Electronic Medical Billing - Industry Challenges

TIME CONSTRAINTS:
Day-to-day business operations at a practitioner's site represent a bustling and eventful array of healthcare services. But most medical offices are very limited on administrative time as their primary focus is healthcare operations. As such, a conversion to a new system will require a significant effort and expense for the practice, a move that they are reluctant to make.

BUDGET CONSTRAINTS:
As with any successful business, one of the keys is to keep overhead costs to a minimum and to extend the useful life of all capital assets. To process claims electronically, the practice will need to acquire additional software, perhaps additional hardware, and spend a large dollar amount for training on the conversion.

On-going costs are also high. Due to the high employee turnover in medical clinics, doctors constantly hire and train new staff. Maintaining a computer system means paying for constant annual upgrades, training and support contracts.

STRICT PROCESSING GUIDELINES:
Healthcare providers are required to adhere to strict processing guidelines established by insurance companies and government agencies. Failure to comply with these strict guidelines results in claims being rejected, which in turn has an adverse effect on cash flow. Healthcare providers seldom are willing to take this chance. Additionally, when they process claims, they are required to batch claims which may result in a delay in processing, thus forfeiting one of the key benefits of electronic claims processing.

LIMITED EXPOSURE TO THE BENEFITS OF ECP:
Most healthcare providers are familiar with electronic claims processing but are unsure how the process may impact them specifically. With limited exposure, they do not have the ability to recognize the tremendous potential in cost savings, efficiency and improved cash flow that electronic claims processing can provide.

MOST DOCTORS ARE NOT TRAINED FOR BUSINESS:
Healthcare providers spend 10-15 years in medical studies. Even while they are practicing medicine, they have to stay active in medical research and development. Most doctors are not experienced in running a business. They rely heavily on professionals to take care of their business.

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