How has the Affordable Care Act Transformed Healthcare Billing Services?

The Affordable Care Act marks a significant movement in US healthcare history. First appearing as a comprehensive reform, the act was signed into law later. The great president of America, President Barack Obama, did so in March 2010, so we call it ‘Obamacare’ as well. Now what does the law do? Well, this law encloses a list of healthcare policies to be expanded in the coming future. Among these, the law puts a spotlight on costly healthcare billing services and strict policies. Therefore, it has decisively addressed the transformation of such healthcare billing policies.

Anyhow, whatever the law encompasses, the main goal is the expansion of insurance access. Thus, millions of uninsured and poor Americans will be able to get medical assistance easily. Costly medical billing will not be a nightmare for them. In this blog, we’ll discuss the profound impact of the ACA on healthcare billing services. For this, we’ll analyze the changes it brought about in medical billing as a whole.

The Obama Healthcare Act (ACA)

The Obamacare Act contains the following provisions that have altered US healthcare delivery:

• Expansion of Medicaid
• Health Insurance Marketplace
• Pre-existing Conditions

Check out these key provisions to get a better understanding of the subsequent policy changes.

Expansion of Medicaid

First and foremost, the law increases Medicaid eligibility to a great extent. In the past, Medicaid provided coverage benefits to low-income children, pregnant women, and the disabled. Anyhow, the coverage criteria today pay close attention to the patient’s income. It provides the Medicaid benefit to all those who satisfy a certain income threshold.

Health Insurance Marketplace

On this platform, different related personnel can buy and sell their insurance plans. Apart from sharing, this initiative fostered a competitive environment among insurers.

Pre-existing Conditions

Numerous Americans had previously been turned away from the insurance market. However, the ACA guaranteed that those with pre-existing diseases could no longer be denied coverage. They could not be subjected to excessive charges.

The Pre-ACA Healthcare Billing Landscape

We will delve into the changes ushered in by the ACA shortly. First, let’s overview the healthcare billing environment that prevailed before its enactment.

The Intricate World of Medical Codes

Healthcare billing was a maze of complex medical codes before the ACA. These codes were frequently complex and obscure. As a result, medical billing services must invest a lot of time and energy in understanding them. This intricacy resulted in claims being delayed and administrative expenses rising.

Lack of Accountability

Furthermore, we find that there are no strict standards governing healthcare billing services. It has become extremely difficult to hold providers responsible for billing mistakes or overcharging. Patients sometimes find themselves struggling with enormous costs. The intricacy of these bills was mind-boggling, in addition to being monetarily onerous.

The ACA’s Impact on Healthcare Billing

The Affordable Care Act brought forth transformational improvements in healthcare billing services. It has an overarching goal of improving the system’s accessibility, affordability, and patient-centeredness.

Standardization of Medical Codes (ICD-10)

The ICD-10 is a thorough coding system that was implemented by the ACA. ICD-10 not only shortened the billing process but also dramatically increased documentation and billing accuracy. Thereby, it lessens the likelihood of mistakes and eases the administrative strain on organizations.

Pricing Transparency

The ACA established a new age of pricing transparency. Healthcare providers have to be open about their charges. As a result, patients are given the right to decide on their care. This increased openness was a key factor in lowering unexpected medical costs. Overall, it gives patients the freedom to look for low-cost treatment choices without unpleasant financial surprises.

Medicaid Expansion

This extension aims to provide support to a larger group of low-income people. As previously said, it has successfully lowered the number of patients without insurance. So, the burden of uncompensated care on healthcare providers has been greatly reduced. Overall, it has paved the way for a more equal healthcare system.

Challenges Faced by Providers

While the ACA brought several positive changes, it also posed some challenges for providers.

Administrative Burden

Despite the ultimate benefit of ICD-10, its implementation in healthcare billing services was initially cumbersome. Healthcare professionals have faced difficulty getting expertise in the new medical billing and coding rules. They required immense training before moving ahead. So, at first, things became more complex with an increased administrative workload. However, healthcare professionals have combated these challenges and subsided over time. At that time, the pronounced benefits of the new ICD-10 became clearer.

Revenue Adjustments

The Medicare reimbursement rates for some providers changed to pay for different ACA activities. While these changes did create financial difficulties for the providers, they also helped reallocate funds to the broader goals of healthcare reform.

Conclusion

The ACA undoubtedly made significant and long-lasting changes to healthcare billing services. It has paved the way for a healthcare system that is more equitable and accessible. While it posed difficulties for healthcare professionals, it greatly reduced the cost pressures on patients. The ACA is a significant step in guaranteeing that access to healthcare is not only a privilege but also a basic right for all Americans. You may check out the official website or use HHS’s resources to get more information on the ACA.