Monday, March 13, 2017

Five Month Waiting Period for Disability Social Security May Soon Be Scrapped for ALS Patients

Currently, disability social security policies require a five month waiting period for the approval and release of disability benefits to victims of ALS (Amyotrophic Lateral Sclerosis or Lou Gehrig’s Disease). The length of the waiting period can be attributed to the sheer volume of applicants and the actual process required by the application.

Depending on where you sit in the queue, you sometimes can’t even be guaranteed that you will be approved within this waiting period. Any back payments can therefore be made past five months.

Immediacy of Need

For many citizens suffering such a disability, this amount of time may prove to be too long and perhaps, too late, especially when they are seeking treatment. For example, patients of ALS suffer from progressive symptoms, such as difficulty in walking, constantly tripping or falling and general weakening of the muscles. Eventually, they may even lose the capability of holding their head up, which affects breathing, speaking, swallowing and chewing. Read more from this blog.

Friday, March 10, 2017

Challenges to Gaining Eligibility for Social Security Disability for Rare Diseases May Intensify

With the impending repeal of the ACA (aka Obamacare), everyone is on guard and trying to figure out what’s going to happen next with their insurance coverage. If reports on supposed amendments are true, then a substantial number of covered individuals under the ACA will lose their coverage.

Among the sectors concerned about these changes are those suffering from rare diseases. As it stands, it can already be challenging to gain eligibility for social security disability on account of a rare disease. How much more difficult it will be under the new system is a major concern for those afflicted by a rare disease.

Status Quo

Under the current system, being granted benefits for disability under the social security system requires proof that the individual is suffering from total and permanent disability. Typically, it can be a severe physical or mental disorder lasting anywhere from a full 12 months. In determining the level of disability, the SSA refers to the “Blue Book,” a compendium of all SSA-approved disorders and their corresponding requirements for qualification. Read more on this article.

Thursday, March 9, 2017

Gaining a Deep Understanding of Your Patient’s Eligibility for Social Security Disability

In 2015, the Social Security Administration reported that the agency has paid disability benefits to more than 10.2 million Americans. In total, disabled members and their beneficiaries received approximately $11.4 billion in that year alone. In terms of the type of disabilities, nearly 31.7 percent have been diagnosed with musculoskeletal disorders.

Every month, these disabled individuals and their families are receiving supplementary pay of about $1,165 on average. At present, the SSA continues to cater to the concerns of its members as the agency strives to upgrade to a better system.

Overview of the Application Process

When a patient files for Social Security disability insurance, the medical provider’s task is to verify the extent of his disability. This may be supported through medical diagnoses, laboratory results, psychometric tests and other documents. Such evidence must be able to prove his physical and/or mental capacity to do work or resume work. Read more from this blog:

Eligibility for Medicaid and Health Coverage Itself Up in the Air as ACA Repeal Looms

It’s been a tense past couple of months as efforts to repeal the ACA, dubbed Obamacare, appears to be more imminent than ever. At this point, people are now simply wondering when it will happen as opposed to whether it will happen. With the resounding support of the Republican majority in Congress, its repeal is most certainly guaranteed already.

Beyond the abolishment of the ACA, however, the more pressing question for all those affected centers on its replacement. Without the ACA in place, what kind of system will be introduced to fill its void?

Filling the Gap

There are no concrete plans announced as of yet, although there have been plenty of talks pointing to what the changes could be. Included in the possible revisions is the removal of the highly contested income-based tax credit of the ACA. In its stead, an age-based tax credit system might be invoked. In this new system, it wouldn’t matter if you are a high or low wage earner. You’ll be getting coverage and benefits equally, as long as you meet the age bracket requirement.

Another looming issue drawing much concern from those currently insured under the ACA is the report of anticipated revisions to Medicaid. A couple of days before February ended, a “discussion draft” was leaked to the public. The draft was supposedly a work in progress by the GOP. However, it conveyed a very telling picture of what will most likely transpire once the ACA is repealed. Read more from this blog.

Wednesday, March 8, 2017

Current Status and Possible Changes: Important Notes on Social Security Disability Eligibility

Hospitals should assist individuals who work hard to earn a living but get disabled to process their claims for Social Security Disability benefits. As part of the mission of the Social Security Administration (SSA), disabled members, despite their current health condition, still have the chance to receive benefits so they can provide for their family’s needs.

For more than 60 years, the SSA has implemented the Disability Insurance Program to dole out cash benefits for members in need of assistance. Hospitals and healthcare facilities also play a crucial role in this process. By providing accurate medical data on each patient, they bridge the gap between the SSA and members who seek benefits.

How Helpful Has the Program Been?

Of the more than 65 million members that are under Social Security in 2015, more than 10.2 million people have reaped disability benefits. By the end of the year, the total amount that was paid out to disabled workers and their beneficiaries have reached more than $11.4 billion. Read more from this blog:

Folks Keep a Keen Eye Out for New Health Insurance Marketplace Coverage Options

In 2013, the Department of Labor rolled out a memorandum explaining to its staff the new health insurance marketplace coverage options for the yet-to-be-enacted Affordable Care Act. The memo reassured everyone that the marketplace would be a “one-stop-shop” experience so that customers may find the health insurance option best suited for them.

Apart from that, a communication was issued specifically to employers offering health coverage to their employees and another to companies unable to fast-forward in response to ACA. The same department will now see the forms and guidelines related to these communications expired.

Originally, the purpose for the guidelines and forms was to compel all employers to coordinate with the proper authorities so that their employees could select their own health coverage. Now that the ACA is at risk of being repealed, guidelines such as those from DOL are being rendered moot.

The Waiting Game Begins

It’s not just employers under the governance of the Department of Labor that are awaiting for new word on new marketplace options. States and local communities are also becoming anxious, if not nervous, as the ACA repeal becomes more likely day-by-day and without a replacement in sight.

When the repeal is enacted, among the features possibly affected is the inhibition of coverage denial in the marketplace for health related reasons. The basis used for premium costs may also be soon revised. Under the ACA, factors such as gender, age, pre-existing conditions, health status, coverage duration, small employer specifics and industry, as well as, claims history, cannot be used in the basis of cost computation. Read more on this article.

Tuesday, March 7, 2017

Moving Forward: Possible Effects of New Health Insurance Marketplace Coverage Options

At the end of January 2017, the open enrollment for health insurance enrollment through Obamacare has closed. To date, while many recognize the need for medical insurance, there are still a number of people who are hesitant to sign up for it. Not only that, but with President Trump’s victory comes rumors of drastic changes to or possible total repeal of the Affordable Care Act (ACA).

The Promise of Obamacare

Since 2010, the Affordable Care Act (ACA), fondly called Obamacare, has aimed to make health insurance simple to manage and easy to obtain for every individual. As of 2016, there are more than 11.7 million people who have found better and more affordable health insurance plans through the marketplace. This was an impressive improvement over the 47 million uninsured people prior to the implementation of the new health insurance marketplace.

Possible Futures for the ACA Marketplace

A few weeks after the national elections, there was a buzz about the possible repeal of the ACA. Now that President Trump has taken office, lawmakers under his administration have already been pushing for their own versions or revamps of the Obamacare program. For instance, Rep. Tom Price proposed increasing the premiums or contributions of each individual for their insurance accounts. He would like these paying individuals to receive tax credits so they can have enough funds set aside for their medical expenses. Read more from this blog:

Monitoring the Metrics of Healthcare Revenue Cycle Management Poses Benefits to Revenue Stream

Amid high-deductible health plans and healthcare consumerism, providers are experiencing changes in revenue sources. However, many of them still face challenges in cash flow and payment collection. According to one study, although hospital receiving offices collect from 35% of their patients, the total amount accounts for only 19% of patient financial responsibility.

One way to keep the cash flowing is to monitor revenue cycle management metrics. With regular monitoring, healthcare organizations and systems create the ability to gain maximum reimbursement and improve the assessment of their billing departments. These metrics should be carefully selected and tracked to inform providers of where their flows currently stand and whether they are heading in the right direction, based on their goals and objectives.

Rate of First Pass Payment Recovery

Experts say that organizations should be receiving a first pass recovery rate of at least 80% to ensure that they are able to close out receivables accurately and on time. Monitoring this metric allows providers to determine efficiency in terms of getting full payment for insurance claims at first pass. Due to submitting claims a second time around wastes time and money, hospitals must strive to collect on the initial submission. They should focus on checking whether claims are processed instantly and closed on time. Read more on this article.

How Social Security Disability Eligibility May be Affected by Changes to Medicare

One of the benefits of Medicare comes from part D, which provides drug prescription coverage to those enrolled. However, in 2017 the number of different plans available is likely to drop to its lowest level since 2006. Those enrolled in Medicare will have around 22 prescription drug plans to choose from, the problem being that these plans vary widely in terms of specific drugs they cover. This means that those who need specific medication may find it difficult to tailor their Medicare package to suit their needs.

Because it has larger budgetary impact at a federal level, the government is looking to revise Medicare too. These potential revisions include trying to move patients toward insurer provided Medicare Advantage plans rather than the traditional Medicare program, as well as introducing a voucher system cap, which would shift the financial burden of rising healthcare costs onto participants.

How it will Affect Social Security Disability

Since many people who are eligible for Social Security Disability benefits are also enrolled with Medicare, they could find themselves unable to get the prescription drugs they need. While the benefits from Medicare don’t kick in until 24 months after you have met the Social Security Disability eligibility criteria, it’s still something that could have a large impact on the number of non-payment patients in your hospital. Read more from this blog.

Monday, March 6, 2017

Sign-Ups for 2017 Now Closed: What to Expect from the Affordable Care Act Marketplace

The open enrollment period of the Affordable Care Act, otherwise known as Obamacare, has come to a close, recording a noticeable dip in the numbers compared to what was initially expected. According to the previous administration, they were set to sign up at least a million people during the final week of the open enrollment period. It missed that mark, however, and the total number of sign-ups was pegged at 9.2 million. This reflects a 4% decline from the 9.63 million recorded people at around the same time last year.

Despite this minor setback in sign-up numbers, and despite the worries about the future of Obamacare, those who did enroll with the program can still expect to be offered the full service guaranteed by it. Experts note that, confusion in policies aside, people should still go for the opportunity to be covered, especially since the Affordable Care Act marketplace this year has various health plans and subsidies in place.

Hospitals and other institutions that will inevitably be affected by the shifts and movements in the implementation of Obamacare should be equally alert so as to ensure a smooth continuity of service delivery to their patients. Read more from this blog:

A Host of Reforms to Social Security Disability for Children Can Improve the Lives of All Involved

Despite the number of children in need of healthcare assistance, social security disability and other public programs remain a minor topic. According to statistics, around 11.2 million children have special healthcare needs. That’s 15% of the child population in the country, with 73% of that percentile coming from either low or middle income families.

These children, especially those suffering from Down Syndrome, Autism and Cerebral Palsy, require nursing care at home, counseling and therapies to improve their living condition. Without stable finances, they just could not afford proper medical care.

With social security disability for children (SSDI), handicapped children in low income households are granted financial assistance for their medical needs. In fact, the number of people receiving SSDI benefits has increased over the years. Read more on this article.

Revenue Cycle Management Companies Discuss the Likely Impact of the Proposed ACA Repeal

Many Americans, healthcare facilities and revenue cycle management experts are preparing for the possible effects of the proposed changes in the country’s healthcare policy. In recent years, the Affordable Care Act (ACA) have expanded its health coverage to at least 20 million people. It also offers insurance subsidies and other provisions, as well as, takes out insurance lifetime caps and includes pre-existing conditions. By making it easier for Americans to get insured, the ACA provides easier access to medical care, regardless of their status.

Under the new administration, however, there’s a possibility that the ACA could be repealed and replaced by new policies. These plans are keeping healthcare facilities on their toes. With the impending repeal expected to affect millions of Americans relying on healthcare insurance, these changes will have a direct effect on healthcare revenues as well. Read more from this blog.

How The Affordable Care Act Marketplace Would Be Affected by a Shift in Health Insurance Tax Credits

As a result of the many reforms that are taking place within the healthcare marketplace and with health insurance tax credits, it’s unsurprising that many patients are left confused; some may even find themselves without medical insurance.

What if Tax Credits are Removed or Lowered?

Currently, an important part of discussions surrounding the repeal and replacement of the Affordable Care Act is focused on the type and amount of subsidies that help people afford health insurance. Through the Affordable Care Act, households are rewarded tax credits based on various criteria, including family income, the cost of insurance locally, age and whether or not premiums have increased annually. Under the current Affordable Care Act, households with lower incomes receive higher tax credits.

Under new plans, however, the tax credit offers will not vary with income. In effect, this gives those with higher income levels higher tax credits. Additionally, new plans will not vary tax credits by location. In areas where premiums are higher, no higher tax credits will be given. Read more from this blog.

Sunday, March 5, 2017

Crucial Reforms Suggested for Social Security Disability for Children and Others

Social Security Disability Insurance (SSDI) maintains the goal of helping individuals with disabilities and impairments. Giving financial support so they can have medical attention and other special needs eases a lot of burden not only on individuals but their families as well.

In the past decade or so, however, calls for reforms have been on the upswing, especially in light of what appears to be the system’s shortfall. As reports would have it, Social Security could possibly be at a loss by as much as $11.4 trillion. This means that Social Security’s lifespan could be put to a grinding halt by 2023, by which time the resources for the Disability Insurance Trust Fund would have been already depleted.

With this scenario, it’s easy to see why the alarm has been raised. A shutdown in the SSDI system would mean that only 89% of the benefits will be paid out by the year 2035, which is also roughly around the same time that the Old-Age and Survivors Insurance Trust Fund would have been exhausted. Beyond this time, only 77% of the benefits would be paid out. Read more from this blog:

Saturday, March 4, 2017

Potential Changes to Disability Social Security Under the Trump Administration

The recent executive order from President Donald Trump freezing federal hiring and the proposed Republican reforms to the Affordable Care Act (ACA) would change eligibility for and utilization of disability social security. The changes are expected to be drastic.

Status of Disability Claims

Claims for Social Security disability insurance are rising. Applications jumped from 1.9 million a decade ago to 2.7 million. The rate of approval of the Social Security Administration, however, is low, at only 36% of all claims filed from 2004 to 2013. Around 25% received benefits for initial claim, 2% were approved through appeals, while 11% are still being considered at hearings. Social Security benefits give income support to people who paid contributions, but, because of disability, could no longer work for a year or more.

Approval for disability Social security is low, while processing takes a long time. At of the end of 2016, 1,650 judges studied and decided on disability claims. Around 1.1 million applicants with disability await their decision for eligibility. Furthermore, waiting for a hearing can extend the application process for a year or more. The entire processing puts the bulk of responsibility on the applicant who is expected to ensure that the right materials go to the right people at particular schedules. Read more from this blog:

Friday, March 3, 2017

Analysts Project Bright Future for Hospital Revenue Cycle Management in the Next Decade

If there’s one thing that hospitals can look forward to in terms of the revenue cycle management, it’s that more good things are expected to come out of it this year. A recent study conducted on the matter showed that RCM practices are expected to increase due to a rise in the rate of claim denials as well as the reduction in healthcare reimbursements from both private providers and government.

Other factors that will further highlight the importance of adopting RCM measures include the ever-evolving and complex medical coding for bill reimbursements. It is crucial for healthcare institutions to ensure the validity of their billing, especially with the expected changes to the coverage of the Affordable Care Act. Reducing billing errors can be achieved with an efficient hospital revenue cycle management program.

Technology Forecasts

Helping along the improvement of RCM systems in healthcare institutions are new developments in technology. Artificial Intelligence (AI), for example, is expected to play an even bigger role in the healthcare industry, not only with the medical procedures, but even for the administrative tasks in the hospital. Read more from this blog:

18 Months On: Learning the Real Impact of ICD-10 on Hospital Revenue Cycle Management

The introduction of ICD-10 as a new classification system sparked controversy in the healthcare community. ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems issued by the World Health Organization.

There were many predictions that the hospital revenue cycle management process would be severely affected, as the coding system increased diagnostic codes to over 68,000- up from just 14,000. Procedure codes had a similar story, rising from 4,000 to 87,000.

It’s now been 18 months since the ICD-10 system was implemented in America. What has the real impact of this change been and was it as bleak as was expected?

Falling Productivity Levels?

It was expected that productivity levels would drop by around 50%, causing far more hold ups and errors than ICD-9 had done. This was based on Canada’s results back in 2001, which found the amount of work required to input each code had been underestimated. Read more from this blog.