Medicare
Jul 22, 2021
Helping practices thrive, not just survive.
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Senate leaders introduced the spending package earlyTuesday, and the Senate approved it Thursday. The House passed it Friday andPresident Biden is expected to sign it.
The measure averts some Medicare reductions, althoughhealthcare groups hoped for more relief. There are also provisions that addresssome key priorities, including telehealth service.
The package avoids some steepMedicare cuts but provides only part of the relief doctors and medical groupswere seeking.
Doctors and medical groups pressedCongress to avert a 4.5% reduction in Medicare payment rates for doctors, butthat effort was only half successful. The omnibus package calls for a 2% cut inphysician payment rates.
While not asbad as initially feared, doctors and medical groups criticized Congress forallowing any cut to happen.
A much more successful spending reductionwas blocked preventing a scheduled 4% cut in Medicare under the Pay-As-You-Go(PAYGO) sequester. Health groups said the cut would have been devastating andhad urged lawmakers to block it. Under the package, the PAYGO cut is blocked in2023 and 2024.
Health groups scored one of theirbiggest wins on telehealth.
Telehealth waivers would becontinued through 2024 under the spending package. The telehealth waivers previously werelargely tied to the federal COVID-19 public health emergency, which is nolonger the case.
The package also includes a two-yeardelay in implementing the Medicare telemental health in-person requirement, anda two-year extension to offer telehealth in High Deductible Health Plans, theAmerican Telemedicine Association said in a news release.
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.
Our Complimentary Consultation is a discovery and feedback initiative built to help practices. You get one on one advice from our experts, plus a report for your practice to use, absolutely free for you.
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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: