Considering the rollout of healthcare reforms and deadline for ICD-10 transition, 2014 will prove to be a challenging year for physicians.
Medical billing and reimbursement changes in 2014:
- 20.1% drop in Medicare reimbursement has been announced by CMS for professional services. While some specialties will benefit in 2014, other specialities including pathologists, interventional pain management specialists, allergists and rheumatologists will have to bear the biggest hits
- Emphasis will increase on patient payment collection because as per the health insurance plans offered through health insurance exchanges, patients will be required to shoulder major part of their healthcare costs. Due to this, practices will have to spruce up their efforts for patient payment collection and streamline medical billing tasks
- Due to reforms, many physicians will get newly insured patients or their existing patients will change plans. As a result, in-house staff will be spending more time on educating patients about insurance and coverage information rather than billing and patient care. This will affect timely claim submission
- Since reimbursement will keep declining, practices might have to establish partnership with a larger healthcare system or with other practices to stay afloat. In order to survive, independent practices will have to provide high quality patient care at low cost which will be difficult due to payment cuts and rising expenses
- It has been estimated by the Association of American Medical Colleges that by 2020, US will be facing a shortage of more than 91,500 physicians. Practices, especially in rural areas already find it difficult to hire and retain good physicians due to lack of money and in 2014 the situation is likely to worsen due to the shortage
- In 2014, incentive payments through Physician Quality Reporting System enter the final year with 0.5% bonus for physicians who will qualify. Requirements to participate in the program have been increased. To participate, practices will have to invest time and effort in meeting the requirements because non-participation will lead to reduced Medicare reimbursement
- Transition to ICD-10 by 1st October 2014 will also pose reimbursement and medical billing challenges if practices are not well prepared. Even penalties related to HIPAA breaches have increased along with compliance requirements, demanding more time for planning and managing HIPAA risks
All the above challenges will be affecting the revenue cycle and billing of practices in 2014. Since staff will be asked to take on more responsibilities at the same pay scale, it will also bring down their productivity to a great extent. Hence, in order to streamline billing tasks and ensure timely payments, many practices are outsourcing these services to a third party billing service.
Billing partners like Medicalbillersandcoders.com have a team of certified coders and billers who ensure maximum reimbursement and minimum claim denials for your practice. MBC with more than 10 years of medical billing experience has been helping practices across 50 states in the US sail through payment cuts and billing challenges. You can rely on us for all your billing needs and eliminate the headache of hiring, training, HIPAA compliance, claim submission and other vital tasks.