Thoughts About the Affordable Care Act

The reductions in Medicare payments that will result from the implementation of the Affordable Care Act started last year and will continue to increase during the next years. They were supposed to be somewhat offset by the increase in people eligible for insurance–either due to expanded Medicaid eligibility or to the employer insurance mandate.

However, the Medicaid expansion is dependent on the individual states voting in favor of it and the additional federal funds for it don’t start until January 1, 2014. The employer insurance mandate, which was supposed to be effective also January 1, 2014 has now been delayed a year.

On the expense side, ICD-10 implementation is set to begin Oct 1, 2014. Experience in other countries has shown that to be a nightmare, at best. Most countries have experienced their Accounts Receivable tripling!

So, the squeeze is on for hospitals and physicians…

At Omega, we go back 2 years for our Lost Charge Recovery projects and since payments are date of service dependent, we can recoup the charges under the old reimbursement methodologies. So, that’s one way to bring in additional revenue.

On the expense side, we offer advanced technology at basement prices–probably 10% of the price for a large in-house installed system. We can analyze your Chargemaster for compliance, pricing, and completeness. We can analyze your claims on a daily basis for Medicare billing compliance, RAC issues, lost charges–you can even write your own edits for your specific issues! And don’t forget, you always get Omega’s professionalism and service.

So, isn’t it time to give us a look?

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