Practice Management: The Game Changer

Abstract

The reimbursement landscape is undergoing significant changes. Practice management, which encompasses reimbursement, is becoming increasingly more important in securing business success. Each practitioner within a facility is responsible for fortifying the practice through thoughtful business protocols. Knowing legislation that impacts health care along with understanding the foundational components of reimbursement is key for keeping a practice financially healthy. Change is good, but making the changes is what counts! Legislation such as the Medicare Access and Chip Reauthorization Act defines the new payment models. Correcting current business practices might seem difficult on the surface, but implementing change is rewarding and an obligation of the practitioners within a facility to their patients. Financial stability for a practice occurs when sound business practices are routine. Today's audiologist must not only be proficient at performing his or her scope of practice, but must also accept that performing best business practices is part of the job. In the end, the patients seeking the services of the audiologist benefit most when a practice has the financial stability to be best in its class.

Keywords

Reimbursement - practice management - pay-for-performance - Medicare - key performance indicators - third-party payers

• References

• 1 American Academy of Audiology . Available at: www.audiology.org . [search key word “reimbursement”]. Accessed August 15, 2016
• 2 Medicare Benefit Policy Manual . Available at: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c15.pdf . Accessed October 13, 2016
• 3 Department of Health and Human Services. Pub 100–02Medicare benefit policy. Available at: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R84BP.pdf . Accessed February 29, 2008
• 4 CMS.gov. Delivery system reform, benefit payment reform. Available at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html . Accessed November 8, 2016
• 5 American Medical Association Available at: https://www.ama-assn.org/rbrvs-overview . Accessed October 25, 2016

• Further Reading

• Chapter MBPM 15 Section 80.3: https://www.cms.gov/manuals/Downloads/bp102c15.pdf
• CMS Audiology Services. https://www.cms.gov/Medicare/Medicare-Fee-For-Service-Payment/PhysicianFeeSched/audiology.html
• American Academy of Audiology Resources.
• PQRS. http://www.audiology.org/practice_management/pqrs/physician-quality-reporting-system-pqrs
• Reform MP. MIPS and APMS. http://www.audiology.org/practice_management/reimbursement/medicare/medicare-payment-reform-merit-based-incentive-payment
• ABN. http://www.audiology.org/practice_management/reimbursement/medicare/helpful-references-and-resources-related-abn
• http://www.audiology.org/practice_management/reimbursement/medicare/abn-quick-reference-guide
• Medicare FAQs. http://www.audiology.org/practice_management/reimbursement/medicare/medicare-frequently-asked-questions