Affordable Care Act Impacts Cardiology Revenue Cycle Management

/, blog, Cardiology/Affordable Care Act Impacts Cardiology Revenue Cycle Management

Proponents of the Affordable Care Act (ACA) are hoping the ruling may provide the tools for both combating CVD and improving the health care system. But what about the health of your cardiology practice? How will your Cardiology revenue cycle management be impacted?

Along with healthcare reform, payment reform is here and with it come the pressures to understand and implement new policies and procedures in Cardiology medical coding and billing. In June 2012, the MGMA-ACMPE released the results of a questionnaire that ranked members’ most pressing practice management challenges. No. 2 was: Preparing for reimbursement models that place a greater share of financial risk on the practice.

Within the next five years, cardiologists will be adopting this shared-risk model for revenue reimbursement (vs. fee for service) with the emergence of population health management through Accountable Care Organizations (ACO) that coordinate care and meet performance standards of care for Medicare patients.

According to a Dec. 11, 2012 online article posted on the American College of Cardiology’s CardioSource, “The ACC will also continue to advocate for overarching payment and medical liability reforms that were not included in the ACA, but critical for overarching health reform to be truly effective. In addition, the College is focused on several regulatory proposals and legislative efforts expected in the coming months that will have major impacts on cardiology though not directly associated with the ACA. Among them:

  • The 2013 Medicare Physician Fee Schedule
  • Additional cardiovascular coding changes as a result of continued bundling efforts;
  • The annual battle to repeal/stop the flawed sustainable growth rate (SGR) formula used to calculate Medicare physician payment; and
  • Looming physician penalties for non-participation in federal incentive programs like e-prescribing, EHR and the Physician Quality Reporting System.
  • The federal government, in tandem with commercial insurance companies, is changing the way patients pay doctors and hospitals in the new ACO environment. The reimbursement environment is transitioning from volume-based (fee for service) to a value-based (pay for performance) one focusing on quality care and efficiency.
  • As a result of ACOs and its correlating population health management and shared risk models, Cardiology revenue cycle management models need to change too. Proper Cardiology medical coding and billing is vital to a practice’s strong heartbeat. It’s an exacting science that requires in-depth, insider industry expertise in Cardiology revenue cycle management that only an independent third party specialist with decades of expertise in Cardiology coding, billing and compliance regulations can provide to ensure nothing falls through the cracks and revenues are optimized.

revMD.com is the results-proven alternative for healthcare revenue cycle management, with a niche specialization in medical coding and billing that generates unprecedented results and builds profitable medical practices. Leveraging a history of industry wide success spanning 25 years, revMD.com partners with medical practices in Arizona and throughout the U.S. to optimize revenue for hospital based and practice based physicians.

About the Author

2012-12-15T15:32:38+00:00