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

Medical Coding

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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Captricity Seeks to Further Enhance EHR

Berkeley-based startup Captricity is looking to capitalize on the ACA-mandated transition to electronic health records (EHR).

Captricity, helmed by CEO Kuang Chen, is a “crowd-guided machine learning and computer vision platform” designed to convert records of all formats into easy-to-use digital records that can be imported into a variety of systems for internal use.

The system utilizes a “shredding” process in which uploaded records are divided into minute pieces of data and converted using a special set of algorithms and, when necessary, human entry. The process allows Captricity to comply with federal privacy standards, including HIPAA compliance. The converted data is then reassembled into a secure digital record that the subscriber can download or import as needed.

In addition to basic Latin characters, Captricity is capable of converting any non-Latin based languages that can be entered into a computer. The company also offers 24/7 access from anywhere in the world, via cloud-based platforms such as Dropbox as well as mobile applications currently available for iOS devices. Much like mobile check deposit (and protected by the same levels of encryption), Captricity allows mobile users to upload photos of documents for conversion.

Subscription to Captricity can allow backlogged health systems to quickly come into ACA compliance regarding EHR without sacrificing the integrity of the data or dedicating countless person-hours to manual conversion. Furthermore, Captricity can improve the accuracy of medical billing and coding by properly converting often illegible doctors’ notes in order to reduce the number of costly coding errors.

Captricity offers a pay-as-you-go service and graduated subscription services that increase the monthly page limit, length of data availability, and available features. Prices for paid subscription begin at $75/month.

Healthcare providers and medical billing and coding companies can greatly benefit from services like Captricity, but may lack the cash flow to make an upfront investment in the service. Medical billing and medical coding factoring offer access to immediate cash that these companies can then use to ease the transition to EHR in their own firms. PRN Funding has more than a decade of experience with medical coding and medical billing factoring programs, and can help your company get started today.

Obamacare Greatly Boosting Areas of Healthcare Staffing

Obamacare has been receiving plenty of criticism due to accusations that the health care law will hurt employees by eliminating positions or reducing hours to part-time. While the actual effects are still relatively unknown, staffing recruiters and HR professionals are confident that Obamacare will help drive job growth in certain areas.

Since PRN Funding works with numerous healthcare staffing companies, let’s take a look at the positions that are prepping for fast growth in the healthcare realm.

1. Nurse practitioners and physician assistants
Due to an increased demand for routine checkups and preventative medicine, physician services are set to increase at least 2 to 3 percent by next year. Nurse practitioners and physician assistants can perform similar services for the fraction of the cost of a doctor. Not to mention, general physicians are still in short supply and take much longer to enter the workforce. The Bureau of Labor Statistics (BLS) predicts the demand for PA’s will swell by 30 percent and staffing for registered nurses will increase 26 percent by 2020.

2. Medical billing coders
Healthcare IT staffing will be huge. Combine the requirements for healthcare facilities to transition to electronic health records and comply with a new medical coding system (ICD-10) with millions of newly insured patients and you have a recipe for lots of jobs to fill.

The International Classification of Diseases (ICD-10) will include a staggering 69,000 diagnostic codes and physicians will be required to submit claims with the new codes starting Oct. 1, 2014 if they want to get paid. Lots of healthcare IT staffing will be necessary to build these codes into the electronic health records software. According to Staffing Industry Analysts, medical coding is one of the hottest jobs right now.

3. Occupational therapists
Occupational therapists make appropriate modifications to the homes and workplaces of the disabled to accommodate their mobility needs. Since Obamacare prohibits insurance companies from denying coverage, more disabled people will be able to take advantage of health insurance coverage. The BLS forecasts a 43 percent spike in occupational therapy employment by 2020.

4. Wellness and fitness coaching
The need for health education specialists is expected to rise by 37 percent in 2020, according to the BLS. Many employers will want to encourage healthy lifestyles, so the demand for workplace wellness programs will skyrocket.

Aside from healthcare staffing, Obamacare is also expected to help spur career growth for payroll service providers, computer programmers, lawyers, insurance consultants, customer service reps and human resources professionals.

Demand for Medical Coding is High, While Supply of Coders is Low

With so many clinical and regulatory initiatives in limbo, numerous hospitals that are already operating with thin-stretched staffing are finding their resources being further taxed. While the demand for quality medical coding healthcare professionals is high and getting higher, the supply of these individuals is at historic lows. Some professionals in the coding industry believe the challenges and obstacles created by this medical coding staffing strain will be one of the worst healthcare has faced in around 10 years.

Health Information Management (HIM) departments are also affected by these challenges and for years, they’ve operated under an ever-worsening scarcity of qualified medical coders, a situation which will be exacerbated by looming changes to the industry. Though no one can project how widespread the shortage will be, some expect nationwide medical coder deficiencies as high as 30 to 50% as soon as later this year.

Medical coders typically review patient information for preexisting conditions, like diabetes, and also retrieve patient records for medical personnel and act as a liaison between the health clinician and billing offices.

One of the upcoming changes in the healthcare world is the expanding elderly population that will need more healthcare services and extensive care, which will increase the demand for trained medical coding workers. A second change is that the medical coding industry will lose many qualified professionals due to retirement over the next decade because of an aging medical coder workforce whose average age is currently projected at 54. Further aggravating the situation is the shifting environment in which coders are working, characterized by shorter days to bill, the ICD-10 transition, and other regulatory enterprises.

Unless the healthcare industry can draw the interest of a younger workforce, this combination of factors indicates that hospitals will face an uphill resource battle to uphold high levels of medical coding quality and acquiescence.

Hospital HIM departments are in a rare position to lessen the impact of the degenerating coder shortage. They have the ability to train internal medical transcriptionists, of which there is now an excess with technological advances in the field, to be medical coders. The change to coder is possible for many medical transcriptionists and is a win-win for hospitals looking to streamline costs without firing staff and for transcriptionists looking for job security. Medical transcriptionists trained in coding make themselves more valuable asset to their organization as they can be tapped to manage fluxes in volume and planned or unplanned staff deficiencies. However, it is the hospitals that ultimately must decide whether they want to spend resources and energy finding new coders or leverage the skills of good employees who are already associated with the organization.

Since faster than average growth is predicted in the medical coding field through 2020, it’s a good idea to be sure you’re prepared to handle any sudden growth spurts in business. Learn more about PRN’s medical coding factoring programs and how they can help manage cash flow with zero debt.

Prepare for Affordable Care Act: Tips for Employers

With the Affordable Care Act (ACA) set to go into effect in January 2014, many employers supporting group health care plans are rushing to get ready for the impending changes. Here are some tips on how to prepare for the upcoming implementation of the ACA:

1. Figure out how the ACA will affect your business. According to Forbes, when the ACA is ratified, it will oblige businesses with over 50 full time workers to offer affordable healthcare to them. The ACA is demanding employer coverage just for those who work over 30 hours per week for a period of a month. Corporations who wish to avoid providing this medical insurance for their workers and who are on the verge of having 50 employees may then look to temps and staffing agencies in order to evade being forced to obey the law or create more part-time jobs as another way to shirk the ACA’s policies. Companies doing this will undermine the legislation and its intentions of increasing coverage to more American employees.

2. Choose whether to “pay” or “play” and make decisions about your insurance. To “pay” is to pay employer-shared-responsibility penalties of around $2,000 per employee per year. To “play” is to offer employer-sponsored coverage to fulltime employees.

3. Think about adding wellness program incentives. According to a recent survey by the Midwest Business Group on Health, more than 80% of the country’s biggest employers are looking to implement a penalty and reward system to encourage their workers to get healthy.

4. Organize and give out obligatory employee communications like a summary of benefits and coverage, plan descriptions, etc.

5. Amend your Health Insurance Portability and Accountability Act privacy and security rules and processes before the Sept. 23, 2013, deadline for acquiescence with final regulations.

6. Pay the first comparative effectiveness research fees by July 31, 2013, and plan for future reinsurance charges.

Medical Billing and Coding Industry Predicted to Boom by 2020

While some industries are stagnant or losing steam in the slowly rebuilding economy, one industry is predicted to grow faster than any other- medical billing and health information.

The Bureau of Labor Statistics projects that job growth in that sector will increase faster than any other occupation at 21 percent by 2020. Salaries for these positions are also expected to increase by over 20 percent over the next five years to match as well; all in all, great prospects for a growing field.

Any explosion in growth is necessarily followed by expansion. Expansion in staff or facilities requires cash on hand, which can be a problem for outsourced medical coding and billing services waiting weeks for payment from clients. Invoice factoring is one financing option that affords this industry flexibility, and the ability to pay obligations in a timely manner. As the industry grows exponentially, so will the cash needs of medical billing and coding businesses- and that is where factoring can help.

For the full article, see A Whopping 21% Increase in Medical Billing and Coding Jobs Salary

Hospitals for Profit or for Help?

Did anyone see the article A Giant Hospital Chain is Blazing a Profit Trail in the NYTimes earlier this week?

The article talks about HCA’s revamped billing procedures and revised patient screenings that have led them to be extremely profitable health care industry giant during a time when so many of America’s hospitals have been struggling to stay out of the red.

According to the article, “Among the secrets to HCA’s success: It figured out how to get more revenue from private insurance companies, patients and Medicare by billing much more aggressively for its services than ever before; it found ways to reduce emergency room overcrowding and expenses; and it experimented with new ways to reduce the costs of its medical staff, a move that sometimes led to conflicts with doctors and nurses over concerns about patient care.”

What are your thoughts on this article?

Swipe Fees Threaten Merchant-Customer Relationships Nationwide

Did any of the small business owners who regularly read The Factoring Blog see the article in The Wall Street Journal today, entitled: The Swipe Fee Conundrum?

We thought our small business factoring readers and Americans everywhere should be concerned about a recent court settlement against major credit card companies that may open “the way for millions of businesses to add checkout fees when customers pay with plastic.”

This surcharge comes as the result of 1-3% charges burdened on businesses by credit card companies. This fee may be passed on to customers, who may remain entirely unaware that they are being charged extra for credit card companies’ profit.

Of course, though most business owners would rather be transparent in dealing with swipe fees, “many don’t want to run the risk of alienating credit-card users” by exposing swipe fees to the public.

The fees, which have been deemed by merchants and customers alike as “petty” is undermining the relationships that business owners have with their clientele, as well as the hard-won credibility that make those relationships work.

According to this article in The Wall Street Journal, “The proposed settlement sets aside $6.05 billion,” and “the biggest portion of the money will likely go to large retailers.”

Small business owners may be fortunate to even receive several hundred dollars from the settlement, making this lawsuit a purely corporate affair.

Supreme Court Stuns Nation with Obamacare Decision

The outcome appeared uncertain, but in a 5-4 decision, the Supreme Court ruled the Patient Protection and Affordable Care Act to be constitutional in accordance with U.S. tax laws.

Chief Justice John Roberts opined that the individual mandate, the clause compelling all Americans to own some sort of health insurance, was unconstitutional if the penalty took the form of a fine. Instead, if

Americans decided not to follow the individual mandate, they would be taxed in accordance with the burden that any potential uninsured illnesses might pose to taxpayers.

Though, prior to signing the bill into law in March 2010, the president had vehemently denied the bill to be a tax, his wording was corrected by the court on Thursday June 28, 2012.

Beyond compelling Americans to purchase policies from healthcare insurance companies, the bill also limits insurance companies’ rights to severability. The PPACA holds that no insurance company can terminate coverage because of a person’s pre-existing condition.

Limitations upon the rights of private sector insurance firms are subsequently countered by the bill’s expansion of Medicaid. The federal government has offered to fund the expansion in every state, to the tune of 100% of the cost.

The act, pejoratively known as Obamacare, has a host of pros and cons that will be sure to affect the well-being of each and every American. It is unforeseeable how our small business, healthcare factoring clientele will be affected, but we will keep you posted as new information becomes available.