The ACA Impact on Medical Billing and Coding Professionals

When the Affordable Care Act (ACA), which is also commonly referred to as Obamacare, was passed, it was obvious that it was going to have a big impact on all facets of the health insurance industry. A few years have since passed, and this has proven to be true – even when it comes to medical billing. So how exactly has the Affordable Care Act affected medical billing?

How the ACA Has Affected Medical Billing

The Affordable Care Act wasn’t supposed to make things like eligibility verification, pre-certification, medical billing and coding tougher on medical practices, but it did. The following are a few of the issues that have resulted from the ACA:

More claims need to be processed – If the ACA has been successful at achieving one thing, it’s to increase the number of people that have insurance. This is obviously a good thing. However, it also means that fewer people are paying for medical services out of pocket. More people have health insurance now, which means that practices need to file more claims. This, in turn, means that the billing process has become much more involved for most practices as a pure result of an increase in insured patients.

Coverage has changed – Almost all insurance plans have changed in one way or another as a result of the ACA. This means that there have been modifications in patient reimbursement rates and allowances. This has proven to be problematic in instances where the insurance companies have not communicated clearly with their customers, resulting in patients not realizing that the medical services that they’ve obtained may no longer have been covered or may only partially covered. This, in turn, has meant that more patients have needed to set up payment plans in order to pay off their balances.

Copays are more – Many insurance plans require larger copays or even require patients to pay a percentage of a medical service instead of a set copayment. This means that medical practices have had to get in the habit of communicating with patients before scheduled appointments to discuss or set up payment plans in order to avoid a growing outstanding balance.

Medical billing processes have gotten more complicated overall due to the ACA, which has led many medical practices to outsource their medical billing.

ProMD Medical Billing is happy to help with your billing assessment needs so you can maximize profits and increase patient satisfaction. To learn more about how ProMD can make your practice run like a well-oiled machine, call 866-960-9558 or fill out our online form to request a billing assessment.

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