BC Advantage - 2013 Issue 4
Billing Under PPACA... Elusive or Transformational
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Article Overview
This article explores the broader impact of PPACA on medical billing and revenue cycle operations. It discusses how reform-driven change is affecting providers, billing organizations, payors, and patients, and it highlights several general policy and payment topics that are relevant to billing professionals, compliance teams, and practice managers.
Why This Topic Matters
It helps readers understand the operational and organizational significance of health care reform for billing and reimbursement workflows, including why industry practices and payment administration are continuing to evolve.
Article Sections
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Introduction and personal billing experience
An opening narrative uses personal hospital billing experiences to frame how health care financing and administrative processes have changed over time.
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The evolution of billing services and industry support
This section describes how billing services developed in response to growing complexity in health care reimbursement and administrative demands.
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Entrepreneurship, change, and health care reform
The article connects business and organizational concepts to the expected long-term effects of health care reform on service delivery and operations.
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Examples of PPACA-related payment and care models
Several general reform-related topics are introduced, including payment approaches, coordination arrangements, and patient-centered practice concepts.
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Implementation outlook and concluding perspective
The closing portion reflects on the pace of implementation and the need for organizations and individuals to adapt to ongoing change.
What You Will Learn
- How the article frames the operational effects of PPACA on billing and reimbursement
- Why administrative complexity in health care created demand for billing services
- What broad types of reform-related payment and care models are discussed
- How the article views the role of organizations and entrepreneurs in adapting to change
- Why implementation of reform is presented as an ongoing process
Who Should Read This
- Medical billers
- Revenue cycle professionals
- Practice managers
- Compliance professionals
- Healthcare administrators
- Physician office staff
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