19 Aug Healthcare Rights And Protections Under The Affordable Care Act
The Affordable Health Care Act has brought about a number of changes to how healthcare is provided as well as the methods medical facilities use for billing patients’ insurance companies. The same provisions that allow for some types of free health screenings for the insured have also caused many facilities to turn to physician practice management companies to maintain compliance and to handle their billing process. One major change in the way insurance claims relates to the coverage of pre-existing conditions. While those conditions that a patient had when seeing a doctor for the first time were previously not covered under their insurance, the new law prevents patients from being excluded for this reason.
In addition to the exclusion of pre-existing conditions in the AHCA, there are also a number of preventive benefits that must be covered without the charge of copay or coinsurance, regardless of whether the deductible has been met, with any marketplace and many other insurance policies. Some of these preventive procedures include screenings for the following:
• Abdominal Aortic Aneurysm (One-Time)
• High Blood Pressure
• Cholesterol (for adults at high risk or of certain ages)
• Colorectal Cancer (Adults over 50)
• Tobacco Use
Diet counseling and immunization vaccines are also included in the list of covered services. The addition of these and other paid services along with the conditions that apply to each can be managed more effectively by physician practice management companies that have an in-depth knowledge of the new law and the conditions that apply. For instance, some of these services are only provided for free to individuals who are within a specific age range or those who are considered high risk based on other factors.
In order for any medical practice to benefit from the changes in the healthcare laws, they must have the ability to provide the necessary services to their patients and be able to process their insurance claims in a proficient and timely manner. The increase in coverage is also expected to increase the number of people participating in screenings that they no longer have to pay for. This leads to a greater number of services by those practices affected along with a larger volume of claims to be billed.
More people being covered by health insurance and having a number of preventive services provided for free gives many medical practice the increase in patient flow to increase their profits. Without the efficient services that are provided by physician practice management companies, there is a much larger risk that the claims will not be filed on time or correctly, resulting in a larger volume of medical services being provided but with fewer claims getting paid.
Regardless of the area of specialty that your practice focuses on, there are changes to billing procedures that will be affected by the changes in the healthcare law. When considering physician practice management companies, whether that company addresses your specialty as part of their services should be a top priority on their list.