NEW YORK, Oct. 30 -- With most Article 28 clinics failing to keep the pace with the cost of care and medical advances, the current ambulatory care rates do not appropriately pay providers delivering high-quality service. Ambulatory Patient Groups (APGs) is a visit classification system designed to explain the amount and type of resources used in an ambulatory visit and that is used to determine payment for ambulatory services.
With the advent of APGs, providers will be able to predict the average pattern of resource for patients by procedure, visits, test, and similar characteristics. The APGS will provide greater reimbursement for services of high intensity and less reimbursement for services of low intensity. The visits are classified into three types: significant, medical, and ancillary tests/procedures -- the payment is then based on the rate code and CPT codes grouped together. The payments are grouped together based on this information and are categorized into ancillary packaging, bundling, packaging, and discounting.
Many clinics are feeling overwhelmed with the new rules and procedures that come along with the APGs. Information varying from modifiers, non payable services, to ensuring the capturing of all necessary information on a claim can perplex even the most highly qualified staff members and the software being utilized.
Millin Associates ( www.millinmedical.com ), a medical billing and consulting firm based on Long Island and a leader in the industry for over 27 years, is facing this change head on with HIPAA compliant software and the addition of the 3M Grouper.
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With the advent of APGs, providers will be able to predict the average pattern of resource for patients by procedure, visits, test, and similar characteristics. The APGS will provide greater reimbursement for services of high intensity and less reimbursement for services of low intensity. The visits are classified into three types: significant, medical, and ancillary tests/procedures -- the payment is then based on the rate code and CPT codes grouped together. The payments are grouped together based on this information and are categorized into ancillary packaging, bundling, packaging, and discounting.
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Many clinics are feeling overwhelmed with the new rules and procedures that come along with the APGs. Information varying from modifiers, non payable services, to ensuring the capturing of all necessary information on a claim can perplex even the most highly qualified staff members and the software being utilized.
Millin Associates ( www.millinmedical.com ), a medical billing and consulting firm based on Long Island and a leader in the industry for over 27 years, is facing this change head on with HIPAA compliant software and the addition of the 3M Grouper.
Many Article 28 CFOs are now considering outsourcing their billing functions because they are losing revenue due to inefficiencies within their billing departments. Millin comes completely staffed with certified coders, compliance officers, highly-trained IT department, which can come into any work environment, work from any existing database, and relieve overburdened Article 28 clinics' billing and IT departments. Millin offers a free cost benefit analysis to potential clients; they will come in to your facility, assess your procedures and determine the best course of action.
CEO of Millin, Sol Weiss, says, "If you are an Article 28 facility and in New York, why not call us and see what we can do for you? "
SOURCE Millin Associates
