Though the Affordable Care Act has been in effect for over six years now in the United States, the medical industry is still learning about the widespread impact of the legislation on the health care sector, and specifically on medical billing procedures in physician’s clinics and hospitals countrywide. While the full impact of the Act is yet to be known, it is undeniable that there are quite a few changes that will change the face of the medical billing industry as we know it now.
Increased Outsourcing of Medical Billing
Doctors and hospital administrators have never been fond of medical billing, viewing it as a necessary evil that prevents them from focusing exclusively on delivering better medical treatment to patients. Since medical billing tended to be too time-consuming and expensive for healthcare providers there has already been a shift to employing professional medical billers to follow up with patients and insurance companies. This trend of outsourcing billing is expected to get a major boost due to the increased level of complexity of medical coding required to be implemented under the Affordable Care Act.
The act will make it mandatory for medical practices to comply with a new set of rules and regulations that are aimed to improve revenue management by improving the reimbursement turnaround time. However, this will entail greater scrutiny of the billing processes followed by both practices and hospitals undertaking billing independently and professional medical billing companies. According to experts, at least in the initial stages, the new rules will have everybody making more mistakes in billing and there will be an increased necessity of resubmitting claims causing all-round stress and confusion. However, it is due to the increased level of complexity that the professional medical billing industry will continue to be in great demand.
Dramatic Growth in Medical Billing Professionals
According to industry reports, already the major medical billing outsourcing companies are increasing their presence so that they can take on the extra load that is anticipated to result from an increasing number of medical practices outsourcing their billing function. Another very important consideration in medical practitioners and hospitals outsourcing their billing is that there is the reduction of liability of the health care provider.
According to The Bureau of Labor Statistics, there will be a sustained growth in the medical billing industry. It is projected to grow at an annual rate of around 22% until the year 2022. While some of this growth can be attributed to the impact of the Affordable Care Act’s administrative and regulatory compliances, much of it will actually be due to more people being able to access healthcare thus necessitating more medical coding and billing. While increased healthcare access, especially for the poor, is a very worthy objective, it is accompanied by increased costs of administration and regulation, in the short-term at least. The demand for healthcare is also projected to increase as the population ages.
Pre-Certification and Verification of Eligibility to Remain Cumbersome
One of the basic purposes of enacting the Affordable Care Act was to reduce the level of difficulty required for pre-certifying and verifying the eligibility of patients for specific procedures by medical practitioners. However, the initial feedback is that the procedure continues to be as cumbersome and slow as in the past, and many detractors also accuse it of being slower now than before the Act was passed. Contributing to the problem is the fact that many insurers also do not know the proper codes for medical services and the coding procedures; however, this should decline as their level of familiarity with the system goes up.
Conclusion
The entire medical sector is grappling with the many issues of procedures and compliances of the Affordable Care Act. As medical practitioners and hospitals are coming to terms, there is a certain amount of inefficiency creeping in, however, it is expected that over time the process would become far smoother, and both the healthcare sector and the patients would benefit substantially.
Author bio: Henri James is a senior manager at one of the most prominent professional medical billing agencies. James has been writing extensively in the online media regarding the impact of the Affordable Care Act on the medical sector, especially billing.
Photo courtesy of www.nerdwallet.com.
