reimbursement Tag

10 Jul

Posted at 01:02h in Medical Billing

Accurate medical coding is not a small back-office matter. It decides how a claim is read, how fast payment moves, and whether the provider has to fight for money already earned.

A patient visit may be handled correctly. The provider may document the condition. The service may be covered by the payer. Still, one weak code can slow everything down.

How Accurate Medical Coding Impacts Healthcare Reimbursement

06 Nov

Posted at 01:12h in Author Interviews, Cost of Health Care, Emergency Care
MedicalResearch.com Interview with: Jessica E. Galarraga, MD, MPH Resident Physician Department of Emergency Medicine George Washington University Hospital 2120 L. St. N.W. Suite 475 Washington D.C. Jessica E. Galarraga, MD, MPH Resident Physician Department of Emergency Medicine George Washington University Hospital 2120 L. St. N.W. Suite 475 Washington D.C.   MedicalResearch.com: What are the main findings of the study? Dr. Galarraga: This study examined how emergency department (ED) reimbursements for outpatient visits may be impacted by the insurance coverage expansion of the Patient Protection and Affordable Care Act as newly eligible patients gain coverage either through the Medicaid expansion or through health insurance exchanges. We conducted our analyses using the Medical Expenditure Panel Survey, a nationally representative survey managed by the Agency for Healthcare Research and Quality. We found that ED reimbursements for outpatient encounters by the previously uninsured who gain Medicaid insurance may increase by  17 percent and moving Medicaid-expansion ineligible patients to the private insurance market through insurance exchanges may increase reimbursements as high as 39 percent after the act is implemented.