Cash Flow Strategies for the Medical Transcription Industry

Medical transcription service organizations (MTSOs) rely on cash, and for many smaller sized MTSOs, a strong cash flow is crucial for survival. Anything that has a negative impact on cash flow can break a MTSO; learning to recognize threats to your business’s cash flow and how to navigate them can be the difference between your business failing or surviving.

“It’s the nature of healthcare. [Hospitals] have to carefully manage cash flow in order to make sure they can cover their obligations. Revenues are constantly being squeezed, so one way to manage that is to pay vendors slowly,” said Philip Cohen, founder of healthcare factoring firm PRN Funding, who observes that it’s not uncommon to see net 90-day payment conditions. “Any well-run business can manage a slow-pay situation as long as they understand it going into the relationship. Where MTSOs get themselves into trouble is when they expect to get paid in 30 days and instead get paid in 90.”

Getting a credit report on any potential client before signing a commitment is the best way to get an accurate reading on the client’s payment history as you’re about to effectively lend them money.

Problems in cash flow arise when the MTSO fails to account for float time between gaining a new client and receiving the first payment. MTSOs usually pay medical transcriptionists and other personnel biweekly but bill clients monthly, which means the amount of cash coming in isn’t timed well with the amount of cash the MTSO is expected to pay out on a shorter timeline.

For some MTSOs, medical transcription factoring is a viable option that can help improve cash flow, relieve the pressure of scrambling to free up capital to pay employees, and let you focus on you’re the growth and success of your business.

Read the entire article to here for more ways that MTSOs can maintain a healthy cash flow.

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.

Medical Transcriptionists Face Dictation Challenges

For years, physicians have been dictating their patient reports while medical transcriptionists have been trying to figure out what they’re saying. A recent article in For the Record discusses how technology such as electronic health records (EHRs) and speech recognition are turning these transcription challenges into serious downstream problems and what can be done to fix it.

Various habits and practices cause poor dictation, and even articulate dictators can sometimes fall victim to one or more of them. The propensity to multitask also can undermine the quality of the dictation. Physicians may eat or yawn while talking. They may be trying to speak on a speakerphone while driving in the car with the windows down. Oftentimes, dictation is done with others in the room so the medical transcriptionist must decipher one voice among four others in the background.

Unfortunately, the more physicians in a health system, the broader the range of poor dictation excuses. Melissa Campion, RHIA, CHDA, CHPS, CMT, an eHIM senior systems analyst for transcription at a big integrated health system in Melbourne, Florida, says that foreign accents, which many would assume to be an issue for transcriptionists, aren’t always a challenge. “The accents are actually easier to deal with because most of the doctors with a heavy accent are aware of it and try harder to make it clear,” Campion says, adding that her team has more difficult with dictation from physicians from the Deep South who may be oblivious of how their accents come through in the reports.

However, poor dictation isn’t really about accents, background noise, or speech patterns. Manager of transcription services at Lancaster General Health in Pennsylvania Kathy Lengel says communicating correct and complete data in an effective manner also can notably influence the quality and timeliness of the final report. “Poor dictators are very inconsistent in the format they use,” she states. “They don’t provide good patient information, and some of our poor dictators enter no patient demographic information. They jump all over the place. They have no rhyme or reason to how they’re dictating.”

The safety and quality of patient care are the main concerns when dictation challenges arise as they affect the timeliness and accuracy of the report. Treatment decisions are based on information in a patient’s chart so accuracy is of utmost importance as incorrect dosages could be disastrous or fatal. Many organizations refuse to fill something in if they aren’t 100 percent sure. The uncertainty impacts turnaround time and often requires reports being sent to the hospital to be manually fixed.

Being a good dictator takes several qualities, including being cognizant of the fact that someone on the other end has to be able to make sense of what you’re saying.

Medical transcription service organizations (MTSOs) may want to contemplate including contract language that tackles dictation problems. Medical transcriptionists are paid on a production basis, so having to struggle with poor dictation hampers their income potential. MTSOs may want to consider charging more if physicians are poor dictators and unwilling to improve the quality of communication.

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.

How to Manage Medical Transcription Overflow

Sometimes when the work starts to pile up, it makes sense to hand it off to someone else. Overflow is common in the medical transcription industry and outsourcing transcription work can play a big part in reducing turnaround times, eliminating errors and helping to minimize stress on medical transcriptionists.

A recent article from For The Record magazine seems to believe otherwise. It discusses a variety of ways that medical transcription companies can manage the extra work in-house instead of using outsourcing. What does this outlook mean for the medical transcription industry?

Read it for yourself and see what you think.

The Future of Medical Transcription Under Obamacare

In 2010, the U.S. Department of Health and Human Services (HHS) introduced measures that lay a groundwork for the widespread adoption of electronic medical records (EMR) within medical institutions. Electronic medical records are a digital files containing health information about patients that are typically filled out by doctors.

With these electronic medical records now mandated by Obamacare, does that leave any room for flesh and blood medical transcriptionists? Medical transcription is the process of converting voice-recorded reports dictated by healthcare professionals into text format. The transcription industry has faced threats before, such as outsourcing and voice recognition software, but the mandated EMRs are likely to reshape the whole transcription industry.

Almost everyone agrees that completely electronic records will never eradicate the need for medical transcription. Instead, experts say that future transcriptionists will simply need to augment their existing skill set with new EMR structure knowledge. The job will evolve with technology, just like every other industry must.  Accurate health documentation is a must, and the human touch is still needed when it comes to doing so.

For more information, see How EMR is Going to Affect Medical Transcription Industry

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?

Thoughts on ACE2012

The medical transcription invoice factoring specialists from PRN Funding are all unpacked and settling back in from their visit to Indianapolis for AHDI’s Annual Convention and Expo at the JW Marriott Indianapolis. Specifically, PRN Funding had the opportunity to meet up with one of our current clients, and we bumped into two previous clients at the show.

A few additional observations from this year’s conference (from the exhibitor’s perspective):

    1. It seemed like the show, as a whole, was much smaller than in the past. It felt like there were fewer bodies in the exhibit hall (both exhibitors and attendees) at this show.
    2. The attendees were professional and eager to learn about PRN Funding’s medical transcription factoring services. PRN Funding was able to discuss how factoring can help small MTSOs balance out their cash flow to many attendees.
    3. The exhibitors were engaging and interactive.
    4. Everyone (exhibitors and attendees alike) enjoyed the Treasure Hunt (PRN Funding was a participant).

      PRN Funding is dedicated to help medical transcription service owners continue to maintain a positive cash flow as the transcription and documentation industry continues to change over the years. We look forward to seeing everyone again in Lake Buena Vista, FL in 2013.