Title: How to Prevent Shrinking Bottom-Line With A Streamlined Internal Medicine Billing Process
1(No Transcript)
2How 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,
3How 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.
4How 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
5How 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
6How 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
7How 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
8How 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.