Healthcare Reform is changing from fee-for-service to value-based payment models. Providers working with Medicare patients will begin to have difficulty of getting paid due to Affordable Care Act penalties. Doctors who do not participate in the Physician Quality Reporting System (PQRS) will face a 1.5% penalty in Medicare payments and 2% after that. Private insurance is starting to adopt value-based payment models as well.
Experts believe that the Affordable Care Act will cause more submission denials to occur. Insurance companies are denying submissions on minor data entry errors or tiny discrepancies between doctor records and the insurers.
Denials are a major frustration with doctors. Once denials occur it can take anywhere from 30 minutes to several hours to correct. Furthermore, the appeals process can take a month or longer and the physician gets less time to treat patients. Common mistakes such as hyphenated names can cause denials and frustration.
Offering ancillary services that capture more revenue is a way to offset denials and cash flow issues. Physician dispensing is an excellent way to reduce costs and frustration within your practice.
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