The Healthcare Bill and What it Means for Medical Billing and Physician Reimbursement

Simply mentioning the words "healthcare bill" as they refer to the Health Care Reform Bill can cause a flurry of opinions as well as hundreds of questions. And, those seeking medical care are not the only ones asking them; physicians also have their own. Among the many questions being asked by them are what the healthcare bill will mean when it comes to medical billing and physician reimbursement.

Like most of the topics in the healthcare bill, this one is multi-faceted, not only because it deals with regular insurance billing, but because it also affects Medicare and Medicaid patients. On the one hand, you have the fact that, according to the bill, Medicare will now be expanded to cover annual check-ups rather than just the initial one that comes with going on the Medicare program. The coverage will eliminate co-pays for preventive care and screenings as well.

With these expenses no longer required, senior citizens may decide to take advantage of the expanded Medicare coverage, which will mean that medical billing services, as they apply to payments for services rendered and physician reimbursement will see an increase in the number of filings. This brings up the question of whether or not this will delay payments and reimbursements even more.

In addition to those things mentioned above, the healthcare bill also provides additional funding that will be used to combat fraud and abuse, both as they apply to private and non-profit insurance companies and to Medicare and Medicaid. The goal of this additional funding is to sharply diminish instances where health insurance fraud or unnecessary spending occurs.

All of this means that medical billing companies will be faced with new situations as they work to ensure that proper and efficient billing practices as well as timely physician reimbursement occurs. As a physician, you may have already started considering these situations and how they might affect your practice and the way in which it is currently and will be handled.

You might be looking into options that are available which, while changing the way these duties are performed might be more viable as the different parts of the healthcare bill are implemented and changes occur as a result of the implementation. These options may include such things as taking advantage of electronic medical billing or using computer hardware and software programs that will make it possible to accomplish medical billing online.

If you have started researching these options, then you are already aware that there are many software programs which you can have installed in your existing computer system, or companies that provide software programs, along with support and back-up services. And, you may be wondering which ones are the best.

Like other business decisions that you make concerning your practice, only you and your office manager or billing personnel can decide. The best way to do so is to review different programs and conduct your own research into their facets. You might want to include such things as site and information security and how easy it is to use the program.

You may even consider looking into such things as physician practice management agencies that handle these duties. These practice management services may be affiliated with the medical centers, hospitals, or practices that you currently work with or may be totally separate entities.

If you prefer your billing services to remain "in-house", you may consider hiring or contracting with a medical billing specialist. It would then be that person's job to keep up with the changes that will occur in Medicare and Medicaid billing, as well as private or non-profit insurance billing, as a result of the healthcare reforms, changes, and implementations that will come to pass through the healthcare bill.

If you choose this type of service, keep in mind that some medical billing specialists are self-employed. They use proven, legitimate software equipment, but they are not affiliated with the company that manufactures and supplies the software; rather, they have simply obtained usage rights. They will most likely work for you on a contract basis.

This can be a very viable option, as most of them are well-trained and have the necessary equipment and computer capabilities to perform medical insurance billing tasks. However, you will want to research them, as well as those companies who provide their own personnel and software, before making a decision.