How Family Medicine Revenue Cycle Management benefits Physicians Facing Large Medicare Cuts

Family medicine revenue cycle management
July 3, 2013

Posted by MedbillingExperts / 0 Comment

It was certainly a close call, but family medicine physicians were able to avoid a 26.5% cut in Medicare physician payments. This would have had a dramatic impact on the many physician’s offices that make it possible for Medicare patients to have their health issues addressed. The change was scheduled to take place on January 1st, but instead a stopgap measure was put into place to keep the current stipulations in place through 2013.

Changes were expected to happen in January that would reduce physician payments, but a stall measure has given another year of no motion.

Other delay and budget measures were what set up the provision for the cut in the first place. The sequestration had delayed the Budget Control Act early in the year, putting a temporary stay on other issues, making it easier to generate a temporary stall for the physician payment cut. The goal of the initial measure to cut 2 percent for the Medicare physician rate of payment and a further 8 percent cut throughout the funding for medical education programs. All of these changes and the tenuous nature of the industry has made it apparent that medical coding and billing knowledge and expertise will be critical in the years going forward.

Physicians would be wise to work with a team of billing specialists that have been trained in regulatory and legal industry updates.

Although the stopgap solution is certainly positive news for the doctors and their patients who would be affected by such a chance, it’s not a permanent solution. The American Academy of Family Physicians has their eye on a more long-term fix that would allow them to continue to serve the Medicare population. The AAFP wants Congress to repeal the sustainable growth rate, a formula that has previously overshot budgeted Medicare spending.

Their goal is to re-balance the system for primary care physicians, who work hard to serve many Medicare patients around the country.

It will becoming increasingly important to attract and hire billing and coding specialists  who are able to adapt to the rising challenges of managing a practice. Medicare changes are not the only adaptability concerns facing those in the healthcare field presently. The industry has already been working through the changes connected to ICD-10, mandatory EHR, PQRS, and HIPAA 5010, and the demand for experienced billing specialists is increasing. Having a knowledgeable billing and coding specialist in the office relieves many headaches and provides for streamlined procedures that allow payments to be received, ultimately keeping the doors of the practice open.

Physicians are focused on driving factors that will influence their bottom line, and billing and coding is more important than ever.

Many doctors and other healthcare professionals want to work with qualified billing specialists because it saves them time and ensures that they are working with experts in the field who have the most current knowledge about industry changes. Being behind the curve can lead to lengthy delays, denied claims, and loss of payments that offices were counting on to continue operating.

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