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Advice You - Medical Billing - How Bad Are Things Really?
Everybody hears about how the medical billing industry is robbing us blind. Medical costs are out of control, or at least so they say. Medical
According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
billing software, just to be able to run your medical billing practice, costs an arm and a leg. Medical billing agencies like Medicare and Medic
; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.
Examples of combination products may in
Examples of combination products may in
aid, Blue Cross, Blue Shield and even private insurance companies are ripping us off left and right. Nobody wants to pay claims, or at least tha
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
t's the perception. But what's the reality? Does anybody who is doing the complaining really know? Medical billing statistics are posted all o
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
ver the place, especially with the Internet being so filled with information. But does anybody really take the time to look up the stats to see
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
ow bad things really are?
For example. Did you know that it costs between $8 and $10 to process the average medical claim? Now maybe if you're
For example. Did you know that it costs between $8 and $10 to process the average medical claim? Now maybe if you're
ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
charging a procedure that costs thousands of dollars, that's not such a big deal. But what if you're putting in a claim for a $50 walker. That
easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
's almost 20% of the total cost of the item, which is absolutely absurd. So yes, in this case, costs are crazy. And the problem is very simple.
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
To process a claim, the same procedure must be followed, regardless of what the service being billed is. If the walker could be processed at a
and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
cheaper cost, no problem. But that is just not the reality of it.
Forgetting about claim processing costs, what about salaries? Well, for the
Forgetting about claim processing costs, what about salaries? Well, for the
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
fortune 500 company like Prudential, paying a salary of $35,000 a year for a claims processor is not such a big deal. But when you're talking ab
ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.
Following aspects would a
Following aspects would a
out a non profit organization like Medicare, which is actually running in the red and in danger of shutting its doors, paying these people that s
dd to the challenges in developing combination products:
Which markets to tap where the combination products can do fairly well?
Which combination prod
Which markets to tap where the combination products can do fairly well?
Which combination prod
ame $35,000 a year is insane. But they have to. Why? Because if they don't, where do you think they're going to go? To the private sector of
cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
course. So salaries must be competitive.
What about turnaround time for claims. Yes, we all complain that our claims take forever to get paid.
What about turnaround time for claims. Yes, we all complain that our claims take forever to get paid.
tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
But what we don't understand is that the people who are really getting killed are not the patients, because they will eventually have their cla
t?
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
ms paid, but the billing companies. Turnaround time for paper claims can be anywhere from 30 to 90 days or more and this really puts a strain on
ping new procedures for reviewing their safety, efficacy and quality.
Professional from academic institutions, pharmaceutical industries, health care indust
Professional from academic institutions, pharmaceutical industries, health care indust
a company and its cash flow. So as bad as the patient may be having it, the medical billing company is suffering big time.
When you add all th
When you add all th
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
is to the cost of just starting a medical billing agency, you can see that the industry itself is behind the 8 ball before it even begins. Throw
.
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
into this mix doctors who back in the 60s charged $15 for a doctors visit, now charge anywhere from $50 to $100 for a visit and what you end up
elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.
Companies that provide selfless information through particip
Companies that provide selfless information through particip
having are costs that are totally out of control.
This is a spiral that is most likely to continue until people can no longer afford to get sick
This is a spiral that is most likely to continue until people can no longer afford to get sick
tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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