Tag: DAS Health

How Organizations Can Stay One Step Ahead of Cybercriminals

Sophisticated large-scale corporate cyber-attacks are on the rise

When successful, their impact can be devastating and potentially affect multiple organizations.

Recent breaches have demonstrated the skill and ambition that these cybercriminals employ to gain access to data. British low-cost airline group EasyJet became a target of a highly sophisticated cyber-attack that affected approximately nine million customers last year. Similarly, a few months later, Hackney Council was hit by a serious cyber-attack that disrupted services for residents and saw private documents published online.

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Such attacks emphasize the criticality of a multi-layered security strategy that covers the entire network. So, how can businesses go about creating such a strategy in order to be able to successfully guard against these kinds of attacks?

How to put up your guard

To get ahead of the hackers, IT teams must be wary of unusual password activity, files being created and deleted quickly, inconsistencies in email usage, and data moving around in unexpected ways.

One form of cyberattack is through hackers accessing software patch code and adding malicious code to the patch before it is delivered to customers as a routine update.

This method of attack is especially devious because updates and patches are routine maintenance tasks, meaning IT teams are much less likely to be suspicious about them. Anti-malware solutions are also less likely to scrutinize incoming data like a patch from a trusted vendor.

One key component that enables these types of attacks is credential compromise. Hackers are careful to obtain authentic credentials whenever possible in order to gain entry to the systems and data that they want to access inconspicuously, minimizing their digital footprint. As a result, IT teams need to be wary of unusual password activity, such as an uptick in resets or permission change requests.

Phishing isn’t going away any time soon

It’s no secret that the top security vulnerability for every organization is its people. Consequently, phishing will continue to be a major threat. According to the 2020 Verizon Data Breach Investigations Report, 22% of breaches involved phishing and nearly 30% of security breaches involved internal actors.

Phishing is easy, cheap, and, most importantly for hackers – effective. Just a single employee clicking on one phishing message can let loose a wave of havoc. Hackers are now making extensive use of ransomware, which is often delivered through phishing. To fight back the industry will need to continue innovating through automated anti-phishing solutions that utilize AI to keep phishing emails out of employee inboxes.

Raise security awareness to lower email threat

Another powerful tool to reduce the risk of a cyber-attack is security awareness training. This can lower the chance of an incident such as a data breach by 70%. From ransomware to spear phishing, email threats are one of today’s most dangerous forms of cyber-attack. When conducting a phishing attack, cybercriminals will send a malicious email typically disguised as a message from trusted individuals like a manager, colleague, or business associate to trick your employees into activating the enclosed malware or granting unauthorized access. They will ask the individual to take an action by clicking a link or providing sensitive information like login and password credentials.

In response, more businesses should be training employees on how to spot these emails so they can act as an effective form of defense against cybercriminals. Unfortunately, many awareness programs fail because they are not conducted consistently or are not engaging enough for employees. These trainings have been shown to lower an organization’s chances of experiencing a damaging cybersecurity incident and are most effective when conducted regularly. In fact, a recent study around the impact of phishing resistance training found employees who received the training started to forget what they had learned after six months.

In order to be fully prepared for the risk of a cyber-attack, security awareness training needs to incorporate both educational materials and frequent phishing simulations accompanied by refresher training for those who engage with the simulations. Additionally, employees should always check with their internal IT departments if they have any doubts about the credibility of an email they receive. They can help keep their networks safe by carefully screening their emails and being aware of the signs of a phishing email, which include:

• Small mistakes in spelling, punctuation, usage or grammar

• Colour palettes and fonts that are just a little bit off

• Images like signatures or headers that are blurry

• Sentences that misidentify departments or employees

• Emails sent from a free email service provider like Gmail

• Landing pages and emails that use unfamiliar formats

Bolster backup systems

Finally, it’s important not to forget that backup systems present an opportunity to access data from many systems in one place. This means that encryption at rest, immutable backups, air-gapped data copies and hardened backup operating environments become critical components to any security strategy.

It’s recommended that organizations follow the 3-2-1 rule, which involves keeping three copies of data on two different types of media, with one version stored off-site. Additionally, as part of a secure backup environment, businesses should consider backup solutions written in hardened Linux, as ransomware predominantly targets the more prevalent Windows OS. Organizations should also look for backup solutions that use machine learning to effectively identify ransomware conditions, making it easier for IT teams to investigate and mitigate the effects of a cyber-attack.

It is also critical that organizations frequently test their backups for issues that could impact a successful recovery. Too often, organizations only realize their backup solution didn’t work after an incident has occurred.

Looking ahead

At the start of a new decade cyber-attacks are still growing in sophistication and volume, and businesses around the world are facing an unprecedented level of risk. The security threat increased even further with the rise of remote working over the past year. This way of working is set to continue into the future in some capacity as many organizations plan a hybrid working model. It is therefore more important than ever for businesses to have in place a multi-layered security strategy to ensure they are protected for the months and years to come.

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Supporting Patients Aging at Home With Proactive Care

Recently, the home-based healthcare market has boomed in terms of interest and investments from payers, which makes sense given the ongoing need to keep high-risk populations healthy and safe from exposure to the potentially fatal coronavirus.

The promise and value of home care has never been clearer for organizations across the care continuum. However, the home care space faces its own unique set of challenges, from staffing struggles to managing disruptions in routine care, all while the patient population they serve grows in both size and complexity.

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According to a 2020 survey from Home Health Chartbook, 1 out of every 4 home health patients is over 85 years old and nearly half of home health patients suffer from five or more chronic conditions. While this patient population is more likely than the broader universe of Medicare patients to live by themselves, they’re also likely to have two or more functional limitations.

Caring for an increasingly high-acuity patient population like these older adults is difficult, but environmental challenges presented by the current pandemic, like lack of in-person care and feelings of isolation, have made it even more challenging. To efficiently and effectively care for at-risk adults aging in the home, home care providers need more support and collaboration from provider care teams to ensure older adults get the care they need, when they need it, in order to stay well and out of the hospital.

The value of preventive and proactive care processes

It is important that care teams have the visibility needed to monitor patients’ conditions and any changes in status or behavior to deliver proactive, rather than reactive, care for patients in the home. The key is implementing care processes like chronic care management (CCM) and remote patient monitoring (RPM).

Chronic care management helps to improve patient health outcomes through increased oversight, communication, and collaboration between physician appointments. By formalizing a program of collaborative care management between the physician’s office, home care and any other ancillary providers or care teams involved with a patient’s care journey, the patient is more actively engaged by their care teams across multiple touch points. More engagement and collaboration help to prevent any signs of decline from going unnoticed, allows providers to monitor quality measures, and helps increase patient awareness and adoption of their own care plan objectives.

By utilizing remote patient monitoring (RPM), providers are now able to measure and monitor vitals of interest using personal medical devices in the home that previously required a visit to a doctor’s office, which has become increasingly attractive in the space. While the Centers for Medicare and Medicaid Services expanded coverage for RPM before the pandemic even began, interests in RPM from providers, employers and health plans have grown alongside the rise of at-home care and telehealth use.

According to a Hello Heart survey, 65% of benefits executives believe the use of RPM will only increase among patients moving forward. Including RPM technology in a patient’s care plan allows providers to collect important vitals and patient data, despite location, that provides a more comprehensive view of the patient in the home. More visibility into how patients are doing in the home allows care teams to proactively identify risks and home care providers to deliver preventative care before said patient requires a trip to the hospital.

Technology-driven preventive care services and programs like chronic care management and remote patient monitoring are proven to improve overall care and clinical outcomes for older adults aging at home. As the home care patient population increases in size and the acuity of patients becomes more complicated, more proactivity and data-driven insight will support home care providers in delivering efficient, informed and effective care to these patients.

More patients, more complex conditions and more risks for potential decline demand additional support for providers — and remote technology and digital collaboration can help fill in the gaps and ensure higher quality care moving forward.

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Urgent Action Needed to Address Pediatric Mental Health

As the Coronavirus pandemic hits the one-year mark, we’re seeing an unprecedented explosion in pediatric mental, emotional and behavioral health conditions. Kids and youth are in crisis. Some are suicidal and violent, and are filling up emergency departments at children’s hospitals across the country. These are desperate moments for families; all too often, their precious children cannot access the specialized support they need, and they have no place else to turn.

The stark reality is that, without immediate support, demand will overrun the capacity for children’s hospitals to admit kids in the throes of a mental health crisis. In Jacksonville, Florida, at Wolfson Children’s Hospital, up to 25 children have been “boarding” on surgical floors while waiting for a bed to open in the hospital’s inpatient psychiatric unit. Their wait could last as long as five days.

This is not at all unique to Wolfson: Around the country, kids spend days – even weeks – in EDs and on units ill-equipped to serve their needs. The pandemic has worsened the impact of our existing shortage of beds and pediatric psychiatrists. All the while, parents and guardians are nearby, watching a frantic process they cannot control.

Well before the pandemic, children were suffering from mental, emotional and behavioral health conditions at alarming levels. In fact, tragically, youth suicide rates had already been rising for a decade. From 2008 to 2015, the percentage of annual admissions and ED visits for suicide attempts and ideation more than doubled at children’s hospitals. In recent years, suicide has been the second-leading cause of death for youth and young adults, according to data from the Centers for Disease Control and Prevention.

When the pandemic hit in force, in-person school, sports and time with friends all came to a halt. Children and young people lost critical aspects of their social and developmental structures at some of the most important points in their lives: their time to play, learn and grow up. Isolation from a peer group, even as early as the preschool years, can have an enormous effect on children’s development of social competence and social relationships.

The results have been catastrophic. On the front lines of America’s pediatric mental health crisis, our current resources are grossly inadequate to meet the demand. That’s why Children’s Hospital Association and the American Academy of Pediatrics recently launched an awareness campaign to highlight the mental and behavioral health needs of children and youth. We need immediate federal support to address what is undeniably a national emergency related to our war on the novel coronavirus.

President Joe Biden and his new team, along with Congress, can take urgent action to mitigate the pandemic’s harsh impact on children’s mental and emotional well-being. The latest coronavirus relief bill, and funding from legislation passed into law in December, can provide much-needed support – if distributed effectively to meet the greatest needs in each community. We need clear intention and direction of these funds to serve children in crisis at a higher priority than exists today.

We also need to expand telehealth and evidence-based training support to equip community-based providers and teachers with the ability to identify children at risk for or suffering from mental health crises – and refer them on to help.

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Escalating Cyberattacks Highlight Need for Security Interventions

Healthcare organizations have faced continual stress from heavy COVID-19 caseloads in 2020. Cyberattacks on their information networks also loomed as a serious threat, and the pressure to protect data is expected to grow this year, as more criminals target healthcare providers.

Protecting patient data from unauthorized access has long been a regulatory prerequisite for healthcare organizations. But increasingly, cybercriminals see profit potential in attacking and crippling their networks, and restoring operations carry a high cost, both in the expense of repairing IT capabilities, as well as lost revenue, productivity hits, and erosion of community trust.

The rising pressure to protect data systems is prompting healthcare IT security executives to take a hard look at security procedures, and ways to identify and secure potential network weaknesses.

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Attacks on the Rise

The need to batten down security hatches has grown in recent months, as COVID-strained healthcare has been hit with devastating cyberattacks, and government agencies warned that more could be coming.

In late October, the FBI and two federal agencies warned that they had “credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.” The potential attacks were attributed to a Russian-speaking criminal gang targeting providers with TrickBot and BazarLoader malware, leading to ransomware attacks, data theft, and service disruption. The agencies noted that the issues will be particularly challenging for organizations within the COVID-19 pandemic.

The federal warning came on the heels of several high-profile security breaches. In one attack, UVM Health Network had about 5,000 network computers rendered inoperable by a system outage that lasted 40 days; about 300 workers were furloughed because the outage prevented them from doing their jobs. The organization noted that its IT staff had to rebuild the entire infrastructure before re-populating it with backed up files and data, in addition to scanning and cleaning 5,000 computers and endpoints that had been infected. Hospital executives estimate the total cost of the attack at more than $63 million.

Another large cyberattack crippled Universal Health Services, a large hospital system that had a massive IT network outage in late September. The IT outage for the health system lasted eight days after a malware attack; it used downtime protocols and paper records during the outage.

Some reporting suggested that attackers are mounting ransomware attacks on healthcare system networks and charging higher-than-usual fees for its removal, suggesting that criminals may be targeting as many as 400 different facilities across the country.

More broadly, attacks are being aimed at the entire healthcare sector, according to reports from Microsoft. The technology company reported that it has detected cyberattacks from three nation-state actors targeting seven prominent companies directly involved in researching vaccines and treatments for COVID-19.

In addition, providers could face monetary fines from the Office of Civil Rights of the Department of Health and Human Services, which has the prerogative of assessing fines on healthcare organizations or business associates for lack of compliance with HIPAA and willful neglect of practices that protect patient information. As of November 2020, OCR has settled or imposed penalties in 92 cases, resulting in fines of almost $130 million.

Boosting Security Efforts

To counter these threats, healthcare organizations are taking a variety of steps to improve their security postures. Protecting healthcare information is increasingly becoming a challenge because of growing pressure for healthcare entities to distribute healthcare information to better coordinate care, engage with patients and comply with regulations forbidding information blocking. Also, the COVID-19 pandemic has fostered the use of remote patient monitoring and telehealth services, which increase the amount of patient information being exchanged on provider networks.

An important component of ensuring information security for provider organizations involves regularly testing the defenses that protect access to crucial networks. Penetration testing is one way to check for the effectiveness of cyber defenses before potential incidents, rather than afterward, when patient care can be disrupted and expensive to resolve.

Also known as a pen test, the exercise simulates a cyberattack against a healthcare organization’s network to check for vulnerabilities that attackers could exploit. Pen testing can involve outside “white hat” hackers who attempt to breach application systems to find vulnerabilities, such as unprotected inputs that are susceptible to code injection attacks.

Pen testing can be complex, looking for weaknesses that can be exploited by insiders as well as outside attackers. It can involve significant preplanning in terms of reconnaissance, analysis of how systems and defenses respond to different forms of attack, and attempted exploits of weaknesses of systems – such as cross-site scripting, SQL injection, and backdoor efforts – as well as human engineering efforts, such as different forms of phishing attacks to see if system users need training so they don’t give their network login codes to cybercriminals.

Analysis of such efforts also is complex, assessing which vulnerabilities were found and exploited, if any sensitive patient data or administrative systems could be accessed, or how long a pen tester could remain in the system undetected after gaining access.

Many organizations conduct annual penetration tests, subjecting defenses to internal, external and application attacks designed to emulate real attacks. In addition, healthcare organizations do such testing to meet compliance obligations for standards such as the NIST 800-35 CIS ISO 27001, the PCI DSS, and SOC2, which require businesses to conduct regular penetration tests and security reviews using skilled third-party testers.

But the threat environment for healthcare organizations is always changing, and cybercriminals are constantly honing their skills to access networks and extract value from their attacks. To effectively protect critical systems and private health information, healthcare organizations need to develop customized approaches, utilizing the latest techniques, tools, and technical expertise from outside the organization to understand vulnerabilities and develop an actionable remediation plan.

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Bolstering Healthcare IT Against Growing Security Threats

As the COVID-19 pandemic unfolds, healthcare organizations are scrambling to ensure the safety and support of patients and staff, while also integrating and learning new technologies to support telehealth practices.

The constantly evolving healthcare environment has placed immense financial strain on hospitals and increased pressure on healthcare staff, which has been made worse by the influx of possible security threats. The U.S. Cybersecurity and Infrastructure Security Agency (CISA) has recently released an alert highlighting imminent cybercrime threats to U.S. hospitals and healthcare providers.

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Increase visibility

To mitigate cyber-related risk, healthcare organizations’ IT leaders must increase visibility by creating accurate application maps that visualize application and network interactions. This allows them to identify impact and mitigate incidents quickly and accurately, before data is stolen or daily operations are compromised.

The recent ransomware attack that targeted numerous U.S. hospitals was carried out primarily through phishing emails, showing that healthcare organizations must be diligent in training hospital system users to not interact with suspicious emails. If all users take this proactive step, they can collectively serve as the first line of defense against malicious actors.

Healthcare organizations should look to hire more IT security experts when they have open positions, or further train existing staff. For a Nutanix survey, IT leaders were asked about their organizations’ in-house security expertise, and half of the respondents said they did not have enough budget to recruit quality staff.

Further, one in three did not feel they had enough training for staff, and close to ten percent indicated they didn’t have enough staff allocated in general. Ensuring healthcare organizations have enough resources and experienced IT staff on board will help prevent and slow threat permeation.

Stop the spread of healthcare IT security threats

In reality, not all cyber threats can be proactively deterred. Healthcare delivery organizations must have a strategy to stop ransomware spread if their network is infiltrated by malicious actors. Investment in detection and containment strategies can help healthcare institutions save both money and resources. While this preparation requires investment upfront, it will help reduce interruptions and recovery costs should an attack occur.

To start, organizations must invest in technologies that constantly scan for unusual behavior within networks. These abnormal behaviors include things like repeated failed authentications, an unforeseen increase in network traffic, or a large volume of file uploads. In addition to behavioral analysis, it’s important to segment data and networks by sensitivity or priority of need.

Micro-segmentation can be used to divide networks and application components into isolated segments, ensuring that the traffic is limited to what’s required to function and can be monitored and controlled. In the event of an attack, micro-segmentation can help limit the spread to a specific segment rather than to the entire organization. When combined, these solutions can help companies detect and then contain threats more quickly.

However, if a ransomware attack does result in the loss of information contained within the network, healthcare organizations should have a disaster recovery plan in place. Investment in disaster recovery-as-a-solution (DRaaS) technologies allow organizations to recover data from the cloud within minutes, compared to hours, days, or weeks by creating real-time copies of the data that’s stored within the network. A quick response will help limit any disruption to patients or negatively affects the quality of care.

Build a security first infrastructure

Looking ahead, as healthcare organizations prepare for another year of uncertainty, IT leaders should also look to ensure the underlying infrastructure supports their security goals, keeping visibility top of mind. For example, a software-defined, hyper-converged infrastructure allows organizations to reduce complexity by simplifying the hardware and software needed to keep applications running and secure, while providing visibility across the network. Additionally, unified hybrid cloud solutions can also provide visibility, as well as the ability to apply uniform security policies across private and public clouds.

Healthcare organizations must work to secure their networks at the source. Through the implementation, segmentation and securing of digital workspaces, the end user’s access to privileged information is limited. For networks using outside applications, managing third-party vendors on separate networks ensures the protection of patient data. Implementing endpoint security controls, anomaly detection, and zero trust models help protect healthcare organizations from compromising data.

Dealing with healthcare IT security threats

The ongoing large-scale cyber attack against U.S. healthcare organizations shows that health systems can no longer rely on traditional security approaches when it comes to protecting highly sensitive patient data. With COVID-19 further disrupting healthcare IT operations, organizations must be prepared for evolving outside threats that look to take advantage of vulnerable systems.

By increasing visibility and control into networks, educating and hiring expert staff and implementing secure remote work practices, healthcare organizations can best protect themselves from the influx of bad actors preying on an already vulnerable period for the industry.

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Top Errors in Medical Billing and How They Negatively Affect Your Medical Practice

The Key to Practice Profitability

As a healthcare provider, your first priority is to provide outstanding patient care. That is the main reason you went into the medical field – to help others feel better. But, underlying that altruistic goal is the business side of your personality. With your education and experience, you are certainly entitled to be paid fairly for the services you provide. You also have to think about the costs involved in running a medical practice – the building, staff, insurance, and so much more – which means you have to stay on top of your medical billing procedures.

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The medical billing department is the key to the continued profitability of any medical practice. Bills must be created on a timely basis, submitted properly to the various insurance companies and government entities, and followed-up regularly to ensure prompt payment is received. Solid billing practices lead to a better cash flow and improved Revenue Cycle Management, or RCM. You can continue to receive your salary, pay your office staff, and keep the practice running without worrying about money on a continuous basis.

The truth, however, is that medical billing is fraught with difficulty. From miscommunication and sloppy procedures to exasperating guidelines from each payer, billing errors can really add up. Healthcare Finance reports that billing errors can cost the healthcare industry billions in lost time and wasteful spending. A bill that is rejected due to an error requires twice the processing time for the same dollar result to the practice. Additional time can be lost on the telephone contacting the patient or the payer to settle the matter, often extending a rather routine claim time to a months-long struggle. Meanwhile, the current work load piles up and gets delayed as the billing department deals with the issue again.

The negatives for the industry and the practice are obvious, but that doesn’t even take into consideration the impact on the individual patient’s health and welfare. Billing errors lead to delayed payments from the insurance companies, denied claims, and increased stress at the very time a patient needs to be stress-free. It is hard for the medical team to provide the highest degree of care when a patient is upset due to a problem with his/her bill. If errors are consistent or costly, they may even lead to patients leaving the practice.

Top Errors in Medical Billing

Medical billing can differ for every patient, insurer and procedure, making it difficult for even the most diligent of medical practices to experience denial-free claims. If your medical practice is experiencing severe financial difficulties or losing numerous patients, however, it may be due to a high level of costly billing mistakes. Here are some of the top errors in medical billing:

Insurance Errors

With the high degree of competition in medical insurance, it is possible for patients’ coverage to change yearly. The most important step the front desk can take is to absolutely verify current coverage and determine whether the services about to be provided are covered under the patient’s existing insurance plan. This must be done at every visit, as plans can change often or patients can max out their benefits for the year. Explaining to patients that they may be charged for a service can be difficult, but it is far better than dealing with an angry patient who receives an unexpected bill.

Lack of Attention to Detail

Claims can be rejected for a mind-numbing array of seemingly-trivial details – a name doesn’t match what is on file, an input error transposes a date or insurance policy number, inaccurate prioritization when multiple insurance providers are involved, and so much more. This can be due to reasons from a patient’s sloppy handwriting to an office member who is distracted while trying to input the data. Having patients complete forms online can increase accuracy, while staff members responsible for billing need to have undistracted time to complete their duties.

Coding Errors

With the recent expansion of the number of coding possibilities, medical practices struggle to keep their billing claims accurate. Each diagnosis must be coded to the highest level for that code, and the code must exactly match the procedure that is performed, but they can also not be coded beyond what was actually provided. This is a complex portion of the billing process that requires a highly-educated billing staff using the most current codebook, or the use of billing software that is routinely updated to account for all of the changes instituted by the various claims processors.

Miscommunication

Even in the most conscientious of medical practices, some days can be busier than others, which can lead to lapses in communication procedures. A provider might inadvertently give the billing department an incomplete description, or a procedure might be cancelled without notifying the entire staff. A bill goes out incorrectly or needlessly, leading to further entanglements down the road.

Delayed Filing

Sometimes paperwork gets lost in the fray, for whatever reason. By the time the oversight is discovered, it is beyond the insurance payer’s deadline and the practice ends up having to eat the cost or risk angering a patient. A close cousin to this is failing to resubmit a rejected claim in a timely manner, also resulting in a loss of revenue for the practice.

Duplicate Bills

Duplicate bills are usually the result of some type of human error. The billing clerk might not notice that a claim has already been filed and innocently sends another, or a procedure was rescheduled but still shows up in the patient records twice. It could even be that a similar, but different, procedure was utilized but the clerk doesn’t recognize the difference and gives both the same coding.

Unbundling

Some services that are performed together are meant to be billed as one; however, this is lost somewhere in the translation and each sub-unit is billed separately, resulting in a higher total claim than what would have been allowed under the bundled code.

Poor Protocols

Another major oversight is failing to maintain and review a receivables aging report. This shows the claims that are outstanding and prompts a follow-up action.

Beyond the innocent and unintended billing errors, medical practices also have to be on alert for intentional errors instituted as the result of possible fraud by the patient or malfeasance on the part of the employee.

How Billing Errors Negatively Impact Your Medical Practice

The entire billing process can become a rabbit hole of problems if not scrupulously implemented and continuously monitored. Lax procedures or poor management by practice administrators can result in any number of negative impacts, ranging from bad to worse:

Lost Time

At the very least, billing errors result in a huge waste of time, as office staff performs the same function over and over again while not generating additional revenue for the practice.

Additional Personnel

If rejected claims become substantial enough, new claims don’t get processed and the practice is forced to bring on extra personnel at an additional expense to deal with the backlog.

Delayed Payments

Delayed billing and rejected claims makes it nearly impossible to accurately project cash flow. While the delays might all be quite reasonable, that doesn’t help when you are trying to explain to your landlord or insurance company why their payment is late.

Poor Revenue Cycle Management

This process tracks revenue through the entire patient cycle. It begins at the time of an initial appointment and concludes when the final balance due for services is remitted. Short RCM is optimal, while long cycles indicate that there is a problem somewhere in the billing, processing or collection functions.

Angry Patients

Once again, it can be hard to explain to a patient why a claim has been denied or is late being paid. The patient might be facing the thought of having to pay unplanned out-of-pocket medical expenses at the very time his/her ability to earn money has been diminished due to illness or disability. Angry patients seldom return and, in the worst cases, they will spread their negative experience to all of their family and friends.

Audits, Fines…and Worse

If the billing errors are deemed to be fraudulent, it can result in an investigation or audit that can cause a loss of time and irreparable damage to the practice’s reputation. If the practice is found to be at fault, it can even result in legal charges of fraud being leveled. This can result in fines, loss of privileges, or additional legal expenses to deal with the outcomes.

Tips to Avoid Billing Errors

Instead of dealing with the negatives, a far more positive approach is to be proactive in avoiding billing errors. Here are some tips which can help to reduce or even eliminate billing errors:

Training

Institute a careful list of protocols regarding your billing procedures, and then provide on-going training to billing team members to keep them updated as changes take place.

Remove Distractions

Let your billing team concentrate solely on the job at hand. Don’t distract them with other responsibilities unrelated to their primary job function.

Keep Up on Codes

Make sure you staff utilizes and understands the latest coding requirements.

Communication

Improve communications between providers and billing staff to ensure a clear understanding of the patient visit. Have a process whereby cancelled or rescheduled appointments are clearly notated so they don’t get billed twice.

Patients

Explain to patients the importance of providing accurate information and up-to-date insurance policies. Clearly communicate when there has been a billing error, and outline the steps that have been taken.

Timeframes

Have clearly delineated timeframes for submitting claims, addressing errors, and following-up on outstanding claims.

Partnering

Perhaps the easiest way to avoid all of the potential negatives involved with billing errors is to partner with a reputable company that has experience dealing with all the major insurance carriers and can automate the process so you won’t have to worry about it yourself.

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