What tasks does an AMA in billing and reimbursement do?
The American Medical Association (AMA), through its department of Health Care Finance, focuses on the business and economic side of medical practice. As part of this, the department of Health Care Finance provides many resources and services to its physician members, including:
- Advocating for fair and equitable reimbursement for physicians: AMA works with commercial and government payers to ensure fair and adequate payment for physician services. The AMA’s lobbying efforts seek to ensure that AMA member physicians receive reimbursement rates at or above the industry standard.
- Providing education and training on billing and reimbursement: The AMA offers a variety of educational resources and programs to help physicians understand and comply with billing and reimbursement rules and regulations. These resources include workshops, webinars, online courses, and publications.
- Developing and maintaining coding and billing standards: The AMA is responsible for developing and maintaining the CPT® (Current Procedural Terminology) code set, which is used by physicians and other healthcare professionals to report medical services and procedures to payers.
- Providing tools and resources for physicians to manage their practices: The AMA offers a variety of tools and resources to help physicians manage their practices and improve their financial performance. These resources include practice management software, financial consulting, and patient-centered medical home (PCMH) consulting.
- Offering legal and regulatory guidance to physicians: The AMA provides legal and regulatory guidance to physicians to help them navigate billing and reimbursement-related issues. This guidance includes information on insurance, HIPAA, and other federal and state laws and regulations governing medical practice.
- Providing data and research: The AMA regularly publishes reports, studies, and surveys to provide physicians and other stakeholders with data on billing and reimbursement trends. This information helps physicians understand the current landscape and make informed decisions for their practices.