In the cult science fiction film “Pitch Black”, the lead character, actually an anti-hero played by Vin Diesel, is thus engaged by the main antagonist, played by Cole Hauser:
Cole Hauser: Battlefield doctors decide who lives and who dies, it is called “Triage”.
Vin Diesel: Kept calling it murder when I did it…
Among the many mystique terms that the Patient Protection and Affordable Care Act has sprung up, The Patient-Centered Outcomes Research Institute (PCORI) is a notable example. The layman’s term for it though is “death panel” or “Triage” in which doctors or other decision-makers decide who lives and who dies. This rather unflattering interpretation of PCORI can only be deemed as unsubstantiated gossip. But there are other facets of the law which are not hearsay, but very much present in the 900 odd pages of the Act.
Some Facts About the ACA Act:
1. The ACA will ensure or try to ensure that all Americans have access to quality and affordable healthcare. On more realistic terms it will cover about 94% of Americans while keeping the healthcare costs under the $900 billion limit. This is supposed to reduce healthcare spending deficits for more than a decade.
2. Eliminate annual limits on many policies.
3. Dependent coverage will be extended up to age 26.
4. Cover pre-existing medical conditions.
5. By 2014 all states are expected to form health exchanges to enable coverage for all low-income and uninsured groups.
6. Medicaid will expand; almost half the states are committed towards this, while about 17 are opposing this, and 7 still undecided.
7. It is the individual’s responsibility too (including non-adults) to maintain basic medical coverage, else there are fines.
WHAT THIS MEANS FOR THE CLINICS:
While it may seem too early to exactly predict how all this will work out, what is certain is that Family Practitioners, Internists, PCPs, Emergency Room Physicians can expect their practices to burst at its seams with a huge influx of newer patients, most of them Medicaid and CHIP enrollees.
“The role of Medicaid as envisioned by the Affordable Care Act (ACA) is to make Medicaid an integral part of the nation’s health care structure and be the floor for all low-income individuals,” says Kathy Kuhmerker, former New York State Medicaid director.
It is estimated that ACA will increase Medicaid spending by about $420 billion between 2014 to 2019. So, if you have not been accepting Medicaid so far due to lower payment rates, think again. Besides the sheer volume, ACA has increased Medicaid payments for E&M and Immunization Services to 100% of Medicare reimbursement.
This is to stimulate greater provider participation. Also, coupled with the already relatively short payment cycle of 7 days, your clinic stands to gain a lot by seeking a medical billing vendor who understands the nuances of Medicaid Billing and is ready to put into place a dedicated team catering solely to your Medicaid Claims.
The post Equip Your Clinic to Handle Medicaid Enrollees Surge appeared first on BillingParadise.