Expiring Payment Patches Create Administrative Burden for Medical GroupsNewswise — ALEXANDRIA, VA—The American Medical Group Association recently expressed to Donald Berwick, M.D., M.P.P., Administrator of the Centers for Medicare and Medicaid Services (CMS), the difficulties some AMGA members have had surrounding the claims adjudication process for claims affected by the expiring Medicare “payment patches” in 2010.
AMGA first outlined the administrative burdens experienced by members associated with receiving large numbers of paper remittances from their Medicare contractors. These difficulties ranged from the need to hire additional staff to contend with the manual posting necessitated by the paper process to issues with secondary insurance payment adjustments.
AMGA then made recommendations on what CMS could do differently should these same conditions arise again. These included streamlining the reprocessing of claims by batching the claims separately, rather than intermingling them with regular claims; and making estimated payment adjustments on a per- physician basis, with subsequent reconciliation, rather than a claim-by-claim by adjustment.
“AMGA’s members are committed to making the most efficient use of time and limited resources in the best interests of direct, hands-on patient-centered care,” said Donald W. Fisher, Ph.D., CAE, AMGA president and chief executive officer. “Any deviation in this commitment due to expending time and resources on unnecessary administrative burdens serves to dilute these efforts. We stand ready to work with CMS to resolve this issue and any other billing and collection issues that may arise in the future.”
To view the statement in its entirety, visit the AMGA website at www.amga.org.
The American Medical Group Association represents medical groups, including some of the nation's largest, most prestigious medical practices, independent practice associations, and integrated healthcare delivery systems. AMGA's mission is to improve health care for patients by supporting multispecialty medical groups and other organized systems of care. The members of AMGA deliver health care to approximately 110 million patients in 49 states, nearly 1 in 3 Americans. Headquartered in Alexandria, Virginia, AMGA is the strategic partner for medical groups, providing a comprehensive package of benefits, including political advocacy, educational and networking programs and publications, benchmarking data services, and financial and operations assistance. www.amga.org
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