“How the Health Care Reform Bill will affect your O & P Practice?”
The new insurance legislation poses both opportunities and problems for O & P.
What does the bill do?
The gist of the bill is that 32 million Americans who are currently uninsured will now be able to get health insurance. The uninsured and self-employed will be able to purchase insurance through state-based exchanges with subsidies available to individuals and families with income between the 133 percent and 400 percent of poverty level. The good news is that this presents a tremendous opportunity for you!
The Opportunity for your O & P Practice!
Will you be able to see more patients?
First this legislation is designed to give the U.S public the opportunity to obtain insurance no matter their prior or present medical condition. Since O & P works with handicapping disabilities there is a large number of Americans that are currently not eligible for insurance because of their pre-existing conditions. They will now be eligible under the new bill. Second it mandates all persons carry health insurance by 2014. Everyone must purchase health insurance or face a $695 annual fine with some exceptions for low-income people.
Because many currently non-insured patients will become insured, payment for O & P Services will be shifted away from philanthropic organizations and into private insurance companies. The difference is that private insurance is more complicated and harder to collect. Also there is no federal public option for insurance that would have been structured more like Medicare than a state run Medicaid. The O & P Provider will find that they will have a much larger patient base.
The Problem for your O & P Practice!
Will you be able to see more patients and still be profitable?
The downside of this larger patient base is that you will be billing a higher percentage of income to private insurance and have to navigate a complex system that is structured to keep payments to a minimum. .Now is the time to consider how your billing department will cope with increased demand and complexity. Will you be able to see more patients and still be profitable? With the increase in patient claims from the O & P sector, it will be red flagged as an impediment to their profit and targeted for a flag out for denial. The typical O &P billing department staff is typically stretched to their limit and frustrated by the complexity of the insurance industry. Insurance companies understand this and will take full advantage of the situation. Write offs, uncollected secondaries, and deductibles reduce your per claim profit, which means you will work harder for less money Now the already overburdened billing department will be asked to handle this increased load and expected to collect claims more efficiently in an increasingly complicated system.
Should I hire or outsource my billing department?
There are generally two schools of thought when it comes to billing departments. One is to hire an internal employee to do your billing; the other is to outsource your billing to a company that specializes only in billing. Some think that you keep your costs down by supervising your own staff; some think you free yourself up to see more patients by outsourcing and thus become more profitable. The reality is you have to weigh the pros and cons and decide for yourself.
Do you need help deciding what is right for you?
For more than 10 years, CPO Services has been helping O & Practitioners decide whether outsourced or in house billing is right for them. You can call and talk to a 30 plus year veteran that has experience at running an O & P practice as well as billing specifically for O & Practices.
Call or Contact Us today so that you can make the right decision for your practice.
Contact: John Dolza
Phone: (810) 629-6424