Don’t Let Medicare Pay Cuts Impact the Bottom Line of Your Practice


Don’t Let Medicare Pay Cuts Impact the Bottom Line of Your PracticeRecent reports submitted by the Department of Health and Human Services implying an approximate 21.2% cut in the rate of Medicare reimbursement, has come as shocking news to all healthcare providers, across all the states. Caught amid a wounding state of affairs in terms of medical reimbursements, many doctors have chosen to stay away from Medicare patients. This has inadvertently posed a threat to senior citizens and those who depend on Medicare to pay their medical bills. On the contrary, some healthcare providers, who wish to be able to serve the needy, are acting smart and have resorted to medical billing services to offer them expert advice on these matters.

In the meanwhile, all the Medicare charts are being carefully audited for adherence to programs like MU2 and several complex medical coding standards that all physicians have to comply with. Experts in the industry are implying that practitioners will need to produce all the information pertaining to your Medicare patient records, even if the audit happens a several years from now!

Eligible Practitioners were compelled to adjure to MU2, before the end of February. In addition to the 21% cut in revenue already posed by Medicare, those who failed to attest to the rule within the given deadline now face the threat of a penalty ranging from 1-5% each year. Moreover, practitioners failing to report to the Physicians Quality Reporting System are subject to an additional 1.5% penalty over all Medicare payments done in the year 2015. Subsequently, the penalty is expected to rise by 0.5% in the following year.

Adding further complications to the scenario, Value Based Modifier Program has been posing further complications since 2013, cutting down the rate of Medicare reimbursements by an extra 1%, for group practitioners of 10 EPs or more. With the time passing, a large portion of Medicare practitioners are in dire need of medical billing services to help them keep up with the ever-growing list of standardizations.

Apparently, the regulatory bodies have only made things more complicated for medical practitioners, with frequent rule changes posing critical challenges. As CMS had predicted late, last year, healthcare providers are facing upto 200% rise in the rate of claim denials this year, following the implementation of ICD-10 coding standards. A lot of healthcare providers are compelled to spend exorbitant amounts of time and money on training their in-house billing departments to keep up with the current coding and documentation practices, but in vain.

But as goes the saying, some healthcare providers have found light at the end of the tunnel by seeking expert help from medical billing services. After all, why let challenging rules affect the quality of healthcare provided? If there’s a way out of these troublesome realities, why stick to pushing the envelope yourself and risk the damage to your revenue model and more importantly, your quality of service?

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