Risk-based Auditing Software Helps Keep Healthcare Spending Under Control

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Healthcare spending has exploded since the 1970s, in part due to the growing number of administrators needed to oversee compliance issues. To remain compliant and keep more of their money, organizations should use risk-based auditing software solutions.

The United States healthcare system has undergone tremendous transformation since the 1970s. This is reflected in recent data suggesting a 2,300% increase in healthcare spending between 1970 and 2009.(1) This is partially explained by an increase in the number of governmental rules and regulations which implement strict guidelines for many aspects of care, including medical coding and billing. In many cases, the complexity of these guidelines leads to coding and overbilling issues. Ultimately, these issues bring about increased costs for the healthcare system as a whole, with much of the burden falling back on providers and patients. The solution, says Fi-Med Management, is the implementation of risk-based auditing software, which identifies coding problems early on and helps healthcare organizations avoid costly governmental audits.

A significant portion of these increased costs is attributed to the expansion of healthcare administrator rolls, with explosive growth in the number of people hired to fill such positions. However, a key driver of this expansion is the creation of an unprecedented number of regulations to which healthcare organizations must adhere in order to remain compliant.(2) From 1975 to 2010, the number of healthcare administrators grew by 3,200%, while the number of practicing physicians only grew by 150%.(3)

The increasing number of people needed in order to properly oversee complicated processes such as medical coding is driving healthcare spending across the board. While many organizations strive to remain compliant, they can’t do so without a team of professionals monitoring for mistakes and correcting issues that occur.

Adrian Velasquez, president, CEO and co-founder of Fi-Med Management, says, “Healthcare organizations can help keep costs down by employing technology that gets to the root of issues, especially those concerning medical coding and billing. This kind of technology identifies problems before they become major issues, which helps reduce healthcare spending overall.”

Risk-based auditing software, such as Fi-Med Management’s REVEAL/md, makes compliance easier by flagging problems that may lead to overpayments or underpayments. Healthcare organizations can protect their finances by implementing these solutions for all members of their healthcare team.
About Fi-Med — http://www.fimed.com

Since 1993, Fi-Med has been working alongside healthcare providers and networks to maximize revenue and reduce risk—from catching billing errors to providing high-level safeguards against compliance risk. Fi-Med is a healthcare technology company helping to disrupt the status quo of the increasing burden of government compliance for hospitals and hospital systems. As a leader in the healthcare support and management industry, Fi-Med provides billing, receivables management, credentialing, lockbox, and other financial management and reporting services to physicians, labs and medical centers nationwide. Its strong reputation for maximizing revenue and reducing risk for hundreds of hospitals, labs, private physicians and healthcare networks is the result of the technology tools that it has created: a 360-degree understanding of healthcare compliance, chronic care management, and revenue cycle management.

REVEAL/md is Fi-Med’s keystone product, empowering healthcare providers’ compliance departments to proactively manage physician part B audits of documentation and coding. For more information, visit http://www.fimed.com.

About Adrian Velasquez, President, CEO and Co-founder

Armed with an extraordinarily successful career in the healthcare business, Adrian E. Velasquez has successfully blazed new trails, taken risks and defied the odds, and in 1993 partnered with Christine Krause in forming Fi-Med Management, Inc. Their mission: to bring business acumen and compliance expertise to healthcare providers throughout the United States.

Prior to his work at Fi-Med, Adrian worked with healthcare providers across the country, mastering all areas of business function and management for medical organizations of all sizes. His previous experience as a system administrator and healthcare consulting from New York to California formed the foundation that he harnesses today for Fi-Med clients.

Among his accolades, Adrian won the Small Business Person of the Year Award in 2007 for the state of Wisconsin, and represented Wisconsin on the national stage.

Fi-Med has been working alongside healthcare providers and networks to maximize revenue and reduce risk—from catching billing errors to providing high-level safeguards against compliance risk. It has grown exponentially over the last 24 years, becoming a trusted expert in the fields of financial healthcare management, compliance and risk assessment, and chronic care management.
1.    The Chart that Could Undo the US Healthcare System. Foundation for Economic Education. https://fee.org/articles/the-chart-that-could-undo-the-us-healthcare-system/.
2.    The Growth of Administrators in Health Care. Investing Doc. https://investingdoc.com/the-growth-of-administrators-in-health-care/.
3.    The rise (and rise) of the healthcare administrator. Athena Insight. https://www.athenahealth.com/insight/expert-forum-rise-and-rise-healthcare-administrator.

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Karla Jo Helms
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