Healthcare reforms have not changed the goals and responsibilities for physicians but it has certainly increased medical billing and coding complexities. Significant changes like HIPAA, EMR and ICD-10 have imposed additional responsibilities on small as well as large practices, which has been elaborated further-

  • Reforms in HIPAA have increased privacy requirements. The compulsory implementation of EHR under HIPAA-5010 mandate is likely to increase expenditure for practices and cause disrupted operational flow if the staff is not well trained
  • Once ICD-10 is implemented, coding will become more complex, giving a hard time to in-house coders and billers. Even though ICD-10 will prove effective in streamlining the reimbursement process, more codes will create more room for errors
  • Since doctors and in-house staff will be focusing on patient care, lack of time and attention will lead to claim denials. In case claims are not re-filed and follow-ups are not done, practices will get less or no reimbursement at all
  • New reforms have constricted fee schedules, forcing physicians to maximize their billing efforts in order to get paid
  • Practice cost is also rising as physicians are training and hiring more staff to handle the increased coding and billing tasks

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Will new reforms affect or benefit coding?

There is no doubt that accurate coding is extremely vital for any medical practice. Whether or not you will be paid will depend on how your staff is handling the coding procedure. Error free coding will ensure timely reimbursement, reduce claim denials, increase revenue and also help in insurance assessments.

However, in today’s time, when healthcare reforms have made coding complex, special attention is required on this aspect. If your staff is not skilled, it will result in errors and under-coding. This can affect your revenue in a negative manner, leading to huge losses and improper patient care.

Once ICD-10 is implemented, a complete overhaul of coding and billing will also be required. You will have to invest time and money in training staff, hiring more people and upgrading existing systems. Unless these requirements are met, error-free coding cannot be achieved, but what about physicians who have less time, limited resources and limited capital? Practices have started outsourcing coding and billing services to a billing partner so that they have ample time to focus on patient care while a dedicated team is focusing on claim filing, follow ups, coding, billing, documentation and account receivables.

Medicalbillersandcoders.com has the largest team of expert billers and coders that help practices face the challenges of new regulations like ICD-10 requirements, ACO needs and HIPAA norms. Our coders make use of latest technology and software to offer error-free coding and help practices streamline medical billing by handling the complexities posed by healthcare reforms. Our aim is to reduce work pressure, practice cost and accelerate billing procedure. While our team handles coding, billing and documentation services for your practice, you can concentrate on quality patient care.


Published By - Medical Billers and Coders
Published Date - Sep-04-2013 Back

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