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Do Electronic Medical Records Increase Revenues?
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Home Page > Health > Medicine > Do Electronic Medical Records Increase Revenues?
Do Electronic Medical Records Increase Revenues?
Posted: Feb 13, 2009 |Comments: 0
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Do Electronic Medical Records Increase Revenues?
By: Alok Prasad
About the Author
Alok Prasad is the President and CEO of RevenueXL, which is an EMR and Practice Management consulting firm based in Cupertino, CA. RevenueXL provides business transformation solutions including EMR / EHR and back office services including Medical Transcription, Medical Billing, Denial Management and AR Follow-up. RevenueXL prides itself in enhancing and accelerating healthcare revenues.
(ArticlesBase SC #768294)
Article Source: http://www.articlesbase.com/ – Do Electronic Medical Records Increase Revenues?
Does EMR increase revenues?
The economy has been in a recessionary trend for more than a year now. Whilst the economic conditions are challenging, the insurance companies are applying a squeeze on physicians to accept lower reimbursements. Funding by way of donations from private contributions is also reducing thereby adversely impacting availability of cash to implement an EMR / EHR system.
Any investment in EMR is justified only if it can help in increasing revenues, decreasing costs or overheads, improving patient care or any combination of the above resulting in maximization of reimbursements, collections and customer goodwill.
How does EMR/EHR increase revenues?
1. Improves charge capture: When traditional paper charts are used, many services performed in a physician’s office are lost and never billed. The billing staff may either completely leave out an E&M Code or may erroneously enter fewer units, all resulting in lower billing and therefore lower reimbursements to a physician. EMR software can increase revenues by facilitating capturing of charges for all services provided by the physician thereby avoiding lost revenues. In a case study (Nick Fabrizio, July 2005, QIO Presentation quote), a family medicine physician while seeing same number of patients increased revenues by $3000 per month due to timely visit documentation and automated charge capture.
2. Maximizes Billing: When using paper charts, to be on the safe side of the law, many physicians down code (use a lower billing code), rather than use an appropriate level of code. Providers who use EMR software can increase revenues by using System recommended E&M billing codes that are based on the service accurately documented within the EMR, without the fear of an audit. Medical Economics magazine has estimated that physicians, who routinely down-code to avoid audits, lose an average of $40,000 annually.
3. Optimizes reimbursement process: EMR software allows physicians to produce adequate supporting documentation that complies with CMS guidelines and supports the appropriate level of service to be billed. Accurate coding speeds up the reimbursement process and results in fewer rejected claims from insurance companies. Even better, an EMR helps produce clean claims the first time, significantly reducing the number of rejected claims!
4. Increases Physician productivity: When physicians do not use EMR, they have to spend several minutes per encounter, first dictating and then reviewing the transcript before signing the same. With an EMR, progress notes are automatically generated which can be signed electronically from home or work, with no pulling or filing of charts. The time saved can be used to see a few more patients each day. Further, the medical records storage space released as a result of implementing an EMR System can be used to add more consultation rooms. As a result, practices are able to generate more revenue with the same fixed costs in the same amount of time.
5. Increases Services with Health Maintenance Reminders: EMR Systems provide computerized checks and reminders which enable reminders to be sent to all patients who are overdue for recommended services, or who are coming up on their annual check-ups. This helps the physician to deliver enhanced patient care, while at the same time increasing service volume and revenue.
6. Increases sources of income: Electronic Medical Records (EMR) software can allow providers to apply for enhanced sources of revenue from various payers associated with higher quality of care, such as:
(i) DOQ-IT (Doctors’ Office Quality-Information Technology is one of the Physician-focused Quality Initiatives sponsored by the Centers for Medicare & Medicaid Services (CMS).
(ii) Healthcare Pay-for-Performance (P4P) programs like Medicare Care Management Performance (MCMP), which is a 3-year, pilot P4P program that encourages physicians to follow strict quality-control guidelines for treating chronically ill patients. During the first year of treatment, physicians receive bonuses for reporting data on quality measures and in the second and third years, participating clinics receive an extra annual performance-based bonus of $10,000 per clinician plus, an additional 25% reward for using a CCHIT Certified EMR.
To participate in a P4P program, a physician will need to track and measure care, and monitor the efficiency of delivering quality care at an optimal cost. One must also document the patients’ experiences using post-exam surveys. Most EMR systems are capable of meeting these requirements while simplifying the process.
How does it decrease administrative costs / overhead?
A typical medical office employs a transcriptionist, billing and clerical staff such as appointment schedulers, medical billers, collectors, file clerks and others. As a Practice grows, EMRs significantly reduce the need for more personnel to provide these functions, while at the same time, reducing existing office staff time that will no longer be needed spending valuable time hunting down records or filing patient charts. EMR-enabled medical offices mean fewer bodies in the office, generating greater efficiencies and accomplishing more.
1. Reduces transcription cost: Many physicians pay hefty fees for transcription of their medical charts. EMRs ‘virtually’ eliminate transcription costs since medical charts are created electronically at the time of the patient’s visit itself. According to Medical Economics (March 2002), physicians spend between $15,000 and $25,000 over the course of a year for transcription-related services. Implementation of an EMR eliminates the need to use in-house or outsourced transcriptionists. Integration of voice recognition software with EMR Systems also plays an important role for the people who want to have free formatted notes or for some providers who are not comfortable using mouse and keyboard.
Assuming an average of 25 visits per day and a conservative average of $2 per chart, an EMR brings instant savings of $50 per day per physician. Assuming that a physician works for 240 days in a year, this translates into potential savings of $12,000 per physician. Even if some or all of a practice’s physicians continue to use transcription, there is no doubt that these costs can be reduced significantly.
2. Reduces costs associated with storing paper charts: Once a medical office successfully converts to electronic medical records, all costs associated with purchasing, copying, management, storing or destroying paper charts can be eliminated. Additionally, the space typically used for storing patient charts can be utilized to create additional patient exam rooms, or increased office space, resulting in a more profitable use of resources. It is estimated that the total cost associated with maintaining a paper record average $3 per medical chart.
A case study revealed that a 12-physician practice saved $5,000 a year in storage space after converting to EMR. In another study, a major medical center in Boston seeing 750,000 patients a year, estimated they will save $6 million annually by reducing their dependence on paper records. At this saving rate, a practice seeing 5,000 patients annually could potentially save $40,000. In another case study, EMR implementation resulted in a reduction in office supplies expense by 50% with the elimination of paper charts.
3. Reduces liability and malpractice insurance premiums: Improved documentation, audit trails, and accuracy not only reduce incidents of medical errors, but also improve the chances of physicians receiving discounts from insurers. The cost of malpractice insurance has been showing a constant upward trend. A good EMR system leads to reduction in costs associated with poor documentation that otherwise generally means higher malpractice premiums.
a. In a 2005 survey by the Medical Liability Monitor, a four-state average of the highest liability rates for OB/GYN was $230,919. With a two to five percent credit from malpractice insurance companies, clinics would save $4,600 to $11,500 per provider, per year, if they implemented an EMR.
b. In another example, the Midwest Medical Insurance Company (MMIC) is offered a two to five percent credit to physician groups that used an EMR in 2008.
4. Self-service by Patients lowers data entry costs: The Patient Portal module of an EMR allows patients to enter much of their own demographics, even before they arrive to the Physicians office, including health insurance information, medical, family, and social history, and other pertinent data and this can save office staff a lot of data entry time. It can even allow patients to view certain information from their medical electronic file, and schedule appointments.
5. Saves time and increases efficiency: Staff and physician time is often ill spent due to:
i. Waiting: If a pharmacy calls while the chart is being used, or waiting to be filed, the staff receiving the call cannot access the information in a timely manner. EMR Systems allow multi-use access that enables staff to access and update patient records simultaneously – this saves time that would otherwise be spent in waiting for access to patient records.
ii. Time spent in pulling Medical Records: It is estimated that the cost of pulling and handling paper charts averages $5 to $12. In an EMR deployed Practice, Medical Records are accessible 24 x 7 from any web-enabled device or web access point, and this is done, securely.
iii. Data entry for billing purposes: When the EMR System interfaces or integrates with the Practice Management or Billing System, data entry workload reduces significantly while maintaining billing accuracy.
In a recent case study, a Practice reduced labor costs by 10% in the first year after implementing an EMR solution due to more efficient workflow and, the reduction of filing, coding, and data entry staff, while reducing time spent to complete clinical tasks such as Rx refills, referrals, lab, and diagnostic orders.
Revenue Acceleration and Denial Management
EMR implementation can help increase revenues but a physician practice must not forget to look at two other important and often neglected aspects:
1. How can revenues be accelerated by proactive AR Follow-ups?
2. How can we manage denials efficiently and expeditiously?
Revenue Acceleration
Experts believe that effective Account Receivables (AR) Follow up and AR Management are the most important areas requiring attention to ensure optimum revenue recovery. The average profit margin of US hospitals is less than 2% of Net Revenue while lost revenue due to denials accounts for an average of 6% to10% of net revenue, nationwide. In fact, take a look at these powerful facts:
• 14% of all claims submitted to payers are denied and have to be resubmitted, appealed, or written off by Providers.
• 50% of denied claims are never re-filed.
• 90% of denials are preventable.
• 50-70% of denied claims are recoverable.
This can cost a clinic or practice thousands of dollars every year. Aside from the direct impact from the loss of revenue, there’s an additional impact on resources because of the expense associated with reprocessing denied claims. A judicious combination of process, technology and people skills must be effectively used to follow up with the payers to identify, address and rectify the identified problem and accelerate your revenues so that you can get money in your bank – faster.
Denials Processing
Accurate coding speeds up the reimbursement process and results in fewer rejected claims from insurance companies. Sophisticated denial processing solutions can captures claims, payments, and denials and addresses your denial management issues with an effective denial management plan.
Here are some of the tools used to achieve high rates of denial reversals:
• Continuously update denials database
• Immediate identification of the root causes of denials, and use the experience and knowledge to address each denial trend
• Utilize denial data to generate custom reports
• Better feedback to the coding and billing team
Conclusion
The many benefits enumerated in this article can be experienced by all Physicians, however, the payback period (ROI) will vary from Practice to Practice. In most cases, Practices experience increased cost in Year 1, and then, begin seeing increased revenues and, decreased administrative costs and overhead from the second year onward. The key ingredient for success lies in the willingness of the Practice to critically examine their existing workflow and make recommended adjustments to optimize workflow efficiency. If these efforts can be supplemented with other revenue acceleration and denial management techniques, the Practice can see significant improvements in each and every revenue cycle Key Performance Indicator (KPI).
Retrieved from “http://www.articlesbase.com/medicine-articles/do-electronic-medical-records-increase-revenues-768294.html”
(ArticlesBase SC #768294)
Alok Prasad -
About the Author:
Alok Prasad is the President and CEO of RevenueXL, which is an EMR and Practice Management consulting firm based in Cupertino, CA. RevenueXL provides business transformation solutions including EMR / EHR and back office services including Medical Transcription, Medical Billing, Denial Management and AR Follow-up. RevenueXL prides itself in enhancing and accelerating healthcare revenues.
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emr ehr, dhr, medical records, electronic medical records, emr software, emr system, revenue acceleration, ar follow up, denial management, denial processing, medical transcription
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Alok Prasad is the President and CEO of RevenueXL, which is an EMR and Practice Management consulting firm based in Cupertino, CA. RevenueXL provides business transformation solutions including EMR / EHR and back office services including Medical Transcription, Medical Billing, Denial Management and AR Follow-up. RevenueXL prides itself in enhancing and accelerating healthcare revenues.
Categories: Doctors who accept medicaid Tags: Electronic, Increase, Medical, Records, Revenues
What Constitutes Medical Malpractice?
What Constitutes Medical Malpractice?
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Home Page > Law > Personal Injury > What Constitutes Medical Malpractice?
What Constitutes Medical Malpractice?
Posted: Jan 04, 2010 |Comments: 0
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What Constitutes Medical Malpractice?
By: Erich Shrefler
About the Author
If you believe you or someone you love has been injured due to a healthcare provider’s negligence, and you live in the Salt Lake City area, please visit the website of the Utah medical malpractice attorneys at G. Eric Nielson & Associates, LLC.
(ArticlesBase SC #1666405)
Article Source: http://www.articlesbase.com/ – What Constitutes Medical Malpractice?
The presence of medical malpractice is an unfortunate reality in today’s healthcare environment.
Every year in the U.S., anywhere between 45,000 and 98,000 people die from preventable medical mistakes, according to industry surveys of the American healthcare industry and the U.S. Centers for Medicare and Medicaid Services.
Medical Malpractice, Defined
Medical malpractice, also known as medical negligence, is an action or an omission of action by a healthcare provider that results in injury to a patient.
The healthcare provider can be anyone who is charged with provided some level of care, from an emergency medical technician (EMT) or registered nurse (RN) to a surgeon, family doctor, dentist or other specialist.
The test for proving medical malpractice or negligence includes establishing that the healthcare provider deviated from accepted standards of care, failing to administer the degree of medical skill and care that another healthcare provider in the same specialty area would give under the same circumstances.
The patient’s injury typically must be beyond minor, with long-term implications for the patient. Medical malpractice can also end in wrongful death.
Types of Medical Malpractice
The types of medical malpractice range from poor illness management to a operating on the wrong body part. Here are just a few of the other most common types of medical malpractice situations:
Unnecessary and damaging delay of treatment Errors made before, during and after a surgery Anesthesia mistakes, including not asking for a complete patient history that would reveal possible complications Medication/pharmacy errors Making the wrong diagnosis or failure to diagnose a serious condition Causation of birth injuries, including cerebral palsy and Erb’s palsy Using experimental medication, techniques or equipment without a patient’s consent Failure to recognize complications during pregnancy and delivery of a baby. Nursing home patient abuse or neglect Failure to make a patient aware of risks associated with procedures or medications Compensation for Medical Malpractice Cases
Medical malpractice laws exist to protect your rights as a patient should you be injured by a medical error. The laws are designed to help patients seek financial compensation for their injuries, including collecting damages for past and future medical costs; long-term speech, occupational, physical, cognitive or behavioral therapy; loss of income; loss of quality of life and/or companionship; and emotional pain and suffering.
Medical malpractice suits are notoriously complex. The most successful cases take advantage of experienced medical malpractice attorneys, skilled research and discovery teams and reliable, well-respected medical experts.
Retrieved from “http://www.articlesbase.com/personal-injury-articles/what-constitutes-medical-malpractice-1666405.html”
(ArticlesBase SC #1666405)
Erich Shrefler -
About the Author:
If you believe you or someone you love has been injured due to a healthcare provider’s negligence, and you live in the Salt Lake City area, please visit the website of the Utah medical malpractice attorneys at G. Eric Nielson & Associates, LLC.
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Personal Injuryl
Nov 25, 2010
Cosmetic Dentistry and Porcelain Veneers
One of the cosmetic dental procedures that have gained in popularity is porcelain veneers. Porcelain veneers can be placed to mask problems with teeth.
By:
Erich Shreflerl
Health>
Dental Carel
Aug 03, 2010
Digital Dental Impression Technology
Dental impressions, like most dental technologies, have advanced as state-of-the-art equipment became available. Many dentists these days use CAD/CAM devices to create digital dental impressions.
By:
Erich Shreflerl
Health>
Dental Carel
Aug 03, 2010
What to do After a Car Accident
It is estimated that the average person is involved in an accident about once every ten years. That’s about six or seven car accidents a person ranging from fender-benders to more serious incidents. Still, it is important for you to remember what to do after a car accident, and the more you hear it, the more you’ll remember it. This can help speed up the process of dealing with authorities and insurance companies, as well as keep you calmer after that adrenaline rush.
By:
Erich Shreflerl
Law>
Personal Injuryl
Aug 03, 2010
Who is at Risk of Traumatic Brain Injuries?
A traumatic brain injury will change your life. These are serious brain injuries with a variety of symptoms that may be seemingly mild, like a headache, or can cause paralysis, brain damage, and death. Few people will ever experience a traumatic brain injury (TBI) to themselves or their loved ones, but every day people put themselves at risk of this serious personal injury.
By:
Erich Shreflerl
Law>
Personal Injuryl
Aug 03, 2010
The light sensitive tissue that lines the inner surface of the eye is known as the retina. Retinal diseases vary from easily treated to difficult to diagnose, so making an appointment with an eye doctor in your area is vital for your long-term eye health.
By:
Erich Shreflerl
Am I A Candidate For Labiaplasty?
Labiaplasty reduces and reshapes the inner lips of the vulva. It has become a very popular cosmetic surgery procedure, and is sometimes chosen as part of a Mommy Makeover.
By:
Erich Shreflerl
Health>
Plastic Surgeriesl
Mar 05, 2010
lViews: 110
Am I A Candidate For A Partial Abdominoplasty?
Partial abdominoplasty is a similar procedure to full abdominoplasty, but far less extensive. It requires fewer and smaller incisions, and results in minimal scarring compared to the larger version.
By:
Erich Shreflerl
Health>
Plastic Surgeriesl
Mar 05, 2010
lViews: 123
Why See A Cosmetic Surgeon For My Eyelid Surgery?
This can be a very confusing subject. The problem is, any doctor, or even dentist for that matter, can call himself a cosmetic surgeon. You do not actually have to have any special training, education, or experience to make that claim. You just have to be a doctor.
By:
Erich Shreflerl
Health>
Plastic Surgeriesl
Mar 05, 2010
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If you believe you or someone you love has been injured due to a healthcare provider?s negligence, and you live in the Salt Lake City area, please visit the website of the Utah medical malpractice attorneys at G. Eric Nielson & Associates, LLC.
Categories: Doctors who accept medicaid Tags: Constitutes, Malpractice, Medical
Flagstaff Medical Center
One of the nicest things about living in Northern Arizona is you don’t have to travel to get excellent healthcare. Since 1936, Flagstaff Medical Center, a member of Northern Arizona Healthcare, has provided high quality healthcare services to the residents and visitors to Northern Arizona. We are dedicated to patient-centered care with a personal touch. FMC is licensed by The Centers for Medicare and Medicaid Services (CMS), and the State of Arizona.
Categories: Centers for medicare and medicaid services Tags: Center., Flagstaff, Medical
What Is Medical Billing And Coding
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Home Page > Business > What Is Medical Billing And Coding
What Is Medical Billing And Coding
Posted: Oct 05, 2010
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What Is Medical Billing And Coding
By: Shristy Chandran
About the Author
Find more articles on medical billing coding and medical billing.
(ArticlesBase SC #3404508)
Article Source: http://www.articlesbase.com/ – What Is Medical Billing And Coding
As an important point medical billing and coding are 2 terms and they’re utilized for two awfully close and related roles in medical administration. They are dependent on each other and these two fields can also be combined. If there’s anyone who to get command on both of them, they can because it can be possible and there isn’t any trouble in it. If you have command on each of the fields, you’ll be able to demand more money or payment for your services.
It deals with the barristers, insurance firms and patients for providing some medical services that are brought to them. Almost all of the patients usually get insured themselves from personal or federal insurance programs. These programs can be Medicaid or Medicare. These companies need every type of record about the patient and the condition of patient too because this may be the entire responsibility of the biller of medical.
In medical biller, it works for insurance companies and make s it sure that insurance service is delivered or the equal price of the service is rendered as the cost of medical service. There may be some disputes over a few issues but these all issues are fixed by the company. The insurance company will be responsible to handle all these problems and payments.
Medical coding is a term that’s particularly focus and deals with the basic branch of medical executive and office work. It works for transferring the every kind of info among the parties that are concerned in the transactions usually offered by the health care supplier, insurance company and patients. There are numerous alpha numeric codes that are used particularly for designate diagnoses, medicines and some medical processes. The medical coder has some experience in these kinds of codes and they make it certain that every kind of medical info are accurate and all of the paperwork has been taken place in right demeanour. It’s going to be the responsibility of the coder to take the patient basic information in the patient’s file. The doctor will attempt to diagnose the condition of the patient and they decide what treatment will be acceptable for the patient. The medical coder should be expert in doing such works and they can ensure this thing that all types of medical paperwork are correct and correct.
If we chat about or compare both the fields then medical coding is said to be the most highly skilled however if you’re trying hard to get your hand in both fields or you have recently got command in them then you’ll be ready to get the job at the high salary. There are many job probabilities for such folks who know these 2 different fields extraordinarily well. It’ll be down to you that what field you are choosing for your future.
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(ArticlesBase SC #3404508)
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Article Tags:
medical billing coding, medical billing and coding, medical coder, medical billing
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Home Page > Finance > Insurance > Florida Medical Insurance for the Uninsured
Florida Medical Insurance for the Uninsured
Posted: Jul 22, 2008 |Comments: 0
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Florida Medical Insurance for the Uninsured
By: Andy West
About the Author
Andy West is a writer for Get Online Quotes which offers Florida medical insurance plans. For Florida health insurance needs contact Get Online Quotes.
(ArticlesBase SC #492716)
Article Source: http://www.articlesbase.com/ – Florida Medical Insurance for the Uninsured
Purchasing the right kind and amount of Florida medical insurance should be the top of the to-do list for those who are uninsured. Of course that is easier said than done when certain conditions exist. In Florida the insurance companies can include pre-existing conditions in their policies in order to be exclusionary. In fact pre-existing conditions can prevent you from buying the individual policy you have chosen, but it is not the end of the story. There are many different insurance companies offering health insurance and one denial does not automatically mean you will get the same response from other companies.
Defining a pre-existing condition would seem to be simple, but nothing in the insurance world is truly simple. With full latitude given insurance companies as to how they define pre-existing the clauses in policies are as varied as the number of policies written. For example, a pre-existing condition could be defined as one where you have already seen a doctor previously just to discuss a particular issue. In the strictest definitions, there is no requirement that you actually received a diagnosis or treatment. You can merely have sought advice.
In other pre-existing condition definitions, the requirements are not quite as limiting. Some insurance policies require that an actual diagnosis or treatment have been involved in order to be considered pre-existing. The time limit applied is that the treatment or diagnosis must have occurred within the last 2 years. Of course a health insurance provider can also issue an elimination rider attached to the policy which permanently excludes a previously diagnosed or treated condition. When looking for Florida medical insurance it is important to understand the terms as an informed consumer.
People find themselves uninsured for many different reasons. A job loss is one of the primary reasons. People who work for themselves after working for someone else for years frequently do not have health insurance because they believe the cost is prohibitive. When you cannot afford health insurance under a COBRA within the allowed time limits and have a pre-existing condition, it may seem as if you have no options left other than accepting a policy that covers very little. There are plenty of policies issued that only cover a doctor visit, some basic procedures and very few prescriptions. But just like anything else, you get what you pay for.
The issue of pre-existing conditions can cause a lot of heartache when shopping for health insurance. Using an experienced insurance broker who can get quotes from multiple insurance companies for Florida medical insurance is important. An expert that understands the different policies and premium structuring can help the uninsured find private or government backed insurance that provides affordable coverage.
The good news in Florida is there is guaranteed renewability. This means your Florida medical insurance cannot be cancelled even if you get sick. So once you obtain the insurance and keep the premiums up to date, the insurance company cannot cancel your policy.
Just because you have a pre-existing condition and are currently not insured, you do not have to assume you are unable to get coverage. Florida has a number of income based health insurance programs available even if you are unable to purchase private health insurance. There is a lot of talk in the media about uninsured citizens, but the fact is that states like Florida have made a real effort to make Florida medical insurance available to everyone including children. For example, Florida KidCare insurance is offered by the Medicaid program.
You can find affordable health insurance that fits your budget and your needs even if you have pre-existing conditions and are uninsured. The media likes to talk about people without insurance, but they would be better off letting people know about the large number of options available. After you talk to an insurance broker, you will be amazed at the number of possibilities for coverage open to you.
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Andy West is a writer for Get Online Quotes which offers Florida medical insurance plans. For Florida health insurance needs contact Get Online Quotes.
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Categories: Doctors who accept medicaid Tags: Florida, Insurance, Medical, Uninsured
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Home Page > Finance > Insurance > Montefiore Medical Center works out 11th-hour contract deal with Aetna
Montefiore Medical Center works out 11th-hour contract deal with Aetna
Posted: Jan 08, 2010 |Comments: 0
|
Montefiore Medical Center works out 11th-hour contract deal with Aetna
By: john willow
About the Author
Quoting & Saving just got easier…Easy To Insure ME Health Insurance Quotes… Quote all carriers in seconds
(ArticlesBase SC #1686974)
Article Source: http://www.articlesbase.com/ – Montefiore Medical Center works out 11th-hour contract deal with Aetna
A major Bronx hospital group last week averted a crisis that could have left tens of thousands of patients looking for new doctors.
Montefiore Medical Center, one of the city’s largest hospital networks, reached an eleventh-hour deal with insurance giant Aetna just days before the last extension of its contract expired, according to sources close to the talks.
While details of the yet-to-be-finalized three-year deal were not made public, negotiations were so tough that Montefiore sent out 1,800 letters to patients covered by Aetna plans warning that without an agreement by midnight, Jan. 7, the hospital group could no longer accept their insurance.
As well, some 400 Montefiore employees could have been affected by the cutoff.
Aetna is one of the state’s largest insurers, with about 47,000 customers in the Bronx alone, and Montefiore runs four hospitals across the borough.
In addition to its flagship 620-bed Moses Division and 106-bed Children’s Hospital in Norwood, the Montefiore network includes the 396-bed Weiler Hospital of Albert Einstein College of Medicine in Morris Park.
In 2008, Montefiore acquired the struggling Our Lady of Mercy Medical Center in Wakefield, giving it a new lease on life as the new 369-bed North Division.
Together, Montefiore’s hospitals annually log more than 85,000 inpatient stays – including over 7,000 births – and more than 255,000 emergency department visits.
With the anticipated passage of major health insurance reform by Congress, negotiations between insurers and hospitals are likely to grow even more difficult in years to come.
While insurance companies such as Aetna stand to gain millions of new customers, new regulations requiring coverage of preexisting conditions and limiting insurers’ ability to drop customers with expensive ailments will squeeze the companies’ bottom lines.
Meanwhile, hospital groups such as Montefiore should benefit from an expected drop in the number of uninsured patients seeking emergency room treatment – whose cost the hospital must absorb.
But urban hospitals like Montefiore that serve large numbers of Medicare and Medicaid patients, stand to take a financial hit as well as federal cost controls limit doctor reimbursements.
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Quoting & Saving just got easier…Easy To Insure ME Health Insurance Quotes… Quote all carriers in seconds
Categories: Doctors who accept medicaid Tags: 11thhour, Aetna, Center., Contract, Deal, Medical, Montefiore, Works
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