Call Now 703-327-1800

Contact    Blog       About     Resources      Medical Billing Services


5 Ways Physician Practices Can Prepare for the Affordable Care Act (ACA)

Health Insurance Companies Process 1 in 5 Claims Wrong

Is Your Medical Practice Ready for the Affordable Care Act?

With election season in full swing, there’s been a lot of speculation about what will happen to the Affordable Care Act (ACA)–commonly referred to as Obamacare–if Mitt Romney is elected President. In truth, because the ACA is an Act of Congress, there islittle that any President can do to overturn the law. Since it’s likely here to stay, physicians should plan ahead to adapt their practices. Here are five things to do.


1. Prepare for More Patients. The extension of coverage under the ACA and the new requirement for insurance companies to cover individuals with pre-existing conditions will likely lead to an increase in the number of patients that practices have to see. To prepare for this influx, it might be a good idea to expand your staff or extend office hours.

2. Decide if You’ll Support Medicare and Medicaid. These days, Medicare and Medicaid only cover about 81 percent of private insurance reimbursements. Doctors will have to decide whether they will accept Medicare or Medicaid payments–or come up with creative ways to make up the cost difference.

3. Decide Whether You Want Electronic Health Records (EHRs). The ACA expands reporting requirements for the Physician Quality Reporting System (PQRS) for Medicare reimbursements. Starting in 2015, there will be penalties on Medicare reimbursements for practices that have failed to adopt an EHR (click here for more EHR information). This means that if practices decide to serve Medicare customers, they’ll need to adopt an EHR.

4. Consider Moving to Underserved Areas. The ACA offers some incentives for practices that locate in underserved (primarily rural) parts of the country. While established doctors most likely won’t want to move, this can be an attractive option for young doctors just getting their start.

5. Evaluate Bundled Payments. There is going to be a shift from government payers separately reimbursing physicians, labs and hospitals to “bundling payments.” This means that you’ll have to collect payments directly from a mutual association rather than from Medicare directly. This may require you to change the way your bill for care.

These are five areas that Software Advice thinks you should focus on. However, this is not an exhaustive list. What advice can you offer to others? Please leave your thoughts in the comments section below.


This is a Guest Post by Derek Singleton.
Derek blogs at Software Advice. For more information about Derek and Software Advice visit him at http://blog.softwareadvice.com/derek-singleton/

is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

If You Liked This Post You Will Love These

One Response to 5 Ways Physician Practices Can Prepare for the Affordable Care Act (ACA)

  1. […] In the past, patient outcome information was tightly guarded by hospitals, especially if it wasn’t good news. A few consumer groups gathered together what data they could, and put out annual hospital rankings. However, under the ACA, all participating medical facilities have to submit their yearly reports to … […]

Leave a reply

Who Are We?

Capture Billing helps medical practices by reducing their insurance accounts receivable and getting claims paid faster, allowing doctors to focus on providing quality healthcare to their patients without the stress of doing their own medical billing.

That’s why we developed Capture Billing’s Rapid Revenue Recovery System to keep our clients’ Accounts Receivables down and their revenue flowing.

Learn More


The analysis of any medical billing or coding question is dependent on numerous specific facts -- including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies (as well as coding itself) are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Learn how to outsource your Medical Billing today

CALL NOW  703-327-1800

Client Testimonials

Bob Laird


I would recommend Capture Billing to anyone who needs a billing company they can trust.

Bob Laird

Steve Rex

Family Practice

In a six month period Capture Billing increased our Practice’s income by over $100,000.

Steve Rex

Julie Reed-Humeniuk

Family Practice

Capture Billing goes over and beyond the call of duty for their clients to maximizing reimbursement.

Julie Reed-Humeniuk

CaptureBilling.com - Medical Billing Services

Capture Billing is a Medical Billing Company based in South Riding Virginia.

Join the other Doctors and Practice Managers that have benefited from our expert medical billing services.

Capture Billing & Consulting Inc.
25055 Riding Plaza #160
South Riding, VA 20152
Phone: (703) 327-1800