Don’t let Medical Billing and Coding Challenges in 2014 Increase your Financial Worries

May 07, 2014

2014 is set to be a challenging year for medical practices. Even if ICD-10 deadline has been extended to 2015, providers need to prepare in order to avoid financial worries.

Medical billing and coding will become more difficult in the coming years due to major changes being introduced by the Affordable Care Act. Due to change in regulations, providers will be asked for more documentation in order to complete the billing procedure. Rollout of healthcare reforms will also increase stress on practices.

  • It has been revealed by the CMS that “incident to” services should be furnished in compliance with state law. As embedded in the document announcing 2014 fee schedule for Medicare, providers will have to follow the scope of practice for his or her state for billing “incident to”, which refers to services billed under a physician’s NPI but performed by another provider in the physician’s office
  • In conjunction with ICD-10 coding, a new CMS 1500 form will be used. Providers will have to accompany documentation with this form starting April 1 or else claims will not be accepted
  • Government’s latest pay-for-performance program, the value-based modifier, will be implemented for groups of 10 or more eligible professionals in 2016. The rolling out will be based on the coming year’s performance
  • In 2014, incentive payments through PQRS (Physician Quality Reporting System) will enter the final year. Providers who manage to qualify for this program will avail a 0.5% bonus whereas practices that don’t meet the requirements will face reduced Medicare reimbursements. The requirements for participating in this program have been increased, creating pressure on physicians
  • AMA (American Medical Association) announced 175 new and 107 revised CPT codes for 2014. 25% of the changes will fall on gastroenterology. Services, including breast biopsies, abscess drainage, chemodenervations, shoulder and elbow prosthesis removal will also be in for a change
  • In 2014, stage 2 of Electronic Health Record Incentive Program will also be rolled out under which, participants will have to meet 17 core and 3 menu-based criteria. Providers will have to face more pressure on receiving secure electronic messages from patients. They will have to pay more attention to details, bringing changes in workflow
  • 2014 will bring an increase in patient volume and in order to deal with it, practices will have to move to digital billing and coding

Considering the amount of pressure 2014 will put on medical billing and coding, many practices have started outsourcing these requirements to a third party. This is helping them concentrate on patient care rather than worrying about reimbursement issues.

Medicalbillersandcoders.com is a reputed medical billing company that has been helping practices across 50 states in the US sail through billing challenges. MBC has a team of certified billers and coders who make use of latest technology to get physicians paid on time. We work with the aim to strengthen the revenue cycle of medical practices and offer sufficient time to providers to concentrate on quality patient care.


Category : Best Billing and Coding Practices