Claim denials are one of the prime reasons millions of dollars are
lost every year. To reduce and manage denied healthcare claims,
providers often look for better options in the market. However,
they fail to realize that they already own the best tool-denial
management. Denial management can be integrated or availed in the
facility itself, and it does not require looking for extra
solutions. A strong denial policy and affirmed procedures often
lead to a reduction in medical denials. Denial management-
definition The process of claim denial management is formed of two
parts-first is the identification of denial, and the second is its
investigation. Together, these two steps form a strong basis for
the performance of denial’s root cause analysis. This also
incorporates monitoring denial patterns and uncovering trends by
insurance careers. As the final step, claims denial management
should seek to redesign the process of the system to prevent and
eliminate the risk of denials in the future. There may be different
reasons why a claim is denied. Until a provider investigates it,
the reasons and the scope of improvement cannot be visualized. For
instance, a no payment denial may sound an alarm and should be
investigated using the denial management in medical billing,
leading to better optimization of your revenue cycle. Types Till
now, we know that denials lead to a loss in money. But to know more
about the process, you need to realize the types of denial
management, which is vital to prepare the strategy as per the type
of denial. The few main types of denial management are: Hard denial
– a written-off revenue loss resulting from a claim denial which
also requires an appeal Soft denial – a soft version where the loss
can be compensated if the corrective action is taken. No appeal is
needed in this denial. Clinical denial is a hard denial in which
the denial is due to a lack of revenue for mandatory medical
facilities. Preventable denial is also a hard denial type where
there is a lack of practice. This is due to invalid codes used or
ineligibility by the insurance. Admin denial – this soft denial
occurs when the patient often sends a notification to the provider
about why and how the claim is denied. An appeal is possible to
rectify this type of denial. Prerequisites for a clean claim Using
the process of denial management, healthcare providers can
streamline clean claims to a large extent. They can address the
payer about the prerequisites to avoid denials. A clean claim
usually: Includes affiliation and identifying numbers along with
the details of the health professional, health facility, medical
equipment provider, and home health care provider Is capable of
identifying the best health plan for the subscriber Takes into
account recovered services for an eligible individual Has required
information that can help with prior authorization where it is
required Contains all additional documentation as per the rendered
services in the health plan of the claim Uses the best
technological tools and accepted system, taking into account the
source coding Challenges Denial management might appear to be easy
on paper. But it comes with lots of challenges. First, it is
important and complicated to calculate the denial rate. Secondly,
it takes a lot of effort to investigate every denial on the
provider’s part. Some other reasons can cause a hindrance in your
revenue cycle. Some of these include: Lack of trained staff who can
help in healthcare denial management and are capable of using the
advanced system software Shortage of new tech tools such as machine
learning, artificial intelligence, and automation Lack of finances
for developing, integrating, and using a full-fledged digital
denial management system Conclusion Though there are many obstacles
in the road to a successful claims denial management system, there
are also hopeful points to consider. The management of revenue is
the foremost advantage many companies are eyeing. Then, the factors
like the increase of conviction amongst patients, better patient
care, digital healthcare provision, and better medical claims
provide a way to improve and face the challenges. Source:
https://www.osplabs.com/medical-billing-solutions/denial-appeal-management-software/
Mobile health or mHealth provides health services and relevant
health-related information through mobile and other wireless
technology. In simple words, it is the evolution of healthcare into
the virtual world with smartphones. Some institutes also define
mHealth as the use of small wireless devices to enhance healthcare
outcomes, services, and health research. No matter which definition
you choose to imply, the crux remains the same. Mobile Health
Solutions is an essential aspect of the entire electronic health
system now. It is a cost-effective and secure way to spread and
share information, develop communication between technologies, and
provide health surveillance. It further helps in health education,
literature, research, and awareness. With the growing use of
digital solutions in healthcare, mHealth will have a vital role to
play in advanced computing sciences, big data protocols, artificial
intelligence, and even genomics. The most common uses after covid
Mobile health and its use have been rising since covid struck
humanity. From distributing critical information to providing
knowledge remotely, every sector utilizes this technological edge.
Here are some of the most common uses of mHealth after covid:
Delivering and receiving patient information to and from mobile
devices Keeping patients aware through reminders and alerts
Adoption of telemedicine for better convenience Personalizing
patient education systems Support in decision making for healthcare
providers Health surveillance Digital screening and monitoring
Emergency response communication On-demand healthcare
transportation services The boundaries explored by mHealth Covid
forced us to search for novel ways to improve healthcare services.
mHealth provided a robust answer to the situation, and it helped us
recover our lifestyles and opened up doors to a myriad of
opportunities. The contract tracing in digital form was introduced
thanks to the conjugation of healthcare into smartphones. This
allowed the epidemiologists to monitor and control the diseases
better. Another new exploration was with the fitness apps, and
these helped patients and common people monitor their vitals and
check their progress daily. Using sensors, the mHealth fitness
tracking devices could even help us with our daily diet regime,
calories burnt, or water intake. Using smartphones, many healthcare
applications did wonders using sensors such as accelerometers,
gyroscopes, thermometers, magnetometers, and even blood pressure
monitors. Some advanced phones even used hall effect sensors,
barometers, or proximity sensors, further revolutionizing the way
we monitored health. Mobile health even impressed government
authorities, showcasing how they can save time and money using
virtual applications. The use of mHealth apps only led to awareness
about vaccination. A simple caller tune transformed into a Covid
awareness message helped provide information to millions, free of
cost. And who can ignore the use of various Bluetooth-operated
software and local, regional apps that the government used to
provide healthcare services at a mass level? Support patient care
and engagement No matter how many new functions we relate to
mHealth, we won't overlook its importance in providing basic
patient care and engagement. Mobile health allows quicker responses
and better communication lines than earlier traditional methods.
Now, people don't need to wait for the person to pick up the call,
and patients can chat with the automated bots and get a response in
a matter of seconds. Patients can now send secure messages, connect
to providers anytime, schedule appointments, and avail telemedicine
visits. The convenience of having a provider visit your place is
simply remarkable, especially for older patients. Virtual
consultation has also proved to help reduce the commute cost and
time. The entire process is also helping in improving patient
engagement. With quick responses and better conversation,
healthcare providers can better know the patient's needs. On the
other hand, patients can be frank and communicate easily through
mobile apps. Bringing the best of both worlds, mobile health apps
for patients has led to a colossal improvement in patient care
after Covid. Enhance patient safety and medication accuracy When
patients get discharged, they are dependent on the medicine
prescribed by the healthcare provider. Often, they are handed over
substitute medicines that do not offer high potency. As a result,
the care is sacrificed, and things become critical in the case of
chronic disease management. Solving the issue, mHealth solutions
ensure that the patients take the right medicine. The online
applications of healthcare providers are educating patients on the
salts and roles of the medicines they are prescribed. Patients can
now ask the accurate medicine and deny the substitute. Also, the
telemedicine apps offer reminders and notifications which allow
patients to take medicine at the scheduled time. Some apps even
provide notifications about refilling prescriptions, tracking
remaining pills, and online medicine orders. Benefits for
healthcare providers It is equally important to mention how mHealth
apps helped increase communication and coordination for healthcare
providers. Mhealth technology has led to the foundation of:
Organized appointment scheduling Multiple facility coverage Better
communication between healthcare personals Referring physicians
Assigning tasks to office, medical and lab staff Using secure
messaging and texting Mobile health record access Secure phone
calls As of recent discoveries, some apps alert the providers about
the condition of the patients, both at home and at the hospital.
These apps can even offer live pictures of a patient to see the
magnitude of care he is getting at home or the hospital.
Personalized approach toward the patient education system Many
people fail to read long lists of medical records or documentation.
While young ones are not interested in reading papers, elders find
it difficult to explore listed medical documentation with tons of
complicated terms. Mobile health came to the rescue in improving
this patient education system. With the use of data-driven
information, patients find it easy to know about their health and
the latest health discoveries in the world. Tons of apps offer the
latest news in short format, including videos, gifs, images,
infographics, and audio files. Some mobile software even acts as
your daily dose of health-related podcasts, and it is much easier
to access these. Furthermore, a patient can personalize the app to
hear or read the news he is interested in. He can even set
reminders for the updates and manage how and when the notifications
are displayed on his smartphone. The new inventions ahead With an
innate look at the present status of mHealth solutions, it is vital
to talk about the prospects as well. Since healthcare is already
riding the technological wave, it will not stop anytime soon. There
are certain more medical health technologies lined up to astonish
us in the future. Some of the sheer examples include Use of mHealth
for new methods of drug development Bridging the gap of
interoperability to get big data into use Application of
nanotechnology to create new medicines called nanomedicine AI
regulated medical devices to improve sensing, diagnosis, and
testing Automated and response based healthcare mobile app
development 5G enabled internet devices for faster data
transmission and collection Tricorders to quickly monitor vital
signs of a patient automatically Healthcare assistants, something
similar to Alexa or Google AI-supported pacemakers Bottom line With
so much to look forward to, it is incredible to realize that mobile
health has just taken its baby steps in the healthcare industry. As
the benefits continue to evolve, we can see the proliferation of
wireless devices throughout the country. The patient enthusiasm
adds to the application and dependency on the healthcare mobile
apps. And the support by healthcare providers for using such
technologies will pave the way for a better future. Source:
https://www.osplabs.com/mhealth/
The Evolution of EHR Systems in Healthcare The present times have
seen the rise of the virtual healthcare scenario. EHR systems in
healthcare have, consequently, risen to the occasion. Health access
is still limited in many areas, especially remote locations and
villages. EMR systems in healthcare offer patients the convenience
of reaching out to physicians anytime from anywhere. Elderly
patients and chronic needs can also benefit from virtual healthcare
EMR systems. They can have virtual consultations through video
calls or chatbots. Medical electronic medical record systems and
applications provide health access to patients from the comfort of
their homes. Almost every EMR system, in the current scenario, is
geared with coherence, strict security systems, telehealth
offerings, remote patient monitoring systems, and an automated EHR
system. Overall, existing electronic health record applications
deal with the current requirement of virtual access to care, easier
systems, and patient engagement systems. As digital medical records
continue to be used in healthcare software development, a hospital
EMR system will look toward cross-platform mobile EHR applications.
Medical app development companies are also predicted to develop
MVPs of EMR, EHR systems for an overall purview of electronic
health records software solutions. Integrated Healthcare Apps EMR
systems in healthcare apps that offer healthcare interoperability
are poised to be the next big thing. An EHR system in healthcare is
currently designed to address a specific requirement for patients
or healthcare providers. EMR solutions are applied toward either
correspondence, coordination, clinical data analysis, or even
pharmacy management. EMR, EHR systems, in the current space, is
focused on specialization and micromanagement. With the application
of EMR systems in healthcare, medical app development companies
will continually innovate toward multi-purpose applications. EHR
integration software is likely to develop and fulfill multiple
requirements for patients and providers alike. Avant-Garde Security
Solutions: Currently, the focus remains on developing a
HIPAA-compliant app. While HIPAA compliance is an integral part of
electronic health record applications, patient health data is
sensitive. Even though EMR, medical records in paper form, or even
generalized patient data requires security, it is not enough to
satisfy patient concern with revealing this vital information. EMR
– electronic medical records are being used increasingly to develop
mobile EMR solutions for doctors, patients, and even administrative
staff. EHR technology platforms are in constant danger of data
breaches and information leakage. Patients are consciously
skeptical about uploading their information on electronic patient
record systems. Electronic data exchange will be powered with agile
authentication techniques, including face recognition,
fingerprinting, and more, to access open-source electronic medical
records. The security of electronic patient record systems is now
likely to remain at the forefront of cloud-based EHR software.
Agile Interfaces: EHR software development for mobile EHR
applications is all about using advanced interfaces. EHR software
solutions can no longer be based around traditional designs with
plain interfaces. While maintaining natural communication patterns
and simplicity, touchless interfaces are the future of EHR
solutions and EMR software development. Clinical informatics can be
advanced to offer voice-driven interfaces in an EHR solutions. With
a rise in voice partners, such as Siri and Alexa, it is only a
matter of time until this trend is established across EHR software
development. Touchless UIs already see significant movement in
wearable devices of healthcare EMR systems. Conclusion: With the
continually evolving nature of healthcare trends, mobile EHR
applications will follow suit. As technologies grow in strength,
health accessibility through mobile applications will continue to
expand. In a nutshell, electronic health records solutions will be
empowered through acquisitions and mergers to make bigger offerings
toward electronic health records services. EHR/ EMR mobile app
development will be built around EHR interoperability solutions for
an all-powerful super app. Source:
https://www.osplabs.com/healthcare-provider-software-solutions/emr-ehr-software-solutions/
We live in a time when the world population is experiencing
unsoiled interconnectivity. Thanks to the digitization of important
aspects of our lives, we can feel the change in our daily routines.
Health management has not been far away in this regard. The
application of digital technology in the health sphere is
increasing every minute. This has opened up a broad spectrum of
scope for the use of digital health solutions in various fields.
And in the middle of it all remains patient engagement, acting as a
central force that forms the basis of every new invention. Let's
know more about this in detail. What is patient engagement, and why
does it matter? Patient engagement is creating a bond between the
healthcare providers and the patients. The better the engagement
is, the better chance a patient can manage his disease. Patient
engagement platfroms is important as it helps an individual go for
regular checkups and necessary tests to seek better prevention and
cure in the long run. It is the intention a patient has to partner
with the healthcare provider to manage his condition better. Due to
the digitization of the healthcare process, patients seem to be
actively engaged in collecting information about their bodies. They
can also make wiser decisions on their treatment and medications
options, along with symptoms and illness. Nowadays, patient
engagement is not limited to a single individual, and it forms the
basis of a partnership between patient families and representatives
with the entire healthcare team. This also includes organizational
governance and policymaking by the healthcare facility. Digital
health solutions to the rescue Digital health has played an
important role in converting patients from followers to
influencers. Digitalization has played a vital role in the process
and helped stakeholders achieve their objectives in a promising
manner. Earlier, the patient didn't know their pulse rate,
hemoglobin ratio, sugar readings, or blood pressure metrics. The
prescription was handed over to him, indicating the use of medicine
without any additional info. Now, the patient can monitor these
things on his own with the help of a simple, smart app. He can
decide whether he needs medications or not. Same way, the patient
used to depend on the medicine he prescribed for years. But with
the patient engagement system of today, he can look for substitutes
to the medicine using a telemedicine app and choose an affordable
medicine brand with the same salt and same function. The digital
health ecosystem combines instructive, informative, and interactive
structures. It has always been intended to boost the levels of
engagement, leading to better innovations in the entire world.
Bridging gaps in patient care The digital tools are giving
healthcare providers an extensive view of the entire data of the
patient. And the fact that this data can be obtained from remote
places makes digitization more convenient. This has resulted in
increased efficiency and enhanced medical outcomes. Patient care
can be provided remotely using video calls and on-call counseling.
The mobile apps and patient engagement systems are now supporting
the clinical decisions made by doctors. Furthermore, digital tools
help us diagnose a patient accurately using artificial intelligence
and automated engineering. The delivery of patient care has
increased ten folds due to this revolution. Tracking results for
meaningful change With optimized apps, healthcare providers can
track meaningful results to change their services. This is more
evident from behavioral and personal apps used by patients. By
tracking the health progress of a person, healthcare providers can
devise strategies as to which principles will lead to specific
impacts. This has improved the outcome measurably, leading to
better care and treatments. Improving telehealth With more
providers relying on providing virtual assistance to patients,
telehealth has become a significant part of patient engagement
solutions. Through this technology, one can converse with doctors,
medical staff, caretakers, and other patients. Telehealth has
extended the patient's reach to healthcare services using a digital
connection. It can further help by: Providing patient care in
remote settings Offering counsel and guidance to patients isolated
at homes or hospitals Increasing access to better care and medical
treatments Providing online access for patients to test results and
medications An increase in the popularity of mobile health
services, also termed as mHealth Offering virtual healthcare
appointments and visits Aid in finance and billing There has always
been a strong link between patient engagement and medical billing.
Through digital health, patients can track their medical expenses
accurately. The graphs, charts, and bill books shown digitally
through an app or a web application can be decisive in seeking
reimbursements. As a result, patient engagement solutions have led
to increased monetary awareness, which further results in better
financial management. Through better engagement, patients have
become more aware of their medical insurance reimbursement and its
procedures. This helps them understand the financial limitations
while eliminating certain potential finance-related confusions.
Since bills are managed, and finances are streamlined, unnecessary
follow-ups are also reduced. Better pre-patient care Most patients
feel as stressed about appointments as they are about the actual
treatment of the disease. And for most of them, the smooth
experience of scheduling appointments on the website is as better
as getting treated for a disease completely. Use of online
information, online reviews, consultation charges, price packages,
and treatment services is far easier than waiting for your turn at
the hospital. Digital technology is fueling per-patient care like
never before. People are now choosing better health care providers
using online reviews, managing their appointments using hospital
apps, and avoiding long waiting times due to online billing.
Another important thing to note here is the speedy experience
patients are enjoying. Through a closed-loop approach in real-time,
they can get treated quickly. Machines are helping with the speedy
diagnosis, while doctors get help from the patient analysis
provided by digital applications. Furthermore, automated tools help
in providing speed and transparency to service providers. This also
increases communication and helps in good quality feedback.
Improving education and awareness Digitization has placed relevant
information in the hands of the patients. And since then, health
information has been spreading like wildfire. Patients are becoming
well-informed day by day and can adhere to the treatment protocols.
Also, the negative behaviors are being eluded, which otherwise
worsened the patients' conditions. Educating patients is always
beneficial for the outcomes of medical treatments. With healthcare
providers putting less effort into this, digital technologies have
taken up this duty and proved result-driven. Virtual care is
becoming customary: A smartwatch can continuously track your heart
rate and notify you if it exceeds the prescribed limit. Similarly,
a wearable can help detect changes in your health using advanced
biosensors technology. Virtual care is real, and the spectacle is
happening all around the country. And it makes sense now more than
ever with coronavirus restricting people from going outside.
Healthcare facilities can also provide virtual care through
telehealth and telemedicine. Interestingly, the hospitals that
cannot provide virtual care are being nullified in the competition.
This way, patient engagement solutions have paved not just opened
the doors of virtual health care but have also made it a mandate
for the providers to survive in the industry. And the receivables
of this technology, the patients, are experiencing better
engagement protocols than ever. Conclusion: Patient engagement
platform are just the tip of the iceberg, and there are much more
advanced technologies in the line. Inventions like machine
learning, artificial intelligence, virtual reality, etc., are also
waiting to erupt and impact our healthcare system in a good way.
With so much to work on, the future seems bright for patient
engagement. We know that we have come a long way in improving
healthcare. But we should also realize that still, there is a long
way to go. As patients, all we need to do is be optimistic, stay
informed, and never lose faith in technology. Source:
https://www.osplabs.com/patient-engagement-software-solutions/
