here at Infinit-O, we understand the impact of telehealth’s contribution in flattening the curve of this pandemic. Operational support and Revenue Cycle Management (RCM) support such as patient concierge, medical review specialist and other patient inquiry-related needs to back up production capacity and freeing clinicians from answering phone calls and responding to appointment inquiries. They can also help oversee the day to day peer review process from acceptance of medical cases for review, facilitating first level screening if applicable and preparation of case review documents to be endorsed to doctors, nurses and other healthcare providers.

We build great teams of registered nurses, clinical data processors, patient engagement specialists, medical coders, certified medical billers for claims concerns, clinical and medical abstractors among others. Our aim is to create long lasting partnerships and endless opportunities for your institution to grow while managing the sudden demand for healthcare. We render a strong understanding in medical review and analyzing clinical abstaractors for health institution consultancy, process optimization, and outsourced healthcare services; all utilizing the latest technology to provide excellent value for our clients. 

We are ISO-certified, HIPAA– and GDPR-compliant, so your company and patient data are safe with us. HIPAA-compliant companies can provide telehealth services during state emergencies and can transmit any health information in electronic form.

By expanding consultation services and other health related concerns such as billing, claims and insurance through telehealth in partnership with an outsourcing company that can provide these extended services virtually can be one of the key weapons in flattening the infection curve. Having an organized health triage system aids the existing burden that in-person clinicians are shouldering.

Let’s work together in Building a Great Telehealth Team who can duly respond with the expanding healthcare needs.

Start small. Exceed expectations. Think infinitely. Think Infinit-O.

2 weeks ago No Comments
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The 2 Best Reasons to Get an Expert in Health Informatics

Average read time: 5 mins

  • What is Health Informatics
  • What does an expert in Health Informatics do?
  • Why should we get an expert?

It has become more apparent in this modern time that taking care of our health is not so simple, and it can also be costly and frustrating. Thankfully, with the progress of our technology Health Informatics is reducing the challenges of the medical field such as getting the same information (medical history, test results, allergies, etc) to the nurses, doctors, other healthcare providers and even insurance companies. 

First of all, What is Health Informatics? Health Informatics is the collecting, storing, managing, and studying of medical data. This data will be in the form of EMR (electronic medical records) or EHR (electronic health records), and will be given to all their healthcare providers for maximum efficiency. The main difference between the two is that EHR’s records are more broad while EMR is more specific. The data can include but is not exclusive to contact information, medical history, immunizations, patient’s demographics, allergies, laboratory data, vital signs, and current and past medications, and radiology reports. 

What a Health Informatics expert will do is develop and manage the systems on which all this data is gathered. They provide the software for the hospitals or wherever they work and keep it safe while also analyzing all the necessary information. This way all the healthcare professionals under the same system have the convenience to access all the data easily. If that hasn’t convinced you yet of the usefulness of it then here are the 2 best reasons to get an expert in Health Informatics.

Improved and Efficient Results

blographics stethoscope

Doctors and nurses provide and consolidate the data of their patients so they can take care of more people quickly and effectively. Since everything is more coordinated and organized, there will be no worrying about scrambling for all the necessary information. Instead the only thing the healthcare professionals will focus on is what was always the priority, the health of their patients. The best thing to remember is that the main purpose of Health Informatics is to help healthcare providers save lives. This happens through organizing patient’s information and records for easy access by any healthcare professional, resulting in a quicker diagnosis and treatment, and minimizing miscommunication between each healthcare department. Especially during a pandemic like COVID-19, having organized patient records help healthcare providers in tracking and classifying those who are patient under monitoring (PUM) or patient under investigation (PUI).

Saving time and money

Thanks to Health Informatics more procedures are being automated rather than being handled manually such as the collection and logging of medical information. This helps free up more time for the doctors, nurses, and hospitals to focus on their patients and even leads to saving more money because less work is done. Through proper handling of the information more lives will be saved by avoiding medication errors which killed 550 people daily in 2017, in the US. In the US the healthcare cost due to adverse drug events (taking the wrong medication) was about 136 billion dollars. Other errors can also be because of doctor’s handwriting, misreading orders, poor communication, and poor documentation. An expert equipped with Health Informatics literacy can greatly reduce the costs of healthcare and improve the lives of both patients and caretakers.

Closing Remarks

The world is full of complex and specialized diseases, and the human body is still not fully understood. Problems such as lost medical information, slow or lacking results should not be an issue that hospitals or patients face in these trying times. People deserve the best care that can be provided for them.

At Infinit-O Global, we build great teams. Our goal is to create long lasting partnerships with our clients; rendering a strong combination of business consultancy, process optimization, and outsourced services; all utilizing the latest technology to provide excellent value for our clients. We are ISO-certified, HIPAA– and GDPR-compliant, so your company and data are safe with us.

We understand the value of Health Informatics and how it can drastically improve the lives of those using it. Our priority is to improve your healthcare business through our state of the art technological solutions. We can help provide you with an expert in Healthcare Informatics that has proficiency in information technology, skills in project and data management, and excellent with strategy and planning. It could be a nurse informatics, chief medical information officer, director of clinical informatics, clinical data analyst, or an IT consultant that specializes in Health Informatics. The main goal is to help save lives, and we can achieve that if we work together.

Let’s Build a Great Team for you – starting with Healthcare Informatics. 

Start small. Exceed expectations. Think infinitely. Think Infinit-O.

2 weeks ago No Comments
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First Impressions Last: Turn your Patients Into Advocates

Every physician knows that when patients are happy they are likely to become their most loyal advocates. Making your patients happy is important not just because it affects patient retention and clinical outcomes but because they also need emotional support and care at every stage of the treatment. Right from the time when patients enter your facility to the day they return home, it is your facility’s responsibility to offer assistance and care for leaving a lasting impression.

Especially with the influx of people visiting hospitals amidst the COVID-19 pandemic, taking care of each and every patient, may it be a Suspected Case, Probable Case or a Confirmed patient are all equally crucial. These people are not only looking for diagnosis and treatment but are also seeking assurance that they can overcome the novel virus.

When a healthcare provider leaves an excellent first impression on patients, they can promote their services through word of mouth or social media channels. 

Thanks to these new and unique platforms, health practitioners can enjoy steady growth. Today’s businesses can expand their services through social media marketing and promotional campaigns both online and offline. However, that does not undermine the role their patients play in promoting their services.

Word of mouth promotion and testimonials work better than ads because people pay more attention to the experiences of their friends and relatives. That’s one of the reasons why this type of promotion yields consistent and profitable outcomes.

When your happy customers become your most prominent and most influential advocates, they convince their friends, family, and network connections to try out your services at least once.

In addition to providing quality services to your patients, here are some of the most useful tips through which your customers can become your strongest advocates.

Outsource Patient Concierge

The amount of patient inquiries, appointment setting, medical history taking, organizing patient’s records up to medical claims and billing coming in on a regular day is already in large volumes. But during health crises these numbers spiral up to twice the expected figure. When you outsource patient concierge, you work with specialists who assist patients during their first or 100th interaction with a medical facility taking care of not just medical claims but also assist patients with other medical related concerns.

Outsourcing companies can offer flexible and customized solutions to optimize your business. Whether you need a small or large team of healthcare specialists such as Patient Concierge Specialists, Nurse Triage Experts, Clinical Abstractors, Medical Review Specialists, Medical Billers and Coders among others can take care of many operations from telemedicine to medical billing and claims management up to appointment setting. By taking care of your patients you can then focus on improving your core services. 

These qualified professionals answer the inquiries and concerns of your patients and facilitate them in completing their check-in processes. Partnering with a company who builds great teams of patient concierge specialists can help you provide an ultimate patient experience to your expanding business.

Engage New Patients

patient in bed

Do not lose the opportunity of making a new patient your brand ambassador. Whenever a new patient walks into your clinic, facility, or hospital, make sure you leave a lasting impression. Greeting your patients the right way also plays a crucial part in making a new customer happy. Make some effort to know them better so you can provide a more personalized treatment plan.

A hospital’s management or staff performs various tests and tasks on every patient and the best approach your staff should take is to explain each step of the way. This technique helps patients to relax, and they do not feel uncomfortable during any aspect of the treatment.

Generally, it is the little comments and small gestures that go a long way to make your patients feel safe and happy. Whenever a doctor or a staff member is discussing any health conditions, he/she should make eye contact with the patient. Remember to put yourself in their place. How would you feel, and what would you expect out of healthcare providers and medical treatment you ought to receive?

Foster Relationships

Our emphasis should be on fostering and nurturing patient-clinician relationships. Caring for patients when they need it the most helps medical facilities to create and retain patients. During the treatment, medical professionals may need to break the bad news to the patient or his family. Showing empathy and care can help patients cope up better and value your services even more.

Create Targeted Content on Social Media

When you interact with your patients online, remember to provide correct, useful, and unbiased information. Focus on producing the most relevant and only high-quality content for your audience. Research the standard terms and keywords that a large part of your audience uses to search every day. Use these keywords as a guideline to create tips, messages, articles, blogs, and posts for educating your patients.

Creating a social media calendar will help you post different types of content throughout the year. When you offer valuable content to your patients, it builds your credibility. Your audience awaits your posts and shares your content within their network.

Share Tweets and Posts  

Apart from creating your unique content, your team should carefully choose success stories and your patients’ experiences online. You can also encourage your satisfied and happy patients to spread the word by sharing their experiences on your pages.

Sharing content that your patients create is digital gold. This type of content is authentic, generates leads, and promises organic traffic to your business website. Testimonials on LinkedIn, Facebook, Twitter, Instagram, or other channels and sharing uplifting stories grab the attention of potential customers.

Offer Excellent Services

No tweets, likes and posts will offer long-term results if you do not provide excellent services. Your patients will never become your advocates if you fail to diagnose their symptoms or mistreat (reword – positive) your patients.

A great team works because every team member shares the same goals and visions to achieve targets. If you want to be a household name, your team must work with an open-minded approach for improving and offering transparent services. Remember that customer advocacy is rooted in patient satisfaction and the best services.

When you provide state-of-the-art services to your patients, they automatically become your biggest cheerleaders.

Take Pleasure in Your work

Take the history of any successful healthcare provider or hospital, and you will find one thing in common. They all love serving humanity. Although practicing medicine and/or running a medical facility is a type of business, you will be challenged to accomplish any long-term goals if you don’t do it with all your heart.

Providing care is the top priority of any healthcare facility. It contributes to a positive patient recovery experience for improving the mental and physical quality of life for patients with various health conditions. Having the right team to work on non-care related tasks will allow you to focus on offering personalized care that can help patients overcome anxieties and their natural fears.

Acknowledge Negative Feedback

We all make mistakes at some point. The best way to rectify a mistake is to acknowledge it as soon as possible and make amendments if possible. Never cover up an error or place the blame of any wrongdoings on your patient.

In many cases, social media becomes a warzone for nasty comments. Avoid confrontations, be kind always and request all online users to file a complaint offline so that your management can look into the matter. Partnering with professionals who know how to respond to such comments is the best way to avoid creating any problems because they know how to resolve a conflict without offending not just the patients, but their visitors as well. 

When your goal is to have an easy and wonderful experience with your patients, you must make every effort to create a great first impression and follow-through with that. Acknowledging a delay or a full reception room will only make your customers value your credibility more.

Final Thoughts

Exceptional patient service, an unwavering commitment to provide the best medical health facilities, fostering relationships, a peaceful environment and creating a wonderful experience can turn your customers into your advocates. 

Outsourcing patient concierge services can help you focus on providing an outstanding patient experience all the while saving up to 70% on operational cost. Also, in any unforeseen events such as calamities and health crises, partnering with an outsourcing company ensures a continued flow of business. You can consider it as your business continuity plan. When you pay attention to all the factors that contribute to your growth, you generate not only more revenue but happy customers who can promote your business.

At Infinit-O, we understand how important relationships are in any business. A bad complaint from one patient can affect your reputation if not addressed quickly and effectively.

By offering to build you a great customer service team, we assure you that your patients will not only have the best experience at your facility but your healthcare staff will be able to focus solely on patient-care. 

At Infinit-O, we build great teams. Our aim is to create long lasting partnerships and endless opportunities for your business to grow. We render a strong combination of business consultancy, process optimization, and outsourced services; all utilizing the latest technology to provide excellent value for our clients. We are ISO-certified, HIPAA– and GDPR-compliant, so your company and data are safe with us.

Let’s work together to Build a Great Patient Experience Team.

We can start small or large and exceed expectations. Think Infinitely. Think Infinit-O.

4 weeks ago No Comments
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How Nurses Are Using Health Informatics to Improve Patient Care

If you want to pursue a career that will make a mark in every patient’s life, there’s nothing as vital as the field of Nursing. 

While nurses execute orders from doctors, they are also to create a certain level of connection to the patients. They do this so patients will not worry about entrusting their lives to a total stranger.  At any given medical procedure, the doctors act as the brain who finds a solution to a problem. Nurses meanwhile are the hands that carry out to the patients what the doctors conceptualized. This is how vital their function is. Today, as the world of healthcare evolves, so does their function. They are now more empowered to decide on how a doctor’s decision will be executed.

In the field of healthcare, we all know a patient’s life is heavily reliant on every decision nurses and other healthcare professionals make. With the increasing nurse to patient ratio, nurses should also have their supporting arm to carry out their function.  This is where Health Informatics comes in. Introducing robust Health Informatics to their treatment and care plan will make them more efficient in taking care of the patients. 

What is Health Informatics?

Health Informatics started in Europe in the 1940s and mid-1970s in the USA. It is a form of healthcare discipline that uses technology in collecting data, organizing information, analysis, and management that enhance healthcare services. With the use of electronic records obtained, stable information management is built, resulting in high-quality clinical standards. And today, Health Informatics has reached its widest spread across the globe.

So how do nurses use Health Informatics?

Enhanced Patient Documentation Process

One key advantage of Health Informatics is having available data, both real-time and historical.  Having access to electronic data will make the work of the nurses easier. Manually written records need to be read and understood; it takes time. Searching for a patient’s medical history stored in a conventional steel drawer takes time too. Instead of doing those, they can quickly verify a medical record from an automated database in a computer. The needed information can be accessed promptly, having all the information on hand.

The kind of data stored in the database though must be kept accurate and complete. Bad data leads to bad decisions. Lack of data leads to delays in making a decision. The institution must ensure that only actionable data is collected to deliver health care service to a patient. 

Aid Nurses in Decision Making

Nurses work in a fast-paced environment. Every blink of an eye is equivalent to a life threatened or a life being saved. If nurses have quick access to data, making prompt and accurate decisions will not be hampered. The data will be the guiding point of nurses as they treat a patient’s condition. If there is a need for further studies, Health Informatics will be able to provide reporting and analytics, resulting in more sound decisions and actions.

In fact, according to an article from Saudi Medical Journal and Canadian Center of Science and Education, access to Health Informatics reduces medical errors hence enable nurses to deliver high caliber patient care. 

Refining Nursing Care Plan

Establishing Health Informatics means automating the nursing care plan. A care plan is a strategy of action that guides healthcare practitioners about executing patient care; NCP consist of identifying patient’s problem, nursing diagnosis, nursing intervention, rationale of action and expected outcome. Automating these data provides easy access to other healthcare practitioners that refers to NCP for providing treatment and carrying out necessary care procedures. With Health Informatics, computers are used to search and update the patient’s records. A decrease in processing time also allows healthcare providers to accommodate new  treatment and procedures without the need for longer coordination process among other healthcare personnel. 

Help Build Care Network among Healthcare Personnel

For a patient to be discharged from the hospital, may-go-home procedure needs to be done. These include final advice from the attending physicians, arranging financial matters with the billing section, checking with the housekeeping if there are concerns, ensuring that take-home medicines are available in the hospital pharmacy, and scheduling follow up visits after discharge. Coordination with the numerous, different hospital personnel prolongs the patient’s waiting time hence, increasing the agony of waiting to go home. With Health Informatics on hand and updated in real-time, nurses need not undergo long coordination. They can prepare the discharge report at once and release the patient.

This only shows that Health Informatics enables the merging of all the medical reports, findings, and records of a patient. There is a care network on hand. They can refer to the electronic record on hand instead of flipping through pages. 

Cost Efficiency 

In any procedure, processing time being shortened translates to cost savings. Less error in treatment provided, accurate tests and medication given, faster coordination between healthcare providers, all equates to efficiency and cost reduction. With Health Informatics, the productivity of the nurses increases as well because readily available information decreases procedure time such as deciphering doctor’s order and checking patient’s chart manually from time to time. With increased productivity due carrying out treatment faster, more tasks are accomplished, enabling the healthcare institution to not save just time but also save on cost. Automating data records also make processing medical claims more accurate which equates to minimizing billing errors, and equally cost efficient example.

Health Informatics also helps eliminate errors that have cost implications. If procedures are automated, errors are prevented if not, minimized to an acceptable level. This gives the institution savings on operational cost brought by the errors.

Building your Health Informatics

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The most challenging part is establishing your Health Informatics infrastructure. There is so much work to do. Doing it on your own will result in hiring healthcare practitioners thus allocating a higher budget on man power and up to date Health Informatics training.

Having someone who can round up a team of healthcare practitioners who are trained and knowledgeable in Health Informatics can aid your business in overcoming the aforementioned challenges. Leveraging on innovations such as Health Informatics help not just nurses and other healthcare providers but also your business in adapting with the ever growing trend in providing the best patient care and improving their overall hospital experience. One thing you can do is to team up with a solutions partner such as Infinit-O.

Here at Infinit-O we understand the value of the doctor-nurse-patient paradigm. We provide Revenue Cycle Management, Nursing Triage, Patient Concierge, Data Analytics, Business Process Management, Medical Billing and Medical Coding and other healthcare support solutions. We stay on top of the latest updates in Health Informatics to ensure high-turnover of doctor’s orders to the nurses and limit patients wait time in receiving care. By building a great team of healthcare professionals, we can work together to accomplish the goals you are striving to achieve.

At Infinit-O, our aim is to create long lasting partnerships with our clients; rendering a strong combination of business consultancy, process optimization, and outsourced services; all utilizing the latest technology to provide excellent value for our clients. We are ISO-certified, HIPAA– and GDPR-compliant, so your company and data are safe with us.

Let’s Build a Great Team for you – starting with Health Informatics. 

Start small. Exceed expectations. Think infinitely. Think Infinit-O.

3 months ago No Comments
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advantages and challenges of

The Advantages and Challenges of Outsourcing Operational Support in the Healthcare Industry

Healthcare is one of the biggest and fastest expanding industries in the world.  Knowing how businesses grow with outsourcing can be used to your optimal advantage in the midst of a gliding health economy. However, to deliver exceptional patient care requires a considerable amount of resources and manpower. In effect, health facilities spend more on serviceable expenses to cater to the demand for quality.

In countries like the United States, there is a sky-high rise in the cost for healthcare. A recent Black Book Survey states, for an average hospital to break even, it needs to cut its cost to 24% by 2022. Fortunately, one great way to save overhead is outsourcing. An ever present need in any healthcare industry is Revenue Cycle Management which luckily can be outsourced. This entails some but not limited to the following:

  • Patient Scheduling and Registration
  • Insurance Verification
  • Medical Coding
  • Claims Submission
  • Denial Management

But the big decision is not which outsourcing companies are available in the market pool, rather, understanding how outsourcing can be favorable for your business. Laying out the gains and pains is one great way to help you decide.

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The Advantages

Allows Patient-Centered Care

Health practitioners cannot effectively provide excellent care if they are mired by the administrative and financial side of running a practice. By outsourcing non-core functions and optimizing revenue cycle management, you can focus more on what you do best — diagnosing and treating a patient. It is important to balance non-care responsibilities to promote curative and therapeutic services. Less administrative tasks help health personnel realign their focus on managing workload resulting in improved care standards and increased patient satisfaction. 

Reduce Billing Errors and Ensures Billing Compliance

Medical billing companies’ sole purpose is to guarantee that billing claims are accurately submitted in a timely manner. By hiring billers who underwent thorough training and those fully equipped with knowledge on the billing process reduces the number of denied and rejected medical claims. Altogether, it maximizes feedback assistance on reimbursements and future assets. Since this is an ever-changing industry, by working with an outsourced claims team, you stay up-to date with the latest changes in regulation and requirements to maintain compliance and ensure the submission of clean claim. 

Cost Effective and Improved Cash Flow

Most asked question in any industry is, “What to do if labor cost is growing faster than your business?”. By outsourcing, you can curb thousands of dollars from operational expenses while securing the steady flow of profit. Outsourcing generates a pool of professionals on behalf of the company, thereby saving you cost in acquiring and training additional staff. Reducing the workload and administrative burden from your staff increases productivity, efficiency and morale, which is directly proportional to increased patient satisfaction. Happy patients generate profit and improve cash flow by becoming living testimonies of the great service they received. Stable operations ensure quality health service, giving you a cutthroat advantage over your competitors.

However, with every gain comes with an analogues pain. To combat these challenges, awareness on these things fortify your success in the healthcare industry. 

The Challenges

Patient Data Privacy and Security Breach

Information breach predominantly transpires in healthcare thus careful evaluation of which outsourcing company to partner with is very crucial.  Not having direct control and supervision of outsourced staff can pose vulnerability on patient data and information. Whether intentional or accidental, unauthorized disclosure of patient’s information is a breach to the data privacy act and doctor-patient confidentiality. The more people who have access to private and confidential information, the greater the risk for breach. Knowing the pillars of information security is essential for providers and outsourcing partners to protect patient data and comply with HIPAA (Health Insurance Portability and Accountability Act of 1996) regulations. Other things to consider are companies with ISO-certification, complies with the General Data Protection Regulation (GDPR) and the Data Privacy Act of 2012, and superior IT infrastructure coverage. That being so, before considering any partnership, secure your position on the whole operational process.

Practical Limitations

Lack of access to information and miscommunication between the outsourcing company and the medical office can be limiting. In-house staff have easier access to hospital records and patient information than those off-shore. Therefore, during the contracting phase, it is crucial that the outsourcing team receives the proper information they need to function accordingly. It is equally important to partner with a company that has the proper tools and technical knowledge about your business to avoid viable disconnect.

Since outsourcing isn’t a panacea, it is the provider’s due diligence in ensuring that right services are outsourced to the right partners. Companies centered in building great teams of health professionals help you combat these limitations. Knowing the latest trends on the coverage and values of outsourcing also works to your advantage.

Process and Contractual Misunderstanding

Partnership may go downward spiral if the provider and the outsourcing party interpret the contract differently. No contract will ever be perfect, technical and legal lingo can cause contractual misunderstanding. Ergo, necessary adjustments on the terms and conditions should be implied. Managing expectations is as important as finding the right partner. Both parties are accountable in securing a fortified and effective linkage. That is why, before deciding to collaborate, medical providers should be aware of the common outsourcing misconceptions all the while surveying industry experts aligned with operational excellence. On the other hand, outsourcing companies should research more about the industry of their partners and arm their workforce with the proper technical knowledge. 

The Decision Phase

advantages and challenges decision

Weighing the advantages and challenges of outsourcing is the first step to embrace your company’s growth. Knowing the boons and banes of your prospective partners help you to identify what works best for your business. 

Finding the right partner is one of the biggest decisions you’ll ever make. Careful consideration of all the pains and gains of outsourcing can be dreary but is worth all the effort. Researching and reading more about the leitmotif catapults you to success because it gives you the liberty to choose what’s best for your company. True enough that there are a lot of fish in the sea – until you find the best team – then there’s only one. 

Infinit-O is a trusted healthcare solutions partner that can help you build and operate a dedicated team of well-trained healthcare practitioners & RCM professionals specifically designed for your unique needs, with cost savings of up to 70%.

We will assist in optimizing clinical documentation, streamlining medical claims, upto securing patient co-pay collection while you put more focus on patient care and promote patient wellness. By building great teams, we can match you to the right pool of  highly skilled doctors, dedicated license nurses and qualified medical coders that can help you grow your business. 

Start small. Exceed expectations. Think infinitely. Think Infinit-O.

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How to Optimize Revenue Cycle Management

How to Optimize Revenue Cycle Management

Revenue Cycle Management ensures the satisfaction of customers, improve revenue and generate profit—but what is it really and how can businesses harness its benefits?

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Blographics Your Healthcare Solutions Partner - 12192019

3 Essential Qualities to Look For in a Healthcare Solutions Partner

Revenue Cycle Management (RCM) is central to a healthcare provider’s improvement in ROI and contributes to patient satisfaction. However, the in-house staff might spend more time in actual patient care, or are not fully trained in various RCM tasks. There may also be a talent shortage in these RCM specializations. These scenarios may lead to errors in patient information, high denial rates, and ultimately lost revenue.

Download Infinit-O e-book: Pains and Gains in Your Healthcare Business Journey

This is why healthcare businesses are coming to global healthcare solutions partners to team up with and build teams to help them tackle pain points such as reducing billing errors, monitoring claims processes, and efficiently verifying patient eligibility, among others. Not only does partnering up with a solutions provider reduce costs, but it also gives businesses guaranteed results that meet and exceed their expectations based on their agreed KPIs, whether it be the accuracy of processing or improving denial resolve rate to improve healthcare revenue.

But before you go and search for a healthcare solutions partner, what should you look for? Here are 3 essential qualities in a healthcare solutions provider.

Infinit-O is an expert in Healthcare Processes

1. Expertise in Healthcare Processes

Is your healthcare company having a hard time focusing on RCM because your in-house staff is experiencing an increase in workload? Count on a healthcare solutions partner to help you organize healthcare processes such as patient eligibility, appointment setting, and patient concierge.

Choose a partner that understands your unique needs that creates flexible and customized solutions for tasks in:

  • Clinic Documentation Integrity
  • Medical Coding
  • Medical Billing
  • Claims Processing
  • Other tasks within the RCM spectrum

Patients can have better experience and satisfaction given that they will know which services will be shouldered by their insurance provider and which ones they’ll co-pay. This will trust your company more and in turn, this will impact your company’s revenue flow.

Infinit-O complies with HIPAA, GDPR and other international legislations

2. Compliance with HIPAA and Other Legislations

Many healthcare providers hesitate when they want to partner with an outsourcing company because patient information might not be kept safe. Global healthcare solutions partners know that data security is an important aspect of their company, and will make great strides to keep your patients’ information away from any kind of cyberattack & security threats.

That’s why it’s crucial that your healthcare solutions partner is 100% HIPAA-compliant. This means that the patient data your business manages should be protected by the healthcare solutions partner that uses this kind of information. The outsourced team you work with should understand the nitty-gritty details of compliance programs so that they can help your business meet strict security requirements, such as intrusion detection and prevention systems, Palo Alto next-generation firewall, gateway antivirus programs, internet access control, and SSL-based connections.

Check if they’re also ISO-certified and following GDPR regulations, and if they are aware of California Consumer Privacy Act which will take effect on January 1, 2020.

Infinit-O gives Access to Healthcare Specialists

3. Access to Expert Healthcare Specialists 

Are you experiencing challenges in hiring an in-house staff due to a high price job market? You might want to consider building a team with a healthcare solutions partner. Healthcare service providers nowadays turn to global solutions partners not only to reduce costs but also to acquire access to medical coders, billers, and claims processors. These specialists, from registered nurses with experience in a clinical setting to allied health professionals who specialize in medical coding and claims processing, can help you improve productivity efficiently with reduced errors.

With these three qualities in mind, you can look for the right healthcare solutions partner that can help you build a dedicated team of highly skilled RCM specialists as you focus on your competencies that improve and maintain high patient satisfaction, which ultimately leads to a better return of investment and reputation.

Infinit-O is a trusted healthcare solutions partner that can help you build and operate a dedicated team of well-trained healthcare & RCM professionals specifically designed for your unique needs, with cost savings of up to 70%. We can help you meet your goals, whether they be growth, better productivity or simply bottom-line cost savings. With access to excellent healthcare talent who use cutting-edge technology, we provide some of the best strategic solutions for your business. We are ISO-certified, HIPAA- and GDPR-compliant, so your company and patient data are safe with us.

5 months ago No Comments
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Blographics Outsourcing in Healthcare... - 11262019

Outsourcing in Healthcare Industry: 5 Reasons to Do it

The global healthcare industry’s interest in outsourcing has grown massively in recent years due to the industry’s drive to reduce costs while still being able to provide quality healthcare service.

Before, the industry limited their outsourcing to medical data entry and medical transcription. But with the growing awareness that outsourcing has greater benefits for healthcare organizations and hospitals, many are looking into outsourcing healthcare information management systems, clinical research, Big Data, medical billing, and IT needs to keep patient data secured among many others.

According to Jonathan Clarke, Assistant Professor of Health Policy and Administration at Penn State University, “Outsourcing is something we should think about, especially when it fuels efficiency and expands access to healthcare, but we need to be intelligent about it so as not to put patient safety at risk.” He also stated that around 90% of the hospitals in the Unites States are outsourcing some services particularly radiology services.

We list down five reasons the healthcare industry should think more about outsourcing their non-medical operations:

1. Critical Mistakes are Avoided

According to Tom Lowery in his article entitled 8 Ways Outsourcing Can Help Hospitals and Patients, US hospitals leave about $125 billion on the table each year because of poor medical billing practices. He adds that 80% of medical bills contain errors. One factor that contributes to this is that some hospitals are not updated with currently changing billing rules and regulations. With outsourcing, healthcare organizations can have a dedicated team of trained professionals that focuses on billing purposes.

2. Reduced Training Costs

Healthcare organizations that outsource their processes don’t also need to worry about shelling out extra money for education, software or staff training since the outsourcing partner sees to it that their employees are up to date with the latest changes in standards and regulations.

3. Access to Expert and Trained Professionals

There is no need to spend time finding trained professionals for healthcare processes because they will be ready to take on the job as soon as an outsourcing partner is signed in. Employee acquisition and retention isn’t also a concern anymore since these will be handled by the outsourcing partner.

4. More Focus on Giving Quality Patient Care

With an outsourcing partner taking care of looking for a healthcare organization’s staff and training them, healthcare providers will be able to focus on the more important things in the business – in this case, giving the best quality of care for patients. Outsourcing will help providers to lessen their tedious administrative and managing workload, and allow them to provide a positive patient care experience and improve on it as well.

5. Top-Quality Results with Cost Reduction

The biggest advantage of outsourcing healthcare services is the reduced costs in healthcare operations. Outsourcing brings in huge savings with its low-cost manpower and infrastructure. Healthcare outsourcing can help save companies 30-60% of costs. Aside from taking care of staff acquisition and retention, having an outsourcing partner also reduces excess administrative costs since the direct benefit of outsourcing is financial surge.

The Philippines is Top Healthcare Outsourcing Destination

In the next few years, the Philippines is set to become the top healthcare outsourcing destination thanks to its massive qualified workforce, infrastructure, and technology. The country’s outsourcing industry has grown over the recent years and is forecast to hit $2.4 billion in revenue in 2016.

“The Philippines right now, with the way you’ve been able to show how successful you can be with other industries with BPO and other areas, healthcare is the industry where you could play the mark of the world leader,” said public sector and healthcare leader at PricewaterhouseCoopers (PWC) Southeast Asia Consulting.

With our extensive list of outsourcing services available, medical providers—either a Healthcare Payer or a Healthcare Provider, or those belonging to the Software-as-a-Service (Saas) industry or the Pharmaceutical industry, all of these can trust us with everything they need. Being ISO 270001:2005 certified, ISO 9001: 2008 Certified and Six Sigma qualified, we guarantee nothing but the best when it comes to improving your services.

5 months ago No Comments
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Infinit-O Healthcare Kaiser Permanente

Big Data in Healthcare and How Kaiser Permanente Uses It

Electronic medical records (EMR) has not only helped transform the medical information system to be better, it has also allowed the collection and subsequent application of Big Data that ultimately plays a major role in changing patient care in the process.

Even if Big Data faces much controversy and open data still has so many hurdles to go through in the healthcare industry, there is no doubt that this progress has pushed the industry straight into the information age and California’s Kaiser Permanente is showing what can be done with the huge influx of data they are receiving. Kaiser has been using data collected since 1993 in several ways, notably using this information to help treat the youngest patients – infants.

Kaiser Using Big Data to Help Care for Infants

Basing on the data sets maintained by Kaiser Permanente’s Division of Research (DOR) of vital signs of mothers and their babies who developed sepsis, doctors in Kaiser Permanente’s neonatal intensive care units (NICU) created an online calculator to determine the risk of sepsis in preterm and newborn babies.

According to Kaiser’s DOR research scientist Michael Kuzniewicz, MD, MPH, “Prior to the online sepsis calculator, a maternal fever of 100.4 or higher meant a trip to the NICU regardless of how a baby looked, or other risk factors, that meant separating the mother and baby, starting an IV, and putting the infant on intravenous antibiotics. Now we can be smarter on which babies we identify to evaluate and treat for infection.”

The Kaiser sepsis calculator for neonatal care isn’t the only accomplishment done with Big Data. These system-wide health care implementations for newborns and preterm infants are all because of the data received from the patient information:

  • The identification of effective strategies to reduce dangerous bowel infections in preterm infants (called necrotizing enterocolitis)
  • Reductions in the number of days infants spend in the NICU
  • Fewer blood-stream infections associated with central intravenous lines
  • Greater percentages of high-risk infants born at Kaiser Permanente facilities with high-level NICUs, eliminating the need for infant transport

Big Data Helps Kaiser Hit Statewide Benchmarks

Even with issues of patient privacy and the debate about whether who benefits more on Big Data usage, the patient or the medical company (hospital or pharmaceutical company), Kaiser has proven that Big Data can ultimately help improve patient care.

Allen Fischer MD, regional director of neonatology for the region, acknowledges that the data provided by the DOR is indispensable in helping clinicians plan their quality activities. This has been proven effective since Kaiser has been using Big Data to develop quality benchmarks and monitor hospital performance with records going back to the 1990s.

Big Data from a Medical Perspective

Modern healthcare systems produce massive electronically stored data on an ongoing basis. If this treasure trove of information is used for improving patient care and growing knowledge and research for developing effective treatments, we have successfully used the advances of technology to our advantage.

No matter how cliché the statement, “Health is wealth” can be, it is definitely something that each individual should take into account. Need not worry though, because we can provide your medical institution all the assistance you’ll need through our exceptional patient services such as billing, coding, and even back-office responsibilities. Learn more!

5 months ago No Comments
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