Is Your Company Ready for the Changes in Healthcare?

Is Your Company Ready for the Changes in Healthcare?

Pat Palmer

Jan 12, 2015

Is Your Company Ready for the Changes in Healthcare?

 Change has come. America now complies with the rules and regulations under the Affordable Care Act. But although we have already implemented the changes that were incorporated in this ground-breaking legislation, more change is to come.

In the fall of 2015, ICD-10 is set to finally roll out in the U.S. ICD-10 is the coding system brought forth from the United Nation’s World Health Organization (WHO), which is already widely used around the world. Numerous countries started implementing this latest system of diagnostic codes beginning in 1998. The United States will be one of the last developed countries in the world to adopt this coding system, which is more specific and gives more detailed information in each individual code’s seven digits.

While intentions might be good, signs point that the aftermath could be disastrous from a medical billing standpoint. Consider this: The nation’s most well-known and oldest medical bill review firm, Medical Recovery Services, estimates that 80% of medical bills contain costly over-charges. Now imagine what that figure will become when the number of diagnostic codes more than quadruples. That’s right. Our current diagnostic code system utilizes approximately 13,000 codes, but the up-coming ICD-10 system will incorporate a total of approximately 68,000 codes.

The incorrect use of these codes can cause a hospital bill to inflate far beyond a true or accurate price. For instance, where there might have been one code for a broken tibia under ICD-09, there might be five for a broken tibia under ICD-10, each of the five codes a little more descriptive of the type of break. Again, whereas this extra information can be useful for some healthcare employees, the chance for incorrect diagnostic coding is greater.

We live in uncertain economic times. The financial ebb and flow has always been present, but today, corporations must watch their bottom lines even more closely than before. For self-insured corporations, employer health insurance spending can be especially tricky. That’s why it’s so important to take steps to make sure you are making only the soundest financial decisions. One such decision should ensure that your company is only paying what is True & Accurate, Fair & Reasonable for medical bills. Are you utilizing the expertise of an experienced compliance-based medical bill review organization to make sure that your employees are not being over-charged on their medical bills?

One such medical bill review company, Medical Recovery Services, will provide a system of checks and balances for your employees’ medical bills that uniquely combines 20 years of experience with a proprietary compliance methodology based on rules and regulations set forth by the Social Security Act, Code of Federal Regulations, Uniform Billing Act and national AMA and AHA rules and regulations.

Inpatient hospital bills account for the largest percentage of a self-insured company’s expenses, sometimes topping six and even seven figures. With 8 in 10 medical bills containing errors, overcharges and cost padding, it only makes sense to try to protect your business’s finances, now more than ever.

About the Author

Pat Palmer, founder and CEO of Medical Recovery Services and Medical Billing Advocates of America.