June 27, 2013
Internal medicine practitioners offer a wide range of care services and are more often than not, the first physicians that a patient consults in case of an unknown illness. They are not limited to certain body systems, distinct diseases of specific treatments or procedures. Internists have to provide medical attention to a wide range of medical issues, at times even to those patients who don’t even have a particular complaint.
With a range of tests and procedures to make initial diagnosis and providing routine preventive and periodic assessment services, internists face billing challenges very distinct from the once faced by other specialists. Internal medicine practitioners refer their patients to other specialists for focused medical care post initial diagnosis. Such constant collaboration between multiple medical practitioners gives rise to a lot of complexities in internal medical billing. In addition, the interrelated and complicated coding pertaining to varied complex conditions of patients further necessitates meticulous billing practices.
Some of the most recurrent billing challenges faced by internal medicine practitioners are –
Regular changes in ICD-9-CM, CPT, HCPCS Level II and modifier codes further complicate the billing process for internal medicine billers as the knowledge of coding required is not limited to a single specialty but prevails over a large host of medical conditions and treatments
Changes in coding of ancillary procedures like venipuncture, injections and vaccinations as well as minor surgical procedures such as joint injections, skin tag removals, trigger point injections, etc.
Evaluation and management regulations pertaining to documentation guidelines as well as Medicare billing rules
Automation of processes and digitization of patient data can simplify the billing process to a great extent. However, to really improve profitability and reduce administrative burden of the internal medicine practice it is important to install billing practices that are efficient and productive in the long term. Adopting and implementing best billing practices prevalent in the healthcare industry can resolve a number of billing challenges faced by internists.
An efficient RCM can boost the revenue of the internal medicine practice by –
Improving first pass claim resolution rate - Regular reviewing of documents filed with bill statements ensure minimal data entry errors and reduce chances of clearinghouse rejections. This in turn leads to faster payments and improved account settlement ratio
Increasing net collection rate - With a wider demography of patients being covered under Medicare and Medicaid in the months to come, internists will be facing a difficult time ensuring collections. Maintaining an efficient submission process and following up on outstanding amounts from both insurers and patients will result in increased net collection rate
Appealing denied claims - Adapting your billing process to respond to insurer’s queries regarding claim documents and filing appeals with corrected information and before the deadline can also help boost your bottom line
Ultimately, implementing best billing practices require consistency, accuracy and timely execution of billing processes. Medicalbillersandcoders.com is the expert billing service provider experienced in third party billing for various medical specialists. With a team of medical experts handling diverse specialty areas of medicine, medicalbillersandcoders.com can be your internal medicine billing partner and help you face diverse billing challenges effectively.
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