Affordable care act changes to affect optometry billing in 2014

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Affordable Care Act Changes to Affect
Optometry Billing in 2014
As several key sections of the Affordable Care Act (ACA) are set to take effect this
year optometry practices need to gear up to sail through the billing challenges.
The primary focus of the ACA is to increase the number of American citizens with
health insurance and for that, optometrists will need to provide services and eye
care to the newly insured patients over time.
Many states in the US will expand and extend their Medicaid program to
everyone under 133% of the federal poverty line in this year. The federal
government will support this program for approximately three years by providing

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complete funding. Due to this, optometrists seeing Medicaid patients will witness
a significant rise in number of people seeking treatment.
Even though states will receive monetary help for covering this population it will
not translate into increased reimbursements for providers. The expansion is set
to create a new patient dynamic, decrease in payment per transaction for
optometrists. However, there will be a possibility of more transactions.
Optometry practices may face some common challenges as other small practices
in the healthcare industry. This will affect their staff as well as the treatment
procedures.

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Optometrists have increased inflow of patients because of health care reforms.
Various services are being added to the care package and this has made
optometry billing complicated. Some of the billing challenges faced by optometry
practices are as follows:
 Lack of trained staff for data recording is one of the major billing
challenges for optometrists. Since electronic health records (EHR) and
electronic medical records (EMR) have become popular, your staff needs
to be capable of recording patient data at real time. They must know how
to collect the required information and record it with appropriate codes.

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 Millions of Americans will get covered under Medicare by 2015 and a large
number of patients are likely to come to your clinic. Billing and coding
challenges will increase for Medicare and Medicaid patients.
Practices need to check on their clearinghouse for rejections and improve their
Accounts Receivable (AR) reports to ensure timely payments. Everything from
patient access and opportunities to reimbursements are bound to change for
optometrists due to the Act. However, it will depend on the individual
optometrist to understand what value he adds to the system and how he can
prepare his practice for the potential challenges. The need is to capitalize on
opportunities and manage the risks related to billing.

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Bad debts, not adhering to the reforms of HIPAA for protected health information
(PHI) are some additional challenges that can affect billing for optometrists. Since
ACA will bring a lot of changes to optometry practices, it would be a good idea for
providers to outsource their billing and coding requirements to companies
like MedicalBillersandCoders.com. MBC is the largest consortium of coders and
billers who are well-trained in handling billing and coding changes for optometry
specialty. The expert team at MBC makes use of the latest software and
technology to ensure timely payments, maximize revenue and minimize claims
denials

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