Medical billing has always remained an important element of health care industry in US. This year there were major changes witnessed in Medicare and Medicaid services in USA. The “bill” that President Obama signed this year was to fix the much feared “SGR” –Sustainable Growth Rate which was showing the signs of decline in these many years. The bill is about rewarding the value and not volume.
Congress emphasizes more on providing quality care than just curing them and sending them away with a treatment bill. The introduction of the new medical codes has led to major transformations in the medical industry, and it is clear that these changes will be impacting medical billing companies over the next year. How? Let’s see……..
Switching From Quantity to Quality
Recent survey says that 4 out of 10 adults in US do not go to the doctor when they feel that they should have because of no health insurance coverage. The primary reasons that came out of having “No Medical Insurance” – 1) Because of choice 2)Because of gender, health history, age etc.
With this new reform, the individuals require to have health insurance coverage for themselves along with insurance companies to provide them cover irrespective of their health history, age and gender. Now more people enrolling for the insurance, obviously there will be a boom witnessed in health insurance coverage. Since, more claims will be processed more qualified staff are to get onboard. This is how the new reform will focus on providing quality over quantity.
The dispensing of medical claims will go through the new set of rules. This new law aims to enhance the timing of the revenue and reimbursements. With hundred different critics forecasting billing errors and increase in the expenses; resulting into more confusion (which is just a misperception) – there is no such slip up happening; in fact it will streamline the process making it easy, less of hassle, and quick turn-around time.
A trickle-down consequence could arise thus; dropping what doctors are willing or able to pay for outsourced services i.e. Medical billing services.
Medical billing companies may witness some significant impact like:
Expensive Qualified Resources:
Increase in job dissatisfaction amongst medical billing professional, turning them over other careers leaving a huge dent in terms of qualified resources. Hiring qualified people for the medical billing could turn out to be expensive. Even hiring one new resource, along with that there will be training costs, salary, benefits and other compensation to think of.
Staying Updated With The New Codes & Software:
As per the new reform, the proposed codes shall be used as a quality measurement tool which will offer a patient to give feedback about the medical care he/she took, the entire evaluation of the doctor and the treatment offered. Majority of the medical billing companies are using EHRs however, there are varied versions that support the doctor’s requirements. Now each of these companies will have to ensure that their software is up to the mark, with all the necessary changes and error free.
Keeping Tab on the Regulatory Changes:
The transition of the new Medicare has created a plethora of confusion for physicians and medical practitioners let alone the billing companies. 60000+ diagnosis, patient allowance, reimbursements, and treatment codes are some of the significant changes that now the medical billing and coding companies has to adhere to.
Nearly all insurance plans; both federal and state have to undergo the changes as per the new reform. Thus; keeping up with the regulatory changes could prove to be bit of hassles for these billing companies as their will be good long process to transform and get into this new transition.
Millions of dollars are billed every day. With this new law; the healthcare industry will be shifting to quality than quantity. There might be temporary annoyance; trouble and confusion and temporary squeeze of cash flow but in the long run this will be surely giving positive results in terms of both monetary and efficiency.