The head of one of the nation's leading lobbies for healthcare billing firms has asked that Congress reach a firm consensus on the sustainable growth revenue (SGR) formula, noting that indecision on Medicare payments is putting cost pressures on its membership.
"We've been seeing an increasing level of frustration," Scott Everson, president of the Laguna Beach, Calif.-based Healthcare Billing and Management Association, told FierceHealthFinance. The HBMA represents about 700 billing firms nationwide and processes about one-third of the country's initial physician claims.
Everson, who is also vice president of business development for PracticeMax in Scottsdale, Ariz., noted that every time a payment adjustment is made for physician Medicare rates and then Congress temporarily reverts payments to old rates, billing firms and other payment intermediaries need to make similar changes to their billing procedure.
"It is certainly in the realm of 30 cents to 50 cents per transaction," Everson said. He noted that such corrections involve sending out revised claims and debiting or crediting a physician's account.
"If you're a doctor with several hundred or even thousands of Medicare patients, it can add up," Everson said, adding, though, that such costs are often absorbed by the billing firms.
The HBMA has sent a letter to every member of Congress asking that it fix the SGR formula permanently. It recently voted to temporarily halt SGR-related payment cuts set to go into effect next month and in January.