We have all been waiting with great anticipation for the Supreme Court decision in the case of President Barack Obama’s Affordable Care Act. This act, amongst other items, was designed to set an individual mandate for all uninsured people to carry some kind of health insurance or risk a “fine” of some kind for not having insurance. The individual mandate was upheld as a majority of the Justices concluded that the penalty that enforces the mandate is a “tax” and therefore falls within the permissible powers of the Congress to tax and spend.
Because medical care in America is never denied to anyone, regardless of their carrying insurance or not, many people view this quasi-universal healthcare coverage as something that is long overdue. We all need to see the doctor now and again. The choices for the uninsured are 1) pay for the most basic kind of insurance so that you are at least offering something to the overall pot or 2) pay a fine (now described as a “tax”). Of course many Americans are all up in arms over this decision. Not about whether this is a move in the right direction to fix a broken healthcare system, but whether the government can mandate insurance coverage.
Be that as it may though there is another stew brewing. Many people in the medical billing industry are wondering how their future will look based on the Supreme Court’s decision. Some in the medical billing industry see this new law as a benefit if it is implemented, increasing the number of insured going to the doctor instead of the emergency room or “free” clinics. The increase amount of medical claims processing is something which these folks view as a benefit to their industry.
Others, however, fear that this decision will negatively impact the medical billing industry because the Act calls for standardized medical billing using electronic methods. It still requires a skilled, attentive professional to insure accuracy in the information being entered into the electronic system and oversee the medical reimbursement cycle. And how much more “standardized” can the government make medical billing? They are the ones who created the standardized ICD, CPT and HCPS system in the first place.
A mix of both of these ends may be true. Yes, I believe that an increase number of insured will result in an increase in medical billing and coding processing. And yes, I believe that the Federal Government will try and make the process smoother and easier, but that didn’t happen in 1996 with HIPAA. Many know HIPAA as a Privacy Act but it was intended to make the health care system more efficient by standardizing health care transactions. And, ask anyone who has been to see a tax attorney lately and they will tell you that even though the process for “e-filing” taxes is ‘easier’ in some regards, it still lacks any of the panache with which it was first touted. It still takes a lot of effort to get all your deductions tabulated, forms filled out, and paperwork in order. And it will still take a lot of effort for providers to get clean and accurate claims submitted for payment.
How the Affordable Care Act will affect us all? That remains to be seen!