July 03, 2014
Providers need to adopt a series of medical billing changes in 2014 in order to maximize reimbursements and maintain a healthy revenue stream.
How will the influx of insured people change the market? The uncertainty regarding how many people sign up for exchanges or the kind of payer mix for plans have become a major concern with the state and federal healthcare exchanges. With some states already aligning with Medicaid prices, reimbursement rates for doctors has gone down.
Practices need to mitigate their reduced reimbursements by implementing EHRs and practice management solutions. This will help them streamline workflow and treat patients faster.
Revised CMS 1500 Form:
A revised claim form released by the CMS became mandatory for practices from April 01, 2014. The new form was created for accommodating ICD-10, which was to be implemented in October this year. This form is required for all the payers and it doesn’t allow dual coding. Providers need to check with each payer for their anticipated effective dates of the revised CMS form.
CPT Code Change:
The terminology codes by the American Medical Association are expected to undergo a massive transformation this year. This overhaul is going to be the biggest modification to CPT seen in years. Last year, around 353 changes were announced, out of which many were lab-focused and pertained to upper-GI procedures. New technology is the driving force behind this change, which is now in use for lab and GI procedures. Lower GI will receive new CPT codes in 2015.
Even though ICD-10 compliance date has been shifted to October 01, 2015, unprepared practices will have to make necessary changes to ensure their readiness. From implementing system changes to training their staff, providers need to invest sufficient time and money to ensure that coding and billing changes don’t affect the financial health of their practice.
2014 - A Challenging Year:
Physicians have to prepare for these billing changes if they don’t want their reimbursements to get affected for the services rendered. It has become important for them to ensure that their billing department is aware and ready for these changes. 2014 is going to be a challenging year for practices due to billing changes, rollout of healthcare reforms and preparation for ICD-10. To ensure that these factors don’t affect your RCM, you can outsource your billing requirements to a billing company.
Benefits of Outsourcing Medical Billing
Timely claims submission
Error-free coding and billing
MedicalBillersandCoders.com is a reputed billing company, helping practices sail through billing and coding complexities. The well-trained, experienced team of coders and billers at MBC are apprised of the medical billing changes and updates in the healthcare industry. They are proficient in ensuring timely reimbursements with the help of latest technology.
MBC works with the aim to maximize revenue and minimize claims denials. By outsourcing billing requirements to MBC, providers can reduce practice costs and eliminate their worries about investing in hiring staff, training and technology upgrades. Outsourcing also offers enough time to providers for concentrating on the provision of patient care.
ACA / HIPAA / Reforms