Main Subject - Business

Outsourcing to a professional medical billing company to manage your practice’s reimbursements can be both a blessing and a curse. In most cases it will save you significantly in payroll, staff time, and administration headaches, but it can also feel like you’re giving up all con

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

trol of your revenue. As practices consider their options for managing medical billing, it’s important they find (and maintain) a comfortable sense of control over operations. Here are a few mechanisms of control your medical billing company should offer to show you that the work

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

is getting done efficiently and effectively.

Consistent reporting
Consistent reports should be standard for any medical billing company and are your foundation for control over practice revenues. They should be provided at least once a month and include t

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

racking of transactions, A/R, managed care and capitation utilization, and individual provider reports for practices with multiple doctors. Any medical billing company worth your time should also be able to respond to reasonable requests for customizable reports as well. Reports

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

hould be clearly designed to give you a concise understanding of the successes and shortcomings of your practice and medical billing company.

Comparative Analysis
Monthly and periodic reports are helpful in assessing what has taken place over a given time fr

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

ame, but comparative reports will truly show the ebb and flow over the longer term. You will have a greater understanding of your practice and the performance of your medical billing company if you are able to clearly see improvements to your cash flow over time identify periods

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

of lagging profitability. Make sure your medical billing company is able to furnish you with comparative reports monthly, if not at least quarterly or annually.

Performance Metrics
Performance metrics will often be built into a medical billing services contr

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

ct, but you should have a mechanism in place for measurement. An example of a solid performance metric would be: 98% of all claims submitted to the carrier within 48 hours of receipt. This is an attainable measurement in most cases, and almost all medical billing software package

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

s can report on submission date for comparison against the date of service. Periodic spot checks of performance metrics will give practices further control over day to day operations and tasks – and not just monthly trends from the periodic reports.

Reimbursements Se

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

nt to the Practice
When working with a medical billing company, there are a number of ways in which payments can find their way to your checking account. First – not always the number one choice for that heightened sense of control – payments can be sent directly to the

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

edical billing company. While it would be rare that a medical billing company would do something illegal with the payment (and for very little long term benefit), some practices feel this gives away too much responsibility. Another option is to set up a lock box at a local bank.

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

Lock boxes ensure an added sense of security as all mail is received, opened and sorted by bank personnel - but they add often unnecessary steps and time to the process. The most common option for greater control over your payments would be to have all reimbursements sent directl

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

y to the practice. The medical billing company can continue to update A/R based on copies of EOBs if necessary, but you never have to worry about misplaced or misdirected checks if you are receiving them directly.

Patient Information
While the EMR revolution

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

is building, many practices are still moving around enormous amounts of paper. If you are among these, you will need to communicate your patient information to the medical billing company in such a way that you retain copies or originals of encounter documents. Typically, encoun

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

er information is sent via fax or mail mail. If mailing patient encounter information to your medical billing company, consider retaining the originals and sending only copies. Though rare, there is always the possibility that it might get lost in the mail, or the medical billing

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

company could misplace a record. Also, with a more advanced medical billing company you will find scanning or imaging of all documents that come into the office is not uncommon – and they can usually send a monthly CD back to your practice for an extra, electronic copy of patien

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

t information.

Access to Data
More advanced medical billing companies can also offer practices access to data via VPN (Virtual Private Network) connection or via web portal. Such systems are capable of offering real-time, or near-real-time, access to data an

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

allow client practices to view everything almost as it happens – including daily reports, status of claims, patient balances, etc. Keep in mind that such services do not come inexpensively; they require regular maintenance by very savvy staff.

Contract Terms

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

Finally, if your billing service does not provide you with a way out of their contract – be it with 30, 60 or 90 days notice – then think about the relationship carefully. Are you getting locked into something you might not be satisfied with just a month down the road? Your med

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

ical billing company should have an incentive to keep you happy as a client. The service provider whose willing to give you the “out option” with short notice is most likely more confident of their services than the one seeking to tie you down for six months or a year.

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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