Advice You - Business

A new industry of high-technology medical billing has mushroomed under the auspices of its promise to streamline the collections process and leave doctors with more time to care for their patients. Though man

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

y high-quality services and systems exist, an overwhelming variety of options and attractive (yet unsubstantiated) performance claims from some providers have charmed busy doctors into making poor strategic de

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

isions for their practices. "It is surprising how many clinics use a 5-year ROI analysis to justify an investment in technology that will become obsolete in 2-3 years," says Dr. Frischer, a Clinical Professor

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

at Stony Brook University and three times named in New York Magazine's survey of the best doctors in the Metropolitan Area.

Billing Quality Statistics

In order to understand how bad the providers’ f

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

nancial situation is, it is important to recognize that in an average practice, 17.7% of accounts receivable are 120 days past due. In other words, about 1 in 5 procedures billed today won't get paid until fo

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

r months from now. Although this may not seem to be a problem, as it would be expected that the money will come eventually, in fact an unpaid claim that is 180 days overdue has less than 1% chance of ever bei

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

g paid. This may be good news for insurance companies, but it is certainly bad news for doctors.

Importantly, the very fact that these statistics are news to some practices is part of the problem: many medic

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

l practices don't even know their basic financial parameters such as "AR past 120," though it is a standard metric in the industry. As a rule, medical practices seem to be uninformed when it comes to their fi

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

ances, but it's a safe bet that any payer still in business knows exactly how much has been collected and how much is owed, down to the last penny.

Uneven Playing Field

Providers and payers are play

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

ng tug-of-war on opposites sides of the same claims, but the payers have made significant investments in infrastructure and personnel, akin to coming equipped with special gloves, drying agent for the mud, and

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

erythropoietin for the players on their team. Providers, on the other hand, are playing in the worst of conditions. Except for the initial claim submission, they are completely passive at every step. They w

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

ait for the payer to review the claim, wait to receive the errors, wait for the review of the corrected submission, and wait, and wait.

In the medical practice this “waiting” can be difficult to appreciate be

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

ause everyone is busy with new submissions, resubmissions, and reconciliations --there is always a mountain of work to do. There is little time to take a more active role. So how can everybody be so busy if

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

o little is getting done? Several reasons: The work is so painfully boring and the error rate is so high (45-55% on average!) resulting in a significant amount of the staff's time expended on resubmitting cl

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

ims so error-ridden they had should not have been submitted in the first place.

BillingWiki - a Shared Repository of Billing Solutions

The rules of the game will not change in the foreseeable future

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

and the payers will continue to own the tables for at least that long, but today's medical practice is not doomed to lose every hand. More and more practices are learning that by playing the game smarter, th

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

y can spend less time thinking about collections and more time with patients. What's the secret? It boils down to finding errors before the payer even knows the claim exists. This is no small task, but clev

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

r operations-research-types have identified major trouble spots in the process and made dramatic improvements in a variety of ways. BillingWiki is a collaborative repository of such solutions.

BillingWiki of

.

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

ers fresh perspectives on the complexity of medical billing, which is consistently underestimated by medical practices everywhere. "As a free, collaborative resource open to the medical community," Dr. Frisch

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

r says, "BillingWiki is an indispensable guide. BillingWiki is the Wikipedia of medical billing." BBC News has called Wikipedia "one of the most reliably useful sources of information around, on or off-line.

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

HTTP = HTML link (for blogs, profiles,phorums):
<a href="http://www.adviceyou.org.ua/article/3362/adviceyou-Shared-Electronic-Medical-Billing-Knowledge-Base-For-Improved-Control-Compliance-And-Performance.html">Shared Electronic Medical Billing Knowledge Base For Improved Control, Compliance, And Performance</a>

BB link (for phorums):
[url=http://www.adviceyou.org.ua/article/3362/adviceyou-Shared-Electronic-Medical-Billing-Knowledge-Base-For-Improved-Control-Compliance-And-Performance.html]Shared Electronic Medical Billing Knowledge Base For Improved Control, Compliance, And Performance[/url]

In this installment of medical billing, we will be covering the HA0 record, which is extra narrative information. We will explain what it is for and why it is so important.

Business incorporation is a form of legal arrangement open to any business. There are advantages and disadvantages to the corporate form of business which is why you need to consult with your lawyer and accountant to determine if incorporation is the form that you require.

Fleet Management is an issue that any company will be faced with if they have a number of trucks that are used in the course of business. Fleet management is a means of controlling, tracking and monitoring the vehicles that are used in the company.

Tags

Links

Advice You - Shared Electronic Medical Billing Knowledge Base For Improved Control, Compliance, And Performance

Related Articles: