The New Year arrives with an eleventh hour Congressional stop gap measure to avert a 26.5 percent reduction in the Medicare physician payment rates that would impact Emergency Medicine physicians – a temporary stop gap at best.
Providers just missed facing the crippling effects on their clinical and operational efficiency as a result of the Sustainable Growth Rate (SGR) formula overshooting budgeted Medicare spending – for now.
2013 is an essential time for emergency medicine medical coding, billing and collections processes to support and champion new payment and delivery models that prepare for future Medicare cuts still anticipated. Now, more than ever, emergency medicine medical coding, billing and collections will be a critical cog in the wheel that keeps revenue generating for emergency medicine groups in the establishment of these new models.
One such model is the Accountable Care Organization which will become increasingly mandatory for care providers in the Medicare network. Physicians will be required to form a clinical network with the goal of providing better care at a lower cost to patients.
Transitioning to these new models will bring challenges to emergency medicine revenue cycle management, including understanding fee schedules, negotiating and renewing payer contracts and being conversant with multiple payer policies. Along with these evolving processes is the need to monitor and analyze an overwhelmingly large amount of new information such as: eligibility for Medicare, medical outcomes, Medicaid and private insurance, and clinical compliance and reimbursement requirements to name a few.
In addition to these future Medicare reductions, mandatory EHR, PQRS, and ICD-10, and HIPAA 5010 compliant coding will be added to the long list of challenges that face providers. An expert emergency medicine medical coding, billing and collections team is required to collect and sort through a plethora of data including compliance information, detailed billing and reimbursement records.
The right emergency medicine medical coding, billing and collections partner offers both experience and competence in stage-managing transformation to high-performance Medicare models as well as effectively managing compliant coding on behalf of providers who are focused on clinical efficiency.
It takes an industry insider with over 25 years of experience in emergency medicine revenue cycle management to enable emergency medicine groups to run more efficiently, cost-effectively and provide higher quality care to patients. revMD is the results-proven alternative for emergency medicine revenue cycle management based in Phoenix, Arizona.