Affordable Care Act
What does all this Obamacare mean to your practice? The exchanges being offered on healthcare.gov are plans that include the current health plans and new health plans constructed to meet the new requirements. The new health plans often have higher deductibles and co-pays than the previous plans you are familiar with as of today. It is thought that providing more coverage to more individuals will encourage people to seek healthcare before their health issues have become complicated and, perhaps, more costly. Only time will tell…
In the short run, you need to be aware of the changes in coverage for your patients. We continue to recommend that you verify coverage for your patient before the patient is seen by your physician. Realizing that this approach is time consuming and difficult for your front office staff, this prevents discovering after the patient is seen that their health plan does NOT cover your services. Time and again, we are asked to investigate claims denials where the patient was seen but the patient’s coverage did not include the services provided.
Many of the insurers continue to issue member ID cards that all look alike! The ONLY way to discern that the patient’s coverage is different than the “usual” is to check with the insurer.
The carriers enrolling physicians into Medicare and completing the revalidation processes are continuing to grow and merge. This can lead to confusion and difficulties when applying to Medicare, making changes to your Medicare accounts and completing revalidation. The website, http://www.cms.gov/ continues to be a valuable source of “all things Medicare”. Revalidation requests MUST be honored within the time frame requested – usually 60 days. If the revalidation request is not answered, the physician’s billings with Medicare are denied.
The best way to prevent this from happening is to respond to all Medicare requests as soon as possible. Be sure these Medicare letters do not disappear! Please call us with any questions or concerns regarding Medicare revalidation and other requests.
“You can never get enough of what you don’t need to make you happy”. Eric Hofer
If you need any help with Medicare credentialing or credentialing with any commercial insurers, or you are concerned about Medicare Revalidation please contact AddVal for assistance at 215-396-8972, firstname.lastname@example.org.
About Add Val, Inc.
AddVal, Inc., based in Southampton, PA, currently serves over 5,000 clients across the U.S., providing experienced medical credentialing services. The company employs a unique blend of talented individuals experienced in clinical administration, healthcare insurance and medical credentialing. This team, combined with a singular focus on credentialing, produces unrivaled results for clients.
|Unrivaled Medical Credentialing Expertise
607 Lakeside Park
Southampton, PA 18966
Telephone: 215-396-8972 | Fax: 215-364-2187 | Email: email@example.com