ACOs and Their Effect on 3rd Party Medical Billing Companies
Friday, August 24th 2012 12:02 pm
In order to fully appreciate the impact ACOs will have on 3rd party medical billing companies, it’s important to understand what the ACO is and what it’s meant to accomplish. The ACO, or Accountable Care Organization, is destined to play an increasing role in Medicare healthcare delivery in 2012 and beyond. As part of the healthcare reform movement, the idea behind the ACO sounds simple:
However, when increased government scrutiny (some would say micromanagement), regulations (HIPAA) and revenue cycle management are figured into the equation, the task of forming and managing ACOs becomes considerably more complex:
ACOs and Third Party Billing Companies
Since physicians and other healthcare providers rely largely on third party medical billing companies. This opens the door to a whole host of problems:
While all this sounds daunting, the risk for 3rd party billing companies is dwarfed by the opportunity. At no time in medical history has there been a greater need for expertise, technology, compliance assistance etc. There is simply no entity in existence positioned to meet these needs better than the third party medical billing companies. Most already have state of the art technology in place and have had to be on the cutting edge when it comes to compliance and expertise in order to survive. In addition, physicians and healthcare providers will need help in order to make sure they themselves are conforming to all the requirements inherent in the formation of their ACOs. This represents another great opportunity for third party billers; that is, consulting services to make sure that their clients’ ACOs are meeting the ever-changing requirements and compliance standards.
Like anything new and innovative, the ACO is not without its foes. And, like anything that deals with the health and welfare of the population, change is a constant. By leveraging their essential functionality with the potential value-adds referred to above, the 3rd party medical billing industry can not only be an essential cog in the ACO mechanism, but can also ensure that the Medicare healthcare providers have the time and resources to concentrate on their real priority: providing healthcare to our aging population.
Brad Lund is the Executive Director of HBMA.
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