The Affordable Care Act and the Billing Industry

With 2015 finally here, the Affordable Care Act has once again become a popular topic of conversation. The new year rings in the next round of changes for the healthcare industry, with an end goal of making the medical field more accessible and affordable for the population at large. However, since the two thousand page document that implemented this act is a bit of a confusing read, experts are still offering only theories on the final effect on professionals as a whole in the field. However, the impact of the Affordable Care Act on medical billers might be more positive than originally anticipated.

New Billing Structure

A great concern in the industry has been the new way that billing will be handled starting in 2015. With a focus on quality over quantity, a patient will be charged not for the volume of care, but for how well he or she was treated. A patient’s level of care can be subjective, particularly when taking into account fatal diagnoses and the need for consistent care for lifelong conditions. The Affordable Care Act has outlined a “trial and error” billing structure to compensate for this potential variation, but the lack of a formal procedure could be a time suck for seasoned medical billing agencies, much less for the average practice that handles billing in house.

Increase in Patients

Billing for quality might indicate a dramatic pay cut for those in the medical industry, but that only takes into account the number of people who currently seek medical attention. Studies have found that nearly four out of ten adults in the United States did not go to a doctor when they felt they should have due to their lack of health insurance coverage. With the Affordable Care Act requiring more individuals to obtain insurance, the number of patients should increase exponentially as Americans are able to receive the care they need.

Positive Changes for Medical Billing Companies?

Rather than hearing a bad tune, a complicated new billing structure and increase in patients should be music to the medical billing industry’s ears. This equation of more quantity plus paying for quality might make the transition difficult initially, but can benefit billing companies in the long run by inspiring more practices that previously handled their billing in house to turn elsewhere for help. The AFA aims to decrease the time behind reimbursements and to improve revenue management on a whole, which can increase pressure on practices and hospitals that handle their own billing and inspire them to outsource their billing to remove primary liability from their business. Also, some practices simply might not want to learn the new billing codes, causing them to hire a medical billing practice just to decrease confusion around the office. This increased outsourcing combined with the new patient base has led experts to believe that not only will jobs in the medical billing industry not be cut, but the demand for well-trained professionals in the new procedures will increase. This surge of available medical billing jobs will help satisfy the need for new billing expertise to comply not only with Obamacare regulations, but also to comply with the coming rollout of the new ICD-10 medical billing codes. In the short term, medical billing companies should ensure that their staff is fully trained on the new procedures. Also, medical billers should invest in a software that is compatible with the changes ahead that can also provide intuitive and innovative solutions to billing issues.