Medical Billing Association Invited to Address Provider Enrollment and Claims Editing Issues as They Relate to the Affordable Care Act
LAGUNA BEACH, Calif.--(BUSINESS WIRE)-- The Healthcare Billing & Management Association (HBMA), a non-profit educational resource and advocacy group representing third-party medical billers and billing professionals, will participate in a hearing conducted by The National Committee on Vital and Health Statistics (NCVHS). Hosted by the NCVHS’s Subcommittee on Standards, these hearings will take place Nov. 17 and 18 at the Holiday Inn Rosslyn at Key Bridge Hotel in Arlington, Va. Thursday’s hearing will focus on issues related to claims attachments, while Friday’s topics will be centered on section 10109 of the Affordable Care Act. HBMA will deliver two presentations – the first on provider enrollment forms and the second on claim edits – during the Friday hearing.
Dave Nicholson, CHBME, president and CEO of Baltimore-based medical billing and practice management company Professional Management, Inc., will deliver the first presentation on behalf of the association. He will discuss provider enrollment, and common issues and challenges HBMA has seen across its membership. In addressing the questions and concerns of the committee, Nicholson’s testimony will cover:
- Differentiation between enrollment and credentialing processes, including the recommendation for standard definitions;
- Issues created by the number of different provider forms that exist and the need for streamlining the enrollment process;
- The possibility for a shared enrollment system;
- The different data compiled by each health plan and the possibility of consolidating data; and
- The prevalence and inefficiency of paper forms in the enrollment process.
In the second HBMA presentation, Holly Louie, RN, CHBME, PCS, compliance officer for Practice Management, Inc., will testify on the challenges of claims coding when each payor abides by individual sets of rules. Louie will discuss common issues that arise—such as incorrect claim adjudication, improper payor requirements, denials for add-on codes, unpublished bundling edits and unlisted services—and will provide analysis based on incidents that have taken place at her company.
“HBMA members have significant experience working with providers on these very issues,” says Jackie Willett, CHBME, president of HBMA. “Our association is honored to share our knowledge in an effort to make a difference and support improvement in the reimbursement industry. Our active involvement in these hearings, along with other agencies, is just one piece of the educational role we play.”
The NCVHS is the advisory body to the Department of Health and Human Services on health data, statistics and national health information policy. All meetings of the NCVHS are open to the public and the hearings of the Subcommittee on Standards can be heard on the Internet at this link.
A non-profit, member-led trade association, the Healthcare Billing & Management Association (HBMA) represents more than 30,000 employees at well over 700 third-party medical billing firms. Annually, HBMA companies submit more than 350 million initial claims on behalf of hospital-based physicians, office-based physicians and other allied healthcare providers. Founded in 1993, HBMA and its members foster personal development, advocate on the behalf of the profession, and promote cooperation through a wide range of business resources, educational events, networking opportunities, certification programs and adherence to the Medical Biller’s Code of Ethics. As the only trade association representing the interests of medical billers in Washington D.C., HBMA works with legislative stakeholders and federal agencies to improve the business of medical billing and the practice of healthcare. Learn more about how HBMA is elevating the medical billing profession at www.hbma.org.
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