Billers and Coders Digest
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Tuesday April 22, 2014 | Edition 2.00

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A monthly update on Billing and Coding Information
More Jobs for Billers & Coders as practices adapt to new payment models!

With the introduction of new payment models, physicians face a dilemma. Irrespective of the benefits, payment reforms will complicate the process of preparing claims and increase administrative costs. In order to overcome billing challenges and ensure timely reimbursements, practices will require skilled coders and billers.


Industry facts:
Physicians can obtain bonuses up to 5% every year from 2017 to 2022 for transitioning to “alternative payment models”
15 of the 16 key provisions of Affordable Care Act will be taking effect in 2014, impacting numbers of patients physicians see and the way they get paid for medical services
According to a poll conducted of 140 healthcare providers by KPMG LLP, the audit, tax and advisory firm, 44% providers said they have started using bundled payment model, 29% remained undecided and 7% didn’t want to implement the same
Payment reforms to impact reimbursement:
Practices might face several challenges due to payment reforms and only a strong billing team will ensure timely reimbursements Read More
Billers & Coders to help practices assess their ICD-10 readiness in 2014!
Physicians will need experienced billers and coders to assess ICD-10 readiness of their practice. With the deadline extended to 2015, now is the right time to start preparing. ... Read More
News Feed
1
Physicians will be provided information & educational resources on evolving delivery & payment models by the AMA
2 Within the next 5 years, more than half of all health plans will reimburse providers.
3 Value-based payment modifier of Medicare will be launched for physicians in 2015.
CMS Updates
1 Important Payment Adjustment Information for Medicare Eligible Professionals Read More
2 Road to 10: The Small Physician Practice's Route to ICD-10 Read More
3 CMS Booth & ICD-10 Sessions at HIMSS14 Read More
How can coders prepare for tackling payment reform issues for practices?
  • Coders can take up training programs in ICD-10 that have been made available by national organizations such as American Health Information Management Association (AHIMA), American Association of Procedural Coders (AAPC), local state AHIMA and AIHC (American Institute of Healthcare Compliance
  • Coders must establish communication with online coding associations and communities to deal with payment reform challenges in a better manner because new payment models will change the revenue cycles, demanding more precision in coding and billing
  • Billers and coders should join training sessions to learn how to handle a new type of information exchange system that will be required under value-based payment models
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