Family Physicians: Medical Billing Challenges in Family Practice

Medical Billing Challenges in Family Practice

Family Medicine forms a crucial point of entry in the health care system, and the need as well as the shortage of family physicians in the United States is becoming a growing concern. Other specialties such as radiology, neurosurgery, and dermatology are more attractive due to the higher amount of compensation provided to physicians in these areas. Moreover, the looming Medicare cuts that have been postponed for a long time and are now extended to January 1, 2012, present another problem for family practitioners in avoiding losses in income. Family medicine and family physicians play a vital role in the healthcare system of a country.

Another important factor is the health reforms coupled with an increasing number of aging baby boomers in the coming years which would keep family physicians busier than before and hard-pressed for time and money.

Chronic Hurdles

Medicare is facing problems because of Federal fiscal troubles and Medicare cuts have been proposed in order to compensate for the rising health care costs. The recent debt ceiling increase at the eleventh hour by the government bears witness to the fact that Medicare is unable to withstand the increasing pressure brought on by a large number of the aging population in the country. The inevitable solution to this income crisis faced by family physicians and in the field of primary medicine is better payer performance and adherence to the guidelines in regard to administrative or other processes involved in the revenue cycle management. These chronic pressures on the revenue of family physicians can be relieved by ensuring the reduction of errors in the billing and coding procedures which are becoming more complex and extended in nature. Professionals who can perform better payer interaction and medical coding and billing can bring about speedy and fair reimbursement compared to inexperienced or overworked in-house staff.

The Geriatric Paradox

The increasing number of baby boomers and elder people indicates better life expectancy but also makes physicians, hospitals, and clinics dealing with chronic illnesses associated with old age busier by the day. Moreover, the Medicare fiscal issues exacerbate the problem by proposing to provide easy access to insurance for the elderly but lesser payments for physicians. As the baby boomer population grows, the number of physician-patient encounters by the elderly would also increase drastically, leaving very less or no time for physicians to handle paperwork or administrative tasks. Outsourcing the whole process of billing, coding, and payer interaction can be an easy and frugal solution to relieve the administrative burden faced by physicians and healthcare providers.

ICD-10 and Family Practice

The migration from ICD-9 to ICD-10 codes is a major overhaul in the medical billing and coding industry and brings more complexity to the billing and coding procedures. Moreover, the fact that family physicians face diagnostic as well as treatment challenges across all ages, gender, diseases, and parts of the body makes billing and coding more detailed which requires dedicated professionals in order to avoid errors. The repercussions of errors impact not only the amount of reimbursement for physicians but can also jeopardize the privacy of patients’ healthcare data, emphasizing the importance of error-free billing and coding practices.

How Do Healthcare IT Reforms Affect Family Practice Physicians?

The health reforms also extend to the health IT sector which would provide easy access to physicians, administrators, medical billers, and coders, as well as insurance companies regarding the information related to the treatment and other relevant data. Dedicated medical billers, transcriptionists, and medical coders can understand these changes from the implementation and testing of EMR and EHR to follow up with payers to receive timely and accurate reimbursements. The need for medical coders and billers who can cut down on errors and save physicians’ time and money is being felt more in the field of primary care and by family physicians due to the extensive changes in the health industry as the latest health reforms are being implemented across the country.

For more information about meaningful solutions to tackle these issues in the context of family practice and other specialties, as also for professional medical billing and coding services, please visit, the largest consortium of medical billers and coders in the United States, also specializing in Family Practice Billing. To know more about our family practice billing and coding services, email us at: or call us at 888-357-3226.