The only thing that has always been consistent in medical billing is change. Just like every aspect of the healthcare industry, billing is also a complicated and challenging process, especially when you compare it with other sectors. Every minor detail in medical billing matters and even the smallest mistakes can trigger chaos.
Government bodies and agencies have been trying their best to shape medical billing into an ideal form but there will always be opportunities to improve and therefore, changes will keep coming in the near future.
While the changes are brought for good, in most cases, it leaves healthcare professionals and hospitals more vulnerable to compliance risk and disruptive revenue, especially when they fail to stay up-to-date with the alterations and introductions. This might be the reason why so many healthcare professionals and practitioners prefer to outsource medical billing services.
So, without any further ado, let’s try to understand the 5 big medical billing changes for 2022.
No Surprise Act
This might have been the first big change in the medical billing process and it came into effect on 1st January 2022. The introduction of the No Surprise Act means any patient can no longer be held accountable for emergency services from all the providers and healthcare services that are not in the network. This even includes both emergency room physicians and ambulance services.
This act also states that none of the patients should be held liable for balance billing by an in-network healthcare facility for all the services obtained from providers that are not in the network. These providers can be anesthesiologists, radiologists, or pathologists.
Many healthcare professionals find it difficult to stay at the top of these changes and that’s why they opt to outsource medical billing services. Medical billing companies keep tabs on the pulse of medical billing and they know how to introduce these changes in the process.
Modifications in POS codes for Telehealth
The POS code set offers setting information crucial for paying claims with 100% accuracy. In many cases, the healthcare industry has a more important need for specificity in comparison to Medicare.
The ease of coordination of benefits brought through the new changes will ease the setting information they need and they will even benefit when choosing to outsource medical billing companies.
In the series of changes made to medical billing, the point-of-service codes for telehealth are not going to be an exception. It will witness two major changes in POS O2 and POS 10.
The POS 02 has been revised for all those cases when a telehealth consult happens outside the patient’s house. While the brand-new POS 10 has been introduced to provide cover for telehealth consults when the patient is home.
These changes show that now the location where the patient receives the telehealth consultant is going to matter a lot and the healthcare professionals must take care of it even when they outsource medical billing companies.
FY 2022 inpatient prospective payment system
In August 2021, the Medicare Hospital IPPS final rule for the fiscal year was released, and because of the introduction of IPPS, the reimbursement of hospitals increased by almost 2.5%. Apart from this, it even increased the rates of COVID-19 therapies and diagnostics. All these changes came into effect on 1 October 2021.
The new rules of 2022 have brought in new procedural codes and new diagnostics. Furthermore, it has introduced the Medicare severity diagnosis-related group (MS-DRG) adjustments as well.
The final rules of IPPS 2021 have been introduced with the main objective of improving data evaluations and quality measurement. But many healthcare professionals and doctors haven’t been able to successfully incorporate these changes into their system and since they didn’t even go with outsourcing medical billing to India, they are dealing with multiple medical billing issues.
New medical codes
The introduction of new medical codes is nothing new and therefore, changes and introductions were expected in 2022 as well. But all those companies who can’t keep up with these changes have been outsourcing medical billing to India for a very long time.
It all began in 2020 when medical coding companies had to deal with the challenge of ensuring accurate clinical coding and documentation for a virus that was never coded before. This posed multiple new challenges to medical coding sets to account for the new virus and related conditions as well.
A kind of similar change has been introduced in 2022 as well. Coders even have to deal with thousands of ICD-10 codes to report different conditions along with the annual changes to the guidelines and the codes. If you can’t keep up with all these changes, it is better to opt for outsourced billing services.
As a medical professional, it can become arduous to keep up with medical billing changes, especially when they are introduced every year. So, if you wish to focus on patient care only and offload the hassle of keeping tabs on the medical billing changes on someone else, it is better for you to opt for outsourced billing services.
