Pay as you go as a value Based Medical Billing Service Model

Monetary and datacentric nature in the healthcare reforms in us states has left healthcare organizations in all the states of the US to do more data care than healthcare to manage their finances, maintain data integrity and be complaint with regulatory standards. Health Insurance Portability and Accountability Act HIPAA is an example, which, however wellmeaning otherwise, burdens the healthcare provider with a series of compliance activities, involving technical intricacies, which, if not followed to the letter, lead to claim denials and expose the care provider to a postdenial support system thats lumbering and unresponsive.

HIPPA, framed to promote convenience and continuity of health insurance coverage for individuals or groups either changing jobs or unemployed through safe data handling and transfer, seeks to generate a standardized method to electronically transfer data by healthcare providers to Medicare contractors to submit insurance claims and be reimbursed. However, when healthcare organizations are submitting claims through HIPPAs electronic conduit, HIPPA , they are facing claim rejections due to some teething problems HIPPA intending through currently. Medical billing services are usually mostly of administrative and technical in nature, like issues with billing secondary payers, national provider identifiers not being recognized, the care providers are facing while submitting their medical bills to Medicare contractors via HIPPA .

The billing process isn’t just leading to futile administrative works for care providers but also financial losses with Medicare contractors rejecting claims for such minor omissions and errors as claims not having descriptions on them, error in addresses etc. Rejected claims submitted again are meeting with sporadic reimbursements and efforts to contact contractors are inducing one to two hours of callhold period. However, in response to this chaotic situation, The Centers for Medicare & Medicaid Services CMS, the agency overseeing the transition from HIPPA to HIPPA , has delayed the enforcement of HIPPA But will a delayed enforcement of HIPPA , even the hho booster leads to some order and stability, be an answer to healthcare providers woes No.