Concerns of Insurance Administrative Load on Physicians Worries Seema Verma
The administrative burden on physicians and medical billing services has been a constant worry. CMS administrator and American health policy consultant Seema Verma considerably acknowledges this concern and has asked insurance companies to modify their policies to rectify problematic areas.
She asked them to support the idea of accessible value-based healthcare by working on transparency, interoperability, data access, and value-based facilities for the progressive healthcare industry.
At America’s Health Insurance Plans’ 2019 National Conference on Medicare, Seema said that patients, doctors, and medical billing companies are fed up of high expenses, surprise medical bills, and complex medical billing and coding system.
Low Patients Engagement
The idea of an empowered healthcare system seems daunting when clinicians and patients do not agree with the process.
It is so difficult for medical billing services to satisfy insurance companies on behalf of medical practices. The qualifying criteria are so strict that a large number of medical claims get denied, causing revenue loss. This is one of the major reasons for low trust level on private payers by patients and stakeholders of healthcare organizations.
The administrative burden kept on increasing for a few years, although the mission is to simplify the billing process while curbing the cost.
Difficulties Faced by Medical Billing Services
In the name of prior authorization and quality reporting, insurance companies rules have gone strict. Especially medical practitioners who do in-house medical billing, spend a big time of their day on creating accurate medical claims.
On the other hand, medical billing and coding companies certainly have resources to match the expectations of clinicians and medical billing services. Still, they have to spend so much time on a single claim.
Seema Verma has shown evidence to support the complexities in medical billing and coding process that led to increased burnout ratio in physicians and medical billing staff. She further added that many stakeholders of healthcare industry chant the motto of “Medicare for All”, which is a threating situation for private payers.
Insurance Companies Need to Simplify Rules
According to Seema, insurance companies need to adopt an alternative way to stand side by side by patients and physicians. We all want price transparency and quality care services, and only by taking smaller but constructive steps makes survival easy.
Technology can play a forefront role in implementing feasible value-driven practical solutions.
What are your thoughts on this?
