December 9, 2015
With all the changes in healthcare, it can be difficult for your medical practice to keep up on regulations, mandates, and other initiatives that will affect your bottom line. These changes include the transition from ICD-9 to ICD-10 codes, a shift from traditional fee-for-service models to value-based models, and updates to the new Affordable Care Act.
Medical billing services can be your partner during the changes recently enacted and those ahead. Here’s how.
After the move to ICD-10, “86 percent [of physicians] indicated ICD-10 having an impact on patient care,” according to a recent SERMO poll. By now you should have a good idea if your practice’s transition went smoothly or not. If you’re experiencing any issues or rejections, using a medical billing service can immediately solve some of your issues without the need to hire additional coders or make costly software upgrades. Even after the transition, 68% of providers said that ICD-10 conversion is an area that still needs to be addressed, according to peer60’s Healthcare Revenue Cycle Management: 2015 report.
“86 percent [of physicians] indicated ICD-10 having an impact on patient care.”
Get back to doing what you care about and focus on patients rather that dealing with billing. According to a press release by the U.S. Department of Health & Human Services, we are starting to shift away from traditional fee-for-service (FFS) models to value-based models with more emphasis on patient performance. Now is the time put the focus back on patients. Using tools and services that produce an integrated environment within your practice is shown to have greater patient engagement. One key patient experience benefit that comes from medical billing services is an easier bill paying process for the patient. Having systems in place to make paying a bill as painless as possible for the patient is a must when every dollar counts.
The Affordable Care Act added a lot of new rules and regulations to processing medical billing claims, and with that, came confusion for billers. If your practice has in-house billing, these changes have added even more headache. Using a medical billing service company, who is already prepared for these changes, can alleviate any confusions and more importantly, errors.
Another outcome of the Affordable Care Act has been a boom in health insurance enrollment since it requires individuals to obtain coverage, as reported by Medical Billing Advocates of America. This will increase the total number of claims being processed, resulting in a higher demand for billing staff. A medical billing service can help alleviate these added costs and human resource needs. According to the Congressional Budget Office, projections for Medicare Advantage enrollment will reach 22 million beneficiaries by 2020, more than double the number projected shortly after the Affordable Care Act was enacted in 2010. Currently, enrollment sits at more than 16 million.
“Medicare Advantage enrollment will reach 22 million beneficiaries by 2020, more than double the number projected shortly after the Affordable Care Act was enacted in 2010.”
The move to value-based reimbursement that will occur over the next few years will cause issues in the beginning as practices start focusing on quality goals. As stated by HealthCatalyst, “the switch to value-based reimbursement has turned the traditional model of healthcare reimbursement on its head.” A report by Availity also found that “35% of practices have already begun the transition to value-based care, and growth continues at a tremendous rate with expectations that over 75% of practices will have some form of value-based care contract in place by 2017.”
Small to medium-size practices are less prepared for these goals and need the expertise provided by medical billing service vendors and accountable care organizations (ACOs), which handle both payment and care requirements, Healthcare IT News. During this time, it is also important to make sure the quality care incentives are connected to the reimbursements and you are getting paid. Software and billing solutions are available from medical billing service companies to help with these incentives and as the importance of quality care continues to rise, these solutions will only become more necessary as time goes on.
“35% of practices have already begun the transition to value-based care, and growth continues at a tremendous rate with expectations that over 75% of practices will have some form of value-based care contract in place by 2017.”
To start preparing for these changes now and make sure you are completely ready, connect with a ChartLogic Billing expert to get the process started.