Medical Practices & Billers Must Stay Vigilant in State Budget Crisis

November 2, 2015

  • Illinois out of money as their budget is stalled. How does this affect providers?
  • How would you track this missing money?
  • What would you do with a 16.5% cut in Medicaid?

Illinois still does not have a budget for the fiscal year that stared July 1, 2015. And apparently, there isn’t an end in sight.  The Republican governor and the Democratic Legislature in Illinois cannot agree – thus a stalemate (the longest in state history) that has stretched on for almost 5 months.

At this point, the majority of state programs continue to be funded (putting the state further into debt), and there’s been no government shut down — yet.  But, without a budget deal and with a growing list of unpaid bills, many worry the state will not be able to pay its employees, schools or bondholders.

What about Medicaid?  What about state-funded insurance plans such as Cigna and Health Alliance?  We already see a large delay in payment for these plans – will payment stop altogether?

Illinois also, as of May 1 of 2015, initiated a 16.75% reduction in reimbursement for Medicaid payments due to budget woes for the 2014/2015 fiscal year.  This cut was for services May 1-June 30, 2015. However, there’s been no communication thus far on whether the previous reimbursement rates will be reinstated once the budget has been passed.

Due to this budget crisis, and the current and future financial uncertainty with state-funded insurance plans, it is imperative that billing agencies remain diligent on capturing charges. They must also maximize collection efforts with all other insurance plans.

Billers should use reimbursement tracking, denial reporting, and revenue variance reports to identify payment issues, so their team can quickly assess issues and positively respond to negative trends.

Vachette and Stark Medical Auditing work with medical groups and their billing agencies to maximize revenue, even in times like these. With clients throughout the United States, we are in tune with multiple state issues and how they impact your bottom line.

The question to Illinois providers is, “Who’s watching your wallet?”


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