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2019 Medical Practice Payment Changes: What You Need to Know

Closing out 2018 may include a lot of holiday preparations and festivities. It’s easy to get lost in all of the fun (and frustration) of family gatherings and parties, while allowing your business to simply idle until the end of the year.


If you’re an independent medical practice or a private clinic, you should be thinking about a few important things to prepare for 2019 and the payment changes affecting the healthcare industry.


Evaluate Current Patient Intake Forms and Financial Policies


It’s a standard practice for healthcare facilities to ask their patients to update contact information, demographic information, and insurance information. Gather this data at every patient’s first visit of the New Year.

Take this opportunity to update your signed financial policies as well. While your patients are updating their other information, provide a form for them to sign that acknowledges and accepts your financial policies. Evaluate the policy you currently have in place, and make sure it includes any legal and regulatory updates. You’ll also need to think about whether the policy is working for your practice.


A good financial policy for your private medical practice will address:

  • no-shows and appointment cancellations.

  • instructions that payment is expected at the time of service.

  • payment for the entire service when deductibles aren’t met.

  • what payment options are, and how patients can choose to self-pay for treatment.

Prepare a New Fee Schedule

Has it been a while since you reviewed and adjusted the fee schedule for your services?

At the end of the year, evaluate your fees and plan what you will charge in the New Year. Or else, you may be leaving money on the table if you haven't adjusted the fee schedule for your services. Update the costs for your services, and keep your staff informed. You can create an easy list of services and fees so they can efficiently collect co-pays and co-insurance amounts. It’s important to maximize what you earn in 2019.


Pro-tip: The Center for Medicaid Services (CMS) recently released the Medicare 2019 Fee Schedule Final Rule, so make sure you and your staff understand those and align your own fees.


Self-Audit your HIPAA Compliance Policies

In 2018, there were a record number of privacy breaches that affected HIPAA regulations. This touched large healthcare organizations and small medical practices. Providers were subject to large fines, and it’s a good reminder that no practice or clinic is exempt from potential security breaches.


Conduct a thorough audit of all your security systems and data protection plans. You need to do everything you can to protect your patients' privacy. Not only is this your ethical requirement, it’s also required by the Quality Payment Program, or MIPS.


To report MIPS data for this past year, your practice will need to complete a HIPAA Risk Assessment. If you have not done this yet, or you need assistance, check the HealthIT.gov website for help.


If you have any questions about this information, or you need help ensuring you get paid in 2019, please contact us today. Horizon Revenue solutions offers services in and around these areas and it's surrounding locations:

Give us a call at (408) 444-8845 or fill out our form and we'd be able to get you started on being a more profitable practice today.

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