Surviving In The Healthcare Industry

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Surviving In The Healthcare Industry

Notable Issues You’re Going To Deal With

As a healthcare business, you’re going to have difficulties in terms of operation; from hiring the right people to local political realities that force your hand, to marketing, to IT issues, to security as regards HIPAA, a profitable hospital is going to have its hands full. Even if you’re regionally one of the best institutions in your area, you may have trouble staying afloat.

While a writing as short as this can only do so much to help you streamline operations, there are a few things worth at least thinking about that we can cover here. Following are two key challenges you’re going to face as a healthcare institution, and what you can do about them.

Having Strong Medical Insurance Is Costly, And Needed

You have got to get good medical insurance. Did you know that 200,000 to 500,000 people die a year from medical mistakes alone? It depends on who you ask, but the fatalities are in that ballpark.

By contrast, official numbers for COVID-19 fatalities between 2020 and 2021 in America alone are around 700,000. That’s basically a combination of low and high years for medical mistakes that are fatal. Here’s the sad truth: often, malpractice is a complete accident.

Doctors who have taken the hippocratic oath aren’t trying to harm anyone. However, human beings make mistakes owing to their imperfect human nature. Some mistakes are from fatigue, some from technology malfunction. Lawyers don’t care, they just want to win in court.

What do you do? Secure healthcare insurance that covers your bases should the unexpected happen. But that insurance is expensive, and sometimes it isn’t as extensive as it ought to be. As a healthcare institution, it’s integral to choose carefully when it comes to healthcare insurance, and secure the right software.

The Payor Contracting Conflict

You must get proper payor contracting for your healthcare business, or you’ll have payout suspended for a long time. Many insurance companies that are involved with paying your healthcare institution on behalf of patients find creative ways of saving money at your expense.

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For example, they’ll change contractual terms soon after establishing them, and sometimes before you’ve properly been paid. It’s the same principle as a property management company sending a check to landlords without a signature. You get the check, go to cash it, can’t, and tell the company. They fall over themselves apologizing and issue you a new check.

No harm, no foul, right? Well, hold on. The company that did that was able to keep from losing financial resources for the month or so it took to mail you the check, until you realized there was no signature and contacted them to mail you another.

They can only get away with doing that once per landlord for whom they manage, but it’s no trivial sum

A company managing condos with fifty landlords that are paid around $9k per check is seeing about a $450,000 payout. So as a tactic to preserve cash flow, this underhanded faux “mistake” makes sense.

Similarly, payor contracting services “pass the buck” of contract definitions such that what is covered may change from one contract to another without healthcare institutions noticing. Get good payor contracting to avoid such issues.

More Smooth Operations Overall

Between healthcare insurance and payor contracting, you’ve got challenges to overcome. You need good insurance for your healthcare practice, and you need to be sure the insurance companies that pay your institution on behalf of clients do so in a timely way that’s not underhanded.

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