Hospitals suffering from fewer paying patients that take longer to pay, stock market investment losses, and tighter credit from banks

March 25th, 2009 by admin

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Now, because of the recession, many U.S. hospitals are being squeezed by tighter credit from banks, stock market investment losses and many patients have become recently unemployed or otherwise lost their insurance or are now underinsured.  Many are not paying their bills.

All of these conditions have begun to trigger more hospital closings as well as layoffs, cost-cutting in the delay of purchasing new technology and stopping or delaying building projects.

The most susceptible are rural hospitals and big urban hospital in areas with excess empty hospital beds and a lot of poor patients, or the underinsured/uninsured patients.

Hospitals in the United States, employ approximately 5 million people, are reporting that investment returns are down due to the stock market, patient visits have lessened and profitable diagnostic procedures (as in MRI’s) and elective surgeries (as in joint replacements) are declining as people with inadequate insurance or high deductibles delay care. But many of those patients are turning up later at the Emergency Room, seriously ill. This makes it tough for hospitals to lay off nurses and doctors.

All those problems are aggravating their financial status: low reimbursements from commercial insurers and high labor and technology costs. The rising number of people with high-deductible health plans is increasing unpaid patient bills.

In the past year, patients and insurers have been paying hospital bills more slowly due to the economy. As a result, some hospitals want start demanding up-front payments for elective procedures. The problem with this is Medicare, Medicaid, and most commercial insurance contracts do not allow this type of practice to occur.

The cost of borrowing will likely be higher for everyone.  Hospitals borrow for everything from expansions and equipment to payroll and supplies. Hospitals will have to look to other options for huge expenses.

Some hospitals are deferring millions in equipment purchases, shifted management meetings to free facilities and adopted employee suggestions to save millions more.

Some hospitals are doing well financially if they are in control of their expenses. Many closings and bankruptcies are increasing.

Hospitals have to cut costs by outsourcing services like housekeeping, security, coding staff, transcription, and trimming staff through layoffs, and hiring freezes. Since there are many staff shortages many hospitals are trying not to touch patient care jobs — nurses, pharmacists, physical and occupational therapists and X-ray technicians.

Looking at your expenses is critical in determining where money can be saved without the loss of jobs and services. The husband and wife team of Medical Consulting From A to Z (www.atozmedicalaudits.com) has saved many types of businesses money through process improvement. We have saved businesses over $50 million dollars. Businesses fail to look at where think they are not losing money, when in fact can be a big drain on their cash flow. We are so sure we can provide at least one area that can save money that we offer a guarantee. If we cannot provide in writing at least one area in writing that can save money for the business we will give a free four dates of service audit for one physician. Contact us at medicalconsultingfromatoz@yahoo.com if you are interested in learning more about our services.


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Reviewing your auditing and monitoring functions

March 20th, 2009 by admin

The OIG recommends considering the following questions when reviewing the effectiveness of hospital and physician  auditing and monitoring. Is your facility performing the following functions?
Is the audit plan reevaluated semi-annual or annually?
Does it address the appropriate areas of concern, such as the findings from the previous years’ audits, risk areas identified as part of the annual risk assessment, and high-volume service?
Does the audit plan include an assessment of billing systems and billing personnel in addition to claims accuracy?
Are coding and audit personnel independent and qualified with the certifications?
Is the auditor or audit department available to conduct unscheduled reviews?
Is the compliance department able to request additional audits or monitoring?
If the error rates are not decreasing, have further investigations into other aspects of the medical facility compliance program to determine hidden weaknesses and deficiencies?
Does the audit include a review of all billing documentation, including clinical documentation, in support of the claim?

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