How to Prevent Shrinking Bottom-Line With A Streamlined Internal Medicine Billing Process

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How to Prevent Shrinking Bottom-Line With A
Streamlined Internal Medicine Billing Process
Streamlined Internal Medicine Billing
Process Many internal medicine practices in the
US face the challenge of a shrinking bottom line,
mainly due to the diverse aspects of the
specialtydiagnostic, preventive, and curative.
Due to this collaborative nature, the internal
medicine billing process is particularly complex,
where treatment episodes often involve
coordination with various diagnostic laboratories
and specialized care centers. This complexity
underscores the importance of a streamlined
approach to billing and revenue management,
ensuring that all aspects of the treatment
episode are accurately documented and billed for,
thus minimizing the impact of shrinking
revenues. This provides financial challenges to
internists as it leads to complications in
billing and coding, especially as claims require
joint coding of services and knowledge of the lab
tests that are covered and ones that are not
covered. Another source of the financial
challenge that internists face is that the
various health disorders internal medicine deals
with involve multiple codes. CPT Code for
Internal Medicine Here are some of the most
commonly used Current Procedural Terminology
(CPT) codes in internal medicine,

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How to Prevent Shrinking Bottom-Line With A
Streamlined Internal Medicine Billing Process

• based on their frequency and importance in
  clinical practice
• 99214 Office or other outpatient visit for the
  evaluation and management of an established
  patient, typically 25 minutes spent face-to-face
  with the patient and family.
• 99213 Office or other outpatient visit for
  evaluating and managing an established patient,
  typically 15 minutes spent face-to-face with the
  patient and family.
• 99215 Office or other outpatient visit for the
  evaluation and management of an established
  patient, typically 40 minutes spent face-to-face
  with the patient and family.
• 99204 This is an office or other outpatient
  visit for the evaluation and management of a new
  patient. It typically involves 45 minutes of
  face-to-face with the patient and family.
• 99203 This is an office or other outpatient
  visit for the evaluation and management of a new
  patient. It typically involves 30 minutes of
  face-to-face with the patient and family.
• 99212 Office or another outpatient visit for the
  evaluation and management of an established
  patient, typically 10 minutes spent face-to-face
  with the patient and family.
• 99307 Subsequent nursing facility care per day
  for the evaluation and management of a patient,
  which requires at least 15 minutes of the
  physicians time.

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How to Prevent Shrinking Bottom-Line With A
Streamlined Internal Medicine Billing Process

• 99497 Advance care planning, including the
  explanation and discussion of advance directives,
  such as standard forms (with completion of such
  forms, when performed), by the physician or other
  qualified healthcare professional.
• These codes cover a range of evaluation and
  management services and other standard procedures
  in internal medicine practices. The frequency of
  use can vary based on the specific patient
  population and practice setting.
• The most commonly faced challenges include-
• I accurately code peripheral tests and processes
  like injections, removal of skin tags, etc.
• Keeping track of frequent changes to ICD-9-CM and
  CPT codes for numerous treatments included in
  internal medicine
•  Frequent errors faced in claim preparation-
• Selection of wrong codes
• Use of generic protocol instead of
  patient-specific physician orders

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How to Prevent Shrinking Bottom-Line With A
Streamlined Internal Medicine Billing Process
The issues above also leave internal medicine
physicians in a poor position to transition
to ICD 10 by Oct. 2014. Experts say that an
unsuccessful transition to ICD 10 will have a
negative impact, mainly due to the regulatory
changes brought on by the Affordable Care Act
regarding reimbursement. Hence, a successful
transition is mandatory and will require
analyzing current and past claims to identify
billing coding and reimbursement risks related to
the ICD 10 transition. Practices will also need
to check their ICD 9 documentation for gaps
because if there are coding errors in ICD 9, the
prospect for a successful transition to ICD 10 is
bleak. This document audit will help physicians
spot whats working and needs fixing. How to
Prevent Shrinking Bottom-Line With A
Streamlined Internal Medicine Billing Process emph
asizes the importance of efficient billing
practices in safeguarding financial health. By
implementing a streamlined approach, internal
medicine practices can effectively manage legacy
AR (Accounts Receivable), ensuring timely
reimbursement and reducing the risk of revenue
loss due to unpaid claims. This proactive
strategy optimizes cash flow and enhances overall
operational efficiency, allowing healthcare
providers to focus more on patient care and less
on administrative challenges. MBCs Revenue
Management Consulting services can help you with
this by assessing your in-house revenue

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How to Prevent Shrinking Bottom-Line With A
Streamlined Internal Medicine Billing Process

• management cycle and ensuring sound coordination
  between various components of healthcare,
  facilitating a smooth flow of medical data. MBC
  also provides RCM services, which have enabled
  physicians to accurately document their medical
  services and related activities by using CPT and
  diagnostic codes correctly, investigating
  rejected claims, gleaning insights from them, and
  performing self-audits.
• Medical Billers and Coders, the largest
  consortium of billers and coders in the US, has
  been helping several small to medium-sized
  internal medicine practitioners with its
  Outsourcing services, handling the entire range
  of activities involved in billing and coding so
  that they can solely concentrate on healthcare,
  even as they improve their finances. If you dont
  need the entire suite of services, you can choose
  parts of MBCs services that fit your billing and
  coding requirements, such as post-submission
  follow-up or only claim submission.
• FAQs
• What is legacy AR, and why is it a concern for
  internal medicine practices?
• Legacy AR refers to unpaid or outstanding claims
  that have accumulated over time. This can pose a
  significant financial challenge for internal
  medicine practices, leading to cash flow issues
  and reduced

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How to Prevent Shrinking Bottom-Line With A
Streamlined Internal Medicine Billing Process

• profitability. Managing legacy AR efficiently is
  crucial to prevent a shrinking bottom line.
• How does legacy AR affect the financial health of
  internal medicine practices?
• Legacy AR impacts financial health by tying up
  resources that could be used for operational
  improvements or patient care. If not managed
  promptly, it can result in delayed
  reimbursements, increased administrative costs,
  and potential write-offs. Streamlining the
  billing process helps mitigate these risks.
• What strategies can internal medicine practices
  use to reduce legacy AR?
• Effective strategies include implementing robust
  billing software to track and manage claims,
  conducting regular audits to identify unpaid
  accounts, optimizing coding and documentation
  practices to minimize denials, and establishing
  clear communication with patients about billing
  expectations. These efforts help improve cash
  flow and prevent revenue loss.
• Why is it essential for internal medicine
  practices to streamline their billing processes?
• Streamlining the billing process ensures that
  claims are processed accurately and efficiently,
  reducing

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How to Prevent Shrinking Bottom-Line With A
Streamlined Internal Medicine Billing Process

• the likelihood of errors and denials that
  contribute to legacy AR. By adopting automated
  systems, practices can streamline workflows,
  improve collections, and enhance overall
  financial performance.
• How can outsourcing billing services help
  internal medicine practices manage legacy AR?
• Outsourcing billing to specialized medical
  billing companies allows practices to leverage
  expertise and resources to manage AR effectively.
  These companies handle claims submissions,
  follow-ups, and patient billing inquiries,
  freeing internal staff to focus on patient care
  and practice growth initiatives. This approach
  often leads to faster reimbursement and reduced
  AR aging.