1. What impact will the ACA have to physician practice billing? 2. How will bund
ID: 1133883 • Letter: 1
Question
1. What impact will the ACA have to physician practice billing?
2. How will bundling of services under the ACA affect hospital billing and physician reimbursement?
3. Health Care Topics
There is a current trend toward using more physician’s assistants and nurse practitioners in the health care delivery model. Please describe some areas of care delivery where this occurs. Why is this a more effective use of health care resources? Explain how this model would be more cost effective. Cite sources where appropriate.
Explanation / Answer
And 1- When Affordable Care Act (ACA) was passed, it was going to have big impact on health insurance industry. It wasn't to make things like medical billing, pre-certification, on medical practices, the following are few of the issue that have resulted:
1. If ACA has been successful at achieving things, it's to increase the number of people that have insurance. It is a good thing, it also means that fewer people are paying for medical services. Most people hat health insurance, for which practices need to file more claims.
2. Insurance plan s are changed as a result of ACA. There is modifications in patient reimbursement rate and allowance. There are some problems when insurance companies have not communicate clearly with customers. That result in patient not realizing that medical services that have obtained may no longer have been covered or may be covered.
3. Medical practices have had to get in the habit of communicating with patients before scheduling appointments to discuss or set up payments plans in order to avoid growing outdtoutsta balance.
And 2- Bundled payment tend to have lower financial risks for payers and are beneficial to providers as well as payers. Payers are responsible for single payment that covers all the service, which means there is lower financial risk than other types of value based agreement for payers.
Payers can leverage population health management technique and value based insurance to treat high risk, high cost individual. A bundle payment model allow a payers to bundle payment for multiple services in population health programs in years to come, they could falicitate population health programs with longer treatment period to address all the conditions of high risk population. Payers aiming to address the many financial and quality challenges they face when sponsoring health plan could look to bundle payment as a solution to deliver high quality, cost effective care.
And 3- The provisions of health care services has undergone many changes.one of these changes is that non physicians clinician are performing many service that are domain of physicians. Two such group involved are physicians assistsas (PAs) and nurse practitioner (NPs). PAs are licensed health professional, certified by national examination process, practice medicine with physicians supervision. NPs are registered nurses who are certified or state recognized by national certifying body or state board of nursing.
As is true for physicians, the majors force affecting the demand for PA and NP service is the economy . If health care become available or affordable for more people, opportunities for NPs any PAs are likely to increase. If physicians demand continue to correlate with econeecon growth, demand for PAs and NP is likely to continue as well.
The growing presence of PAs and NPs in amerAme society is due to number of factors, the education process has accommodate this demand with a supply of providers who continue to find employment. Demand for their services will continue in near future.
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