Optimal MD Solutions

Physician Billing & Management Service


The Healthcare Billing & Management Association (HBMA.org) is urging Congress to avert the pending 26.5% reduction in the Medicare physician fee schedule (MPFS) Conversion Factor on January 1, 2013, and impose the longest possible Medicare sustainable growth rate (SGR) fix immediately this year, in 2012.

HBMA members believe that should this cut occur as scheduled, thousands of physicians will either dramatically curtail the number of Medicare patients they will see in their practice, or in the most extreme cases, no longer accept Medicare patients.

HBMA is the premiere, non-profit educational resource and advocacy group representing third-party medical billing companies and billing professionals. HBMA President, Don Rodden said, “Either way, millions of Medicare beneficiaries will surely see a precipitous drop in the availability of medical care they have come to expect and deserve.”

Medical billing companies, such as those which are members of HBMA, are retained by physicians to handle the business aspects of a busy medical practice. These medical business experts, or member companies, are intimately familiar with what it costs a physician to submit a medical claim and get paid for the services they render. If Congress decided to retroactively “fix” the SGR problem , as they have done in the past, the costs of the retroactive adjudication would add to the already high cost of doing business.

Whether Congress decides on a long-term or short-term fix, HBMA urges Congress to act now, prior to January 1, 2013, and not to postpone action.

HBMA recognizes that new payment methodologies may be necessary to maintain the long-term viability of the Medicare Trust Fund. However, the more steps a claim must go through, the higher the cost of getting a medical claim processed. In many cases the cost of processing the claim could become higher than the value of the claim.

Rodden added, “Medicare beneficiaries deserve to know that the quality healthcare they have come to rely upon will be there when they need it.”

To learn more about the critical nature of this issue, go to www.hbma.org or call 1-800.640.4262.

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