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

July 23, 2013

Many Internal medicine practices in the US face the challenge of a shrinking bottom-line; mainly due to the diverse aspects of the specialty – diagnostic, preventive and curative. Internal medicine treatment has a collaborative nature where the treatment episode depends on or collaborates with different diagnostic laboratories and focused care centers owing to the various aspects involved in the treatment episode.

This provides financial challenges to internists as it leads to complications in billing and coding; especially as claims require joint coding of services and also the knowledge of the lab tests that are covered and ones that are not covered. Another source of financial challenge that internists face are that the various health disorders internal medicine deals with; involve a variety of separate codes.

Most commonly-faced challenges include

  • Accurately coding 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

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Frequent errors faced in claim preparation-

  • Selection of wrong codes
  • Use of generic protocol instead of patient-specific physician orders

The issues above also leave internal medicine physicians in a poor position to transition to ICD 10 by Oct. 2014. And experts say that an unsuccessful transition to ICD 10 will cause a negative impact especially due to the regulatory changes brought on by the Affordable Care Act on reimbursement.

Hence, a successful transition is mandatory and will require analysis of the current and past claims to identify billing and coding, and reimbursement risks related to ICD 10 transition. Practices will also need to check their ICD 9 documentation for gaps because if there are coding errors in ICD 9, then the prospect for a successful transition to ICD 10 is bleak. This document audit will help physicians spot what’s working and what needs fixing.

MBC’s Revenue Management Consulting services can help you with this by assessing your in-house revenue management cycle and ensuring that there is sound coordination between various components of healthcare facilitating smooth flow of medical data. MBC also provides RCM services which have enabled physicians to accurately document their medical services and related activities, by usage of CPT and diagnostic codes correctly, investigating rejected claims, gleaning insights from them and performing self audits.

Medicalbillerandcoders.com, the largest consortium of billers and coders in the US, has been helping several small to medium size 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 don’t need the entire suite of services, you can choose such parts of MBC’s services as will exactly fit your billing and coding requirements, such as post-submission follow-up or only claim submission.

Category : Revenue Cycle Management