2015 is all set to bring more healthcare challenges and fewer income opportunities for the provider’s office. Rising drug prices, time consuming regulatory obligations, an aging population requiring high-value care and skyrocketing medical technology costs are, in fact, mere curtain raisers. The real grim picture lies behind the many hassles the provider’s office is posed to confront in time to come to get payment realized from insurance companies and patients. Here under are the top three key upcoming changes in 2015, which can adversely impact the income of the provider’s office : –
1. High-Deductible Health Plans
As the Affordable Care Act requires everyone to have health insurance, more and more people this year are expected to be drawn to selecting high-deductible plans because of lower premiums. In fact, Kaiser Family Foundation study in 2014 has already reported that 80% of employees have deductible insurance plan and 18% have deductibles of at least $2000. The downside of these health insurance plans is that the patient is the main source of payment and not the insurer. In other words, the provider’s office will be constrained to undertake more documentation, and spend a considerable amount of its resources to collect payments from patients. Given the very busy schedule a physician has, he/ she will have no option but to appoint a trained front office. Alternatively, the provider’s office could opt for revenue cycle outsourcing, which would certainly be the most sure-shot, stress-free and pocket-friendly way out of the situation for any physician.
2. HIPAA – Patient information security
According to the Redspin Breach Report in 2013, 800 and plus patients’ data has been breached since 2009 and 29 million patient records have been affected by HIPAA violations. As patient’s data continues to get audited by HIPPA in 2015, many more incidences of HIPAA violations are likely to come to the fore. With HIPAA imposing hefty fines to the tunes of $100 to $50,000, containing HIPAA violations is one of the most formidable healthcare challenges before any physician’s office. However, the prevalent use of mobile devices by both patients and staff imposes greater difficulty at provider’s end to keep track of electronic communications within the practice, often leading to increased incidences of data security breach. A viable solution could be to subscribe to one of the reliable revenue cycle outsourcing agencies These agencies are committed to maintain privacy, security and confidentiality in respect of patients’ records and follow regulations to the word.
3. ICD-10 transition
The third most critical of healthcare challenges before provider’s office remains impending ICD 10 transition. Incidentally, Dr. Wergin, the AAFP president, has recently confirmed that the October 1, 2015 looks like the real deadline for the ICD 10 implementation. If that happens, Provider’s office would need to be ready with the new coding system. One immediate step the provider’s office could take is to yet again consider revenue cycle outsourcing. The outsourcing service provider would not only protect you from all the operational hassles, but also develop training modules for your qualified staff, do the testing and prepare documentation protocols, which best serve the practice.
MedicalBillersandCoders’ is a team of highly qualified, trained and credentialed staff, which is abreast with the changing medical billing environment, and caters to end-to-end revenue cycle management needs of the provider’s office.