Primary Care Physicians Can Earn More with Outsourcing

Primary Care Physicians are Leaving Money on the Table

According to a recent study published in the Annals of Internal Medicine, primary care physicians left a large amount of money on the table for services provided but not coded and billed. This research estimates that a single primary care physician could add $124,435 in preventative services to their practice’s annual revenue if coding and billing practices were rectified. R

esearchers from Brigham and Women’s Hospital and Harvard Medical School used national survey data to conclude that a single primary care physician (PCP) could add $124,435 in prevention services and $86,082 in coordination services to their annual revenue if coding and billing practices were resolved. They also estimated that each PCP provided preventive services worth up to $40,187 in additional revenue.

The survey also found that although services were provided to up to 60.6 percent of eligible patients, billing codes were only used at a median of 2.3 percent. The survey suggests that navigating the eligibility, documentation, time, and component requirements of numerous separate codes may be too high of a hurdle to warrant the effort from PCPs to use prevention and coordination codes. The physician fee schedule dominates how primary care and other physicians are paid. However, core features of primary care, first-contact care that is continuous, comprehensive, and coordinated, are poorly matched with visit-based payments. 

Don’t Let Inefficient Primary Care Billing Hold Back Your Practice’s Success!

Earn More with Outsourcing

The Centers for Medicare & Medicaid Services (CMS) is aware of this issue and has added billing codes for these aspects of primary care, including preventive services and coordination services. However, many of these codes have been characterized by low adoption rates, suggesting that the codes are not being adequately used. Primary care physicians can outsource their medical billing and coding operations to code preventive and coordination services accurately. Outsourcing can help primary care providers earn more. Some of the benefits of outsourcing are listed below:

  • Avoid under-coding: As discussed above, most PCPs fail to code for preventive and coordination services because they fear payer audits. They prefer to be under-coded rather than receive more reimbursement for delivered services. With outsourcing, specialty-specific medical coders will assign accurate codes with modifiers (where applicable), which will help them receive accurate insurance reimbursements for delivered services.
  • Avoid in-house billing: Most PCPs prefer to handle medical billing operations all by themselves. Medical billing and coding require a good understanding of billing guidelines and payer reimbursement policies. These policies and guidelines keep on updating from time to time. So, PCPs busy with inpatient care may be unable to stay on top of these billing updates, resulting in claim denials. Hiring specialty-specific medical billing and coding services will free up a lot of your time, which can be used to improve patient care. 
  • Team of experts: A medical billing company has a team of experts in various medical billing functions, such as charge entry, payment posting, AR management, denial management, and credentialing. When these activities are managed by a team of experts, accurate insurance reimbursement will be assured, and payer audits will be avoided. 
  • Insurance coverage report: Medical billing companies also share eligibility and benefits reports. You can use this insurance coverage report to determine the patient’s responsibility. In the case of non-coverage of insurance, patients are well informed, in advance, about their portion, i.e., patient responsibility.

Legacy AR - Medical Billers and Coders

Contact us at info@medicalbillersandcoders.com or 888-357-3226, a Top-Performing Primary Care billing firm, if your Google search for “medical billing near me” yields disappointing results. We simplify procedures to maximize compensation, enabling you to concentrate on delivering high-quality patient treatment. We specialize in medical billing for Primary Care professionals.

FAQs

Q1: What are the benefits of outsourcing primary care billing and coding?

Outsourcing primary care billing and coding can increase revenue, reduce claim denials, and minimize administrative tasks, allowing physicians to focus more on patient care.

Q2: How does outsourcing affect my practice’s financial performance?

Outsourcing can improve financial performance by ensuring accurate and timely claim submissions, reducing errors, and increasing reimbursement rates, leading to a more efficient revenue cycle.

Q3: What services are included in outsourced primary care billing and coding?

Services typically include patient demographic entry, insurance verification, coding of procedures and diagnoses, claim submission, payment posting, denial management, and regular reporting.

Q4: How can I ensure the security and confidentiality of my patient data when outsourcing?

Reputable billing companies comply with HIPAA regulations and implement robust security measures to protect patient data, ensuring confidentiality and security.

Q5: How do I start outsourcing my primary care billing and coding?

Contact a reliable billing company to discuss your needs, get a customized plan, and understand the onboarding process. We will handle the transition smoothly, ensuring minimal disruption to your practice.

Q6: Can outsourcing help with coding updates and compliance?

Yes, professional billing companies stay updated with the latest coding changes and compliance regulations, ensuring your practice avoids costly errors and stays compliant with industry standards.

Q7: How do medical billers and coders help primary care physicians?

Medical billers and coders help primary care physicians by accurately documenting services, submitting claims promptly, managing denials, and ensuring compliance with billing regulations, ultimately improving the practice’s financial health.