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June 17, 2015

How the Affordable Care Act Affects Reimbursement Processes

June 17, 2015

Outsourcing medical billing services

The Affordable Care Act (ACA) is changing the way reimbursement processes are handled. To make sure you receive the payments you are due, it is important that you understand these changes.

More People Insured Means More Business For Your Practice

Thanks to the ACA, over 30 million new participants are expected to have some form of insurance, which can be great for your practice. Also, payers can no longer deny coverage due to pre-existing conditions, which will open the door for many people who previously couldn’t acquire insurance.

Replacement of Fee-for-Service Payments with Quality Performance Payments

Under the Affordable Care Act, we are seeing a shift from reimbursement for individual services to payment for provider value and quality. This reimbursement method relies heavily on data reporting and many medical practices will need to update their IT systems to share information across their networks effectively.

Penalties for Non-Compliance with CMS Initiatives

The ACA will reduce payments to practices that do not comply with the initiatives introduced by the Centers for Medicare and Medicaid Services (CMS). This includes penalties based on the Physician Quality Reporting System (PQRS), penalties for not meeting e-prescribing levels, and many more.

These penalties will increase as the ACA continues to be implemented. Make sure that your practice isn’t penalized by following all of the procedures laid out by the Centers for Medicare and Medicaid Services. The best way to ensure you’re abiding by these guidelines is to turn to outsourced medical billing and coding experts.

Wondering How the ACA Is Affecting Your Practice?

If you would like more information about outsourcing your medical billing and coding to ensure your medical practice, then contact Medical Business Management today.

Our trained professionals can make sure that you are meeting all of the ICD-10 and ACA requirements necessary to get your full reimbursement for services rendered.

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