This article contains important information for any facility accepting medical insurance as payment for services. Reports state that the federal government has launched investigations into healthcare providers steering and/or assisting patients into Healthcare Exchange policies when oftentimes the patients qualify for Medicare or Medicaid.
Steering patients to specific policies, insurance plans, or markets drives up healthcare costs. In turn, higher costs equate to increased premiums and increases the cost of coverage for all. With health insurance, if the risk pool gets to diluted with sick or treatment seeking people, insurers begin to experience great losses. As a result, insurers begin to pull out of markets (i.e. Obamacare Exchanges). We have already been seeing this all across the USA. Healthnet has pulled virtually all of its PPO policies off the Healthcare Exchanges. Aetna and United Healthcare are pulling out of most all exchanges as well.
Treatment providers may wonder, “How does this impact my business”? In the short-run, it may not. However, it boils down to simple economics and will surely impact us all. Less people have access to quality Drug and Alcohol Treatment because they no longer have viable private health insurance. A smaller “qualified” demand pool paired with a flat or increasing supply of rehab beds means times could be getting much more lean in the very near future.
If you have questions about the efficacy of your current insurance billing processes, maximizing your revenue in an honest and ethical way, or ongoing changes with insurance, Give AVA a call today! (888) 502-2826
Original Article: http://www.cnbc.com/2016/08/18/health-providers-may-be-steering-people-to-obamacare-to-get-higher-reimbursement.html