The American Hospital Association (AHA) and seven other national hospital organizations have urged congressional leaders to waive the Statutory PAYGO sequester before yearend to prevent nearly $10 billion in estimated cuts next year to hospital providers in fee-for-service Medicare.
“And this would be on top of the 2% Medicare sequester cuts, which had been waived for part of the pandemic, but are back in full effect as of July 1, 2022,” the groups wrote. “We appreciate that Congress has never allowed Statutory PAYGO cuts to go into effect, and we urge Congress to again act before the end of this year to prevent the reductions from occurring. Additional Medicare reductions to providers are not sustainable and put at risk our members’ ability to care for their patients.”
Initially, physician’s offices had a person in-house that handled everything having to do with billing for the practice. This person added to the overhead of the office – about 10 – 12% and handled everything from A-Z in the billing process. General knowledge of codes was all that was needed to ensure reimbursement from insurance companies as this was before managed care.
The beginning of managed care brought to the industry fee schedules, preferred provider contracts, the need for pre-authorizations and more. These changes meant a more intensive knowledge of medical codes was required as well as continuing to keep updated as codes were added and deleted. These changes increased cost and time required to handle billing.
Initially, physician’s offices had a person in-house that handled everything having to do with billing for the practice. This person added to the overhead of the office – about 10 – 12% and handled everything from A-Z in the billing process. General knowledge of codes was all that was needed to ensure reimbursement from insurance companies as this was before managed care.
The beginning of managed care brought to the industry fee schedules, preferred provider contracts, the need for pre-authorizations and more. These changes meant a more intensive knowledge of medical codes was required as well as continuing to keep updated as codes were added and deleted. These changes increased cost and time required to handle billing.
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After listening to what clients were asking for, a more robust system was created that covered more than just standard medical billing. This full-cycle revenue management system saved doctors time and money by eliminating the need to have different people handling all other aspects. Revenue Cycle Management includes: