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presentation

Addressing Challenges in Medical Billing for Chronic Patients

February 29, 2012



“As physicians deliberate on the efficacy of outsourcing medical billing companies services for chronic disease management services, they also need to be mindful of the credibility of their prospective service providers. In a medical billing environment, characterized by heterogeneous players, choice of a service provider can get as significant as the decision to go for outsourced medical billing revenue cycle management – the service providers competencies in terms of requisite knowledge on ICD and procedural codes, automated billing and coding, denial and delay management, and AR Management should be qualities to be judged.”

Although ICD and procedural codes have grown to be so substantial that physicians can accurately code any clinical procedure that they undertake vis-à-vis patients’ medical conditions, the coding procedure for chronic disease management is altogether a different proposition. Notwithstanding the possible help from the ensuing ICD-10, physicians would still continue to face challenges when it comes to coding medical services rendered to chronic patients. One possible reason for the perennial complexity could be the inclusive nature of the treatment regimen that overlap to diverse medical disciplines – chronic disease is often defined as a medical condition involving acute malfunctioning of the vital body systems. The other reason could also be the intensity of the medical care that rarely allows physicians time to concentrate on equally intense medical billing and coding. Consequently, as a result of the combined contribution of both the possible reasons, physicians may either end up over-coding, in which case they would have to contend with delay or denial of medical claims, or under-coding, which would adversely impact practice revenues.

Therefore, it becomes imperative that physicians attending to chronic patients be well-versed with interdisciplinary medical coding. But, asking them to complement interdisciplinary medical care with interdisciplinary coding may well prove to be doubling up the already unbearable workload. With the idea of managing coding with internal staff has long been proved inadequate, physicians will need to look elsewhere for an adequate and efficient medical billing revenue cycle management – outsourcing from medical billing companies seems to be an ideal option.

As physicians deliberate on the efficacy of outsourcing medical billing companies services for chronic disease management services, they also need to be mindful of the credibility of their prospective service providers. In a medical billing environment, characterized by heterogeneous players, choice of a service provider can get as significant as the decision to go for outsourced medical billing revenue cycle management – the service providers competencies in terms of requisite knowledge on ICD and procedural codes, automated billing and coding, denial and delay management, and AR Management should be qualities to be judged.

While physician practices seek to realign their medical billing practices to a perpetually raising incidence of chronic diseases prompted by socio-biological factors – the recent health statistics put the percentage of chronic patients more than the combined figure for major ailments – Medicalbillersandcoders.com’s (www.medicalbillersandcoders.com) proven credentials may well be the value-differentiator. Its diverse competencies – compliant coding, technology interface and talent-pool of medical billing professionals – can effectively and efficiently address coding and billing issues related with chronic disease management.

 

Category : Best Billing and Coding Practices