Medical Coding Infographic

PRN Funding provides custom accounts receivable factoring solutions for medical coding services.

If your medical coding business struggles with cash flow due to slow paying hospitals, medical clinics or doctors’ offices, PRN Funding can help. We’ve spent the better part of a decade in the medical services industry and understand your unique funding challenges. Let us fix your cash flow and get back to expanding your medical coding business.

Whether you run a medical coding business or are looking to break into the field, we think you’ll enjoy this medical coding infographic courtesy of TopMedicalCodingSchools.com.

Medical Coding
Source: TopMedicalCodingSchools.com

Unpredictability a Challenge in Healthcare Staffing

Healthcare is one of a few industries that never quit. Hospitals and nursing homes are open through weekends, holidays, weather catastrophes and emergencies, with shifts running 24/7. The need for constant staffing and a shift in priorities toward increasing profits has combined to create a staffing maelstrom in which unpredictability is the norm – sometimes, to the detriment of workers and patients.

In their new book Unequal Time, University of Massachusetts sociologists Dan Clawson and Naomi Gerstel break down the movement toward unpredictability as it affects different healthcare workers. Through interviews with multiple workers they determined that while most are experiencing greater unpredictability, the greatest impact is felt by nurses, nursing assistants, and other low-wage healthcare workers.

As mentioned above, the dueling priorities of constant staffing and showing profits lead many healthcare facilities to schedule the minimum possible number of staff for a given shift. When a nurse or aide becomes ill or is otherwise unable to come in, it creates a coverage gap that others must scramble to cover – there is no overlap of extra hands to help out.

Low-wage healthcare workers are often at a greater disadvantage. Demographically, nurses and nurse assistants are overwhelmingly female, with children, and may or may not have a support system in place to handle personal emergencies. Restrictive sick time and attendance policies force these workers to come in even when they are ill, as one of the subjects of Unequal Time shared with Clawson and Gerstel. It should go without saying that workers who come in while ill then put the patients in their care at greater risk.

While this book covered healthcare workers in a facility setting, home care workers often suffer from similar issues of unpredictability and low wages. However, beginning January 1, 2015 home care workers in most circumstances will be covered under federal and state labor laws governing minimum wage and overtime. (Workers can use the Department of Labor’s self-assessment to determine eligibility.)

Nurses and healthcare workers in some states are pushing for changes in staffing ratios, but healthcare staffing agencies can take a proactive approach with their workers by clearly communicating staffing schedules (and not changing them unless absolutely necessary) and implementing less stringent policies governing sick days.

Healthcare staffing agencies that need an additional boost in working capital to take care of their workers may find a solution in healthcare staffing factoring. Access immediate funding without taking on new debt, and invest in your workers with confidence. PRN Funding offers comprehensive healthcare staffing factoring programs to cover a variety of needs and situations – apply today to get started!

CMS Explores Consolidated Payment System

Over the last several years, CMS has worked with the Medicare Payment Advisory Committee to streamline payments for a number of patient services and procedures. Each group has proposed changes to Medicare billing that, if adopted, could streamline and reduce annual healthcare spending for the program.

The current payment system allows for differing payments for the same service depending on where and by whom it was performed. Hospital outpatient departments, for example, receive a higher payment than a physician’s office for the same procedure. However, differentials are also present when measuring payments received by the same physician for the same procedure based on how it was coded.

Several elements contribute to the billing differences that CMS and MedPAC hope to eliminate, including packaged versus separate payments; where providers choose to perform services (and patients choose to receive them); and different methods of weighing payments between different facilities.

Proposed changes include updates to this year’s physician fee schedule and limiting billing to either physician rates or hospital rates. The larger question this creates, however, is which system is the best to determine payment rates at all

A site-neutral payment program is slowly developing: beginning in 2016, long-term care hospital pay rates will shift to align with existing inpatient PPS rates. In the meantime, both CMS and MedPAC continue to identify inconsistencies in payments and potential solutions for them.

In the last 15 years, PRN Funding has provided comprehensive alternative funding solutions for healthcare companies. To learn more about the benefits of healthcare factoring and medical receivables factoring, contact PRN Funding today.

New Bill Delays ICD-10 Again, Indefinitely

Despite claims by the Centers for Medicare and Medicaid Services that the October 1, 2014 deadline for the final transition to ICD-10 was firm, President Obama has signed a new law that will push ICD-10 back until at least October 2015.

H.R. 4302, “Protecting Access to Medicare Act of 2014”, is primarily the latest in a series of patches to Medicare’s sustainable growth rate; however, Section 212 of the bill prohibits the Secretary of Health and Human Services from replacing the current coding standard, ICD-9, with the new ICD-10 any time before October 1, 2015.

The delay has caused significant frustration and may compound difficulties for providers racing to be ICD-10 compliant. Providers at various stages of preparation for ICD-10 will have to maintain both their ICD-10 systems and their current ICD-9 systems until the switch takes place; in addition, many providers who are prepared to begin training for ICD-10 will have to postpone their efforts until a new deadline is announced.

Because the ICD-10 mandate is unfunded, the cost of preparation has fallen to providers who may suffer financially due to a delay. There is also little indication that payers are prepared for billing changes that will take place with ICD-10. At the same time, however, providers who are not as close to full ICD-10 implementation will have at least an additional year to upgrade technology, train their employees, and update their procedures. For payers, the delay will provide additional opportunities for critical end-to-end systems tests.

Proponents of ICD-10 argue that the new system will allow for more accurate coding of a variety of medical conditions, which will not only improve the quality of care but will also streamline billing processes by reducing requests for additional documentation. Health information management professionals recommend that providers stay on track for complete ICD-10 preparation, including a complete shift to ICD-10 coding with translations to ICD-9 until the standard is changed.

ICD-10 may also have a significant impact on healthcare vendors. Medical billing and coding agencies stand to benefit from providers choosing to outsource coding in advance of changing standards, yet all vendors may face longer waits for payment from facilities struggling to meet increasing financial demands.

We will continue to monitor updates to the ICD-10 transition and report on them as they come.

PRN Funding offers alternative financing solutions for healthcare vendors that need to tighten their cash flow in the wake of extended payments. Learn more about our various healthcare factoring programs, then contact us to receive an application and to get started immediately.

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More Nurses Seeking Careers in Leadership

Whether you visit clinics, hospitals, or rehab facilities, you will find that nurses make up the largest group of healthcare professionals. Throughout the country and the whole world, the largest sector of healthcare providers is made up of nurses. Regardless of their overwhelming presence, not many of these nurses are included in important policy discussions that could shape the future of patient care.

A two-year study analyzing nurses’ roles in re-shaping the current healthcare system was conducted by the Institute of Medicine and the Robert Wood Johnson Foundation. Among the findings from the study was a 600-page document, providing a closer look at nurses’ education. Additionally, the report offered suggestions for assigning leadership roles in enhancing the healthcare system.

medican and nurse staffing

Currently, new nursing graduates are being encouraged by their educators and nursing associations to serve as competent leaders in the healthcare industry. Aside from empowering nurses, these efforts aim to increase nurses’ leadership roles, all while promoting change within the industry.

Cathy L. Rozmus, associate dean for academic affairs and assistant vice president for Institutional Assessment and Enhancement at UTHealth School of Nursing, views education as a crucial component to nursing leadership. At the very least, Rozmus said that nurses should have a bachelor of science in nursing in order to prepare for a leadership role. However, she also said that many larger healthcare facilities call for a master’s degree, either in a nursing specialty or nursing administration.

Rozmus offered plenty of advice for new nursing graduates pursuing a leadership role in the healthcare industry. She said that the most effective way to prepare for a leadership position is to offer volunteer services for various committees. Furthermore, she believes that by working in interprofessional groups, nurses will gain invaluable experience that will help prepare them for a leadership role.

Top 10 Healthcare Careers for 2014

When it comes to healthcare careers, many immediately think about doctors and nurses. However, there are many other career options within the industry. In addition to job security, these professions also offer generous salaries. Whether you’re in the medical staffing industry, ready to grow or launch your own healthcare staffing company, or deciding on a healthcare career specialty,  consider these growing fields.

Here are 10 of the best healthcare careers for 2014

Pharmacist: Aside from dispensing prescription medications, pharmacists provide valuable advice pertaining to prescription drugs, as well as how to safely use them. Salary=$117,000, Projected job growth=25 %

Podiatrist: Podiatrists help patients with foot, ankle, and lower leg problems. In addition to providing diagnoses for illnesses, podiatrists also treat injuries and provide surgical care for patients. Salary=$116,000, Projected job growth=20%

Optometrist: Specializing in eye exams, optometrists perform routine checks to detect vision problems and diseases. Optometrists also write prescriptions for eyeglasses or contact lenses. Salary=$98,000, Projected job growth=33%

Physical Therapist: In addition to pain management, physical therapists help patients with injuries or illnesses improve their movement. Salary=$80,000, Projected job growth=39%

Occupational Therapist: Occupational therapists help patients suffering from illnesses, injuries, or disabilities by introducing therapeutic techniques and equipment that can help improve the skills necessary for everyday living and working. Salary=$75,000, Projected job growth=33%

Speech Pathologist: Speech-language pathologists provide treatment and diagnoses for communication and swallowing disorders. Salary=$70,000, Projected job growth=23%

Chiropractor: Chiropractors offer treatment for patients encountering health problems with bones, muscles, ligaments, and tendons. By using spinal manipulation and other treatments, chiropractors also help treat patients’ back or neck pain. Salary=$66,000, Projected job growth=28%

Respiratory Therapist: Patients suffering from breathing problems, such as asthma or emphysema, seek care from respiratory therapists. Additionally, respiratory therapists offer urgent care to patients encountering a stroke, heart attack, or shock. Salary=$56,000, Projected job growth=28%

Laboratory Technician: Laboratory technicians collect samples from patients and perform tests to further examine tissue, body fluids, and other substances. Salary=$36,950, Projected job growth=15%

Medical Records Technician: Aside from managing and organizing health information data, medical records technicians make sure that the information is accurate, secure, and readily accessible via paper and electronic systems. Salary=$35,000, Projected job growth =21%

Thanks to the implementation of Obamacare, healthcare jobs are poised to experience massive growth as more people seek services. For more information on the hottest healthcare careers for 2014, visit the Bureau of Labor Services Occupational Outlook Handbook for healthcare.

Younger Nurses Feel Positive About the Future of Nurse Employment

In a recovering economy, many older nurses are considering retirement or have plans to pursue another career. Although the job market still hasn’t full recovered, a recent survey shows that many younger nurses hold a positive outlook for their profession and plan on pursuing higher education in the field.

According to the 2013 Survey of Registered Nurses conducted by AMN Healthcare, nearly 190,000 nurses admitted that they were thinking about leaving nursing or retiring as the economy continues to improve. Additionally, one in four nurses age 55 and up said they would change their career paths entirely by searching for work in other industries.

When it comes to furthering education, less than half of the nurses who held an associate degree or diploma said they were planning to pursue higher education in the field of nursing. Conversely, younger nurses are more likely to be interested in additional education. The landmark Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, advises that 80 percent of nurses in the U.S. should hold a BSN or higher degree by the year 2020.

Although nurses among all age groups reported that they were highly satisfied with their profession, the survey found that younger nurses (19-39) held a more positive outlook than nurses 55 and older in regards to the current quality of nursing. Furthermore, 66 percent of nurses 55 and older believe that the quality of nursing care has declined.

As a result, a generational gap exists among nurses in regards to their overall perspective of their practice. The survey revealed that younger RNs often hold a positive opinion of the nurse supply. Regardless of shortages in the industry, nurses between the ages of 19-39 said they remain positive about the supply of nurses, and believe that they are capable of meeting the expectations brought on by the new healthcare initiative. Additionally, while 45 percent of younger nurses said the shortage has improved throughout the past five years, 41 percent of older RNs between the ages of 40-54 held the same belief.

The survey also measured nurses’ overall satisfaction with their current jobs. Among the respondents, 90 percent of nurses reported that they were happy with their careers, while 73 percent said they were satisfied with their current profession.

Peter McMenamin, healthcare economist and senior policy fellow for the American Nurses Association, said that this survey projects an optimistic future for nursing. Additionally, he said that the findings revealed from the survey are consistent with research conducted by the ANA.

The future of nurse staffing looks promising. Is your nurse staffing agency primed for growth? PRN Funding offers accounts receivable factoring programs designed exclusively for the nurse staffing industry. Cash flow can get tight during times of growth, but nurse staffing factoring provides a steady source of working capital to cover payroll and other expenses. Learn more about factoring for nurse staffing.


California Nurses Union Defeats Effort to Eliminate Paid Sick Leave

No sick days for California nurses? Luckily, that won’t become a reality any time soon.

Sutter Health, one of the largest and most profitable hospitals chains in the US, attempted to eliminate paid sick days as one of nearly 200 concessions during negotiations over union contracts. After a long fight and nine strikes within the past two years, the California Nurses Association (CAN) defeated the effort.

“The nurses would’ve come to work sick, and the patients’ health would’ve declined,” said California Nurses Association Executive Director.

The union defeated almost all of the concessions in the new contracts. Other concessions included ending health insurance coverage for nurses working under 30 hours per week, as well as reducing the minimum time off between nursing shifts to six hours.

According to the deal, Sutter Health has agreed to retract disciplinary actions against nurses that appear to have been done in retaliation for going on strike. Last July, the healthcare giant was found to have illegally attempted to enact the non-paid sick days rule on certain workers during an investigation by the National Labor Relations Board.

Insurance Companies Helping to Delay Nurse Practitioners Role in Primary Care

While demand for primary care providers is projected to increase dramatically following implementation of the Affordable Care Act, insurance companies and physician groups remain opposed to the credentialing of nurse practitioners to provide primary care services.

Advanced practice registered nurses hold a master’s degree and have an additional 700 hours of supervised clinical experience, allowing them to diagnose and treat many common illnesses as well as to administer anesthesia or deliver babies with the proper specialization. Despite their licensing, however, many states do not allow nurse practitioners to operate without physician oversight and many insurance providers will not credential them as primary care providers in their plans.

Physicians argue that the clinical role of nurse practitioners is different from that of doctors and that ensuing confusion could affect the quality of patient care; however, there is also a financial element regarding the current requirement that nurse practitioners bill through a physician’s office for service.

The American Nurses Associate submitted comments on the federal rules governing the national healthcare marketplace, set to open enrollment tomorrow, in which they encourage the Obama administration to include provisions requiring insurance providers to credential a certain number of nurse practitioners for independent practice. For their part, insurers are more focused on increasing access to primary care through other, “team-based” means.

At present, roughly half of the 250,000 advanced practice nurses in the United States work in physicians’ practices; many of them, it seems, would open their own practices if they were able to bill patients directly and insurers would include them in provider listings.

Learn more about funding options for nurse practitioners and other primary care providers.

Nurse Staffing May Be Slow, but Nurses Should Remain Optimisitic

Nurses throughout the US are seeing flat wages and a decreased availability in jobs in higher-paying states. The U.S. Bureau of Labor Statistics reported that the median annual wage increases for nurses increased only 1% between 2011 and 2012.

A few factors lie behind the wage stagnation and lack of desirable positions for nurses. The first is healthcare reform. The impact healthcare reform will have is unclear and many hospitals are hesitant to hire. Hospitals are being ultra-conservative when it comes to finances in the wake of decreasing Medicare reimbursements, according to the president of the National Association for Health Care Recruitment. Not only is this causing less job opportunities, but it’s also behind the trend in stagnant wages.

More supply and less demand for nurses is another reason. The amount of nursing school graduates has grown in the past decade, but the baby boomers in the field have yet to retire.

Despite the current trend, there’s reason to believe nurse staffing levels will increase in the near future. Here are a few reasons those in the nursing field should remain optimistic:

1. The Affordable Care Act
As more people obtain insurance and seek healthcare, the demand for nurses will rise.

2. Baby Boomers
As baby boomers grow older, they’ll need more care. Also, many baby boomers will be retiring from the nursing field making room for a new generation of nurses.

3. Nurse Staffing Ratio Laws
According to Aureus Medical Group, a nurse staffing company, 15 states have enacted legislation or adopted regulations to focus on nurse staffing levels. As states begin to mandate nurse-to-patient ratios, the number of nursing positions should increase.

Now is the time for nurses to take steps to set themselves apart from the competition. Nurses with specialized training in ORs, cardiovascular ICUs, pediatrics, etc. may see more career options. The ability to use electronic health record systems also gives nurses an advantage. Furthering education is another way to secure a job in nursing, especially since demand for nurse practitioners is likely to grow. According to the Bureau of Labor Statistics, nurse practitioners earn more than RNs with a 2012 median annual wage of $91,450. Nurse midwives and nurse anesthetists also earn significantly more. Nurses with associate’s degrees may want to consider a bachelor’s.

Flexibility is key to riding out the slow nursing hiring trend. Be willing to take on temporary nursing work. Remain open to the idea of relocation. Accept a job even if it isn’t your dream come true. The experience will be essential to landing your ideal position in the future.