With the Affordable Care Act (ACA) health care exchange up and running, officials expect it to make a dent in the state’s high uninsured rate. Roughly 6 million Texans — a quarter of the population — are uninsured. The Texas Health and Human Services Commission estimates 40 percent of those people are eligible for exchange subsidies.
For physicians, that could mean more patients walk in the door with health coverage. But the exchange still holds a lot of questions for doctors, especially exactly how the new marketplace health plans will play out in your practice. You need to figure out if you are participating in the plan(s) offered in your area and if they will affect your current payer contracts. You’ll need to learn how to identify patients on the exchange plans and what happens if these patients fail to keep current on their premium payments.
Released: Dec. 5, 2013
Expires: Dec. 5, 2014
Physicians in all specialties and practice managers
Upon completion of this program participants should be able to:
Identify the challenges of determining if you are participating in qualified health plan networks;
Recognize the potential impact to existing health plan contracts; and
Discuss and develop processes for verifying coverage and collections policies for patients participating in the exchange.
Questions and answers
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