Affordable Care Act Has Immediate Impact on Physicians' Medical Practices

Most physicians, if they had a choice, would prefer to clean up a soiled bedpan than spend any amount of their valuable time digging through medical codes in order to bill insurance for procedures they’ve performed or recommended.

Private practice doctors on average spend 8-10 years, prior to getting licensed, learning human anatomy, pathology, medications, and a host of other health-and-life saving information. However, their first exposures to the nitty-gritty details of running an actual business are usually unlike anything for which medical school could have prepared them: residents and interns are rarely handed business books during shifts in ER. It’s especially true when it comes to getting health insurance plan reimbursement, and that’s why most doctors employ administrative professionals to transcribe their medical charts, and still others to transform those transcripts into codes for insurance (including Medicare and Medicaid) billing.

Picture of affordable care act bill passing on March 21, 2010.In the United States, the 2010 Affordable Care Act legislation has introduced an urgent business necessity for private physicians to adjust to, in the billing and coding space. October 1, 2013 is the deadline for all health care providers in the USA to begin using the new "ICD-10" protocol for coding, which includes among other things:

1. Inpatient hospital procedures
2. Diagnosis coding, and
3. Procedure coding systems.

There are 155,000 codes in the ICD-10 series (which is well over 5 times as many as in the previous version, ICD-9), and most of these new codes cover widely performed procedures in greater detail/specificity than ever. Office managers, medical billers, and coding professionals are spending an average of 5 hours a week studying these new coding protocols, preparing for the quickly approaching deadline.

With that in mind, almost nothing within the new Affordable Care Act legislation has more immediate, short term impact on private medical practices than the new coding and billing compliance requirements. Of course, one could make the case that the availability of insurance to formerly uninsured patients, the changes in beneficiary aspects within Medicare, insurability rules, etc., will have an enormous effect on the health care industry as a whole, but in discrete practice, these aspects wouldn’t directly affect most physicians’ offices-- other than an increase in qualified patients. Most of those changes are still more than a couple of years away, as well. The ICD-10 coding changes, however, are currently increasing man-hours, costs, and directly affect state and federal business and licensing compliance regulations. In addition, it’s something the average patient/consumer is unaware of.

Doctors are in a rush to meet the deadline, and that directly affects the availability of medical services in most localities. If you know anyone uncertain about their future career, tell them to consider Medical Billing and Coding (and medical transcription), which are rapidly growing fields. There’s a definite shortage of qualified professionals. These are administratively necessary professions, people who get to be an integral part of the health care field… but they don’t have to clean any bedpans.

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