The Patient Protection and Affordable Care Act (ACA), or as some may refer to it, “Obama Care” could easily be considered one of the most hotly debated medical reforms the United States has ever embarked on. Love it, or hate it; one thing seems to be increasingly clear, it isn’t going to go away any time soon.
ACA is here to stay
Medical practitioners from every sector of the health industry, especially Mental Health Care, are currently being expected to come into full compliance with a myriad of new rules, and regulations created with the intent to bring universal health coverage to millions of uninsured Americans. But, what exactly does that mean for the Mental Health Care professional?
Well, for one thing, patients suffering from pre-existing mental conditions such as schizophrenia, and chronic depression can no longer be denied coverage. With one in four Americans suffering from some form of mental illness, this means that a wider population will now be able to get the mental health attention they so desperately need. These changes will surely places higher demands on psychological services.
Another added benefit for mental health patients, are the limits set forth by the ACA on out-of-pocket spending. Typical in-house treatment for the mentally ill can quickly overwhelm even the best insurance coverage. Under the new stipulations individual spending cannot exceed $6,350, where as the cap for out of pocket spending for entire families is set at $12,700. Of course these caps only pertain to medical treatments deemed “necessary”. With Obama Care now covering the rest of the expenses, again, a much wider audience will be able to access affordable mental health care services.
In addition to co-pay caps, insurers are also required to cover medications. It is up to the practitioner to verify what types of medications are covered under each patient policy in order to file the proper claims with the accurate codes for each. Inaccurate claim information, or mislabeled codes will create a backlog of denied claims that will hurt mental health practices. The inclusion of this law also boosts the number of people who will now be able to access medicine
Noticing a trend, yet? With a rapid influx of new patients seeking mental health care, and the entire work force of psychiatrists and psychologists desperately trying to learn and implement the new regulations into their practices, many analysts are concerned that the system will not be able to keep up with the demand …and so far, it isn’t.
Any practicing medical professional wanting to avoid claim denials, and delays in payment should consider this rapid expansion seriously, and not only learn and understand how the current regulations affect them, but also install the necessary claims approval processes that will allow them to handle the increased demand while still remaining profitable.