Leading 4 Physician Medical Billing Services Challenges for Individual Practices

Accurate coding, rapid and accurate claim submission, and thorough follow-up on claims, among other factors, is crucial to increasing the likelihood of prompt reimbursement for services rendered. Each of these responsibilities comes with its own unique set of obstacles. For example, numerous revisions have been made to various medical codebooks as a result of the current pandemic. It is a difficult challenge for a private practitioner to stay on top of these developments, put them into practice, process patient bills using correct codes, and at the same time maintain the high standard of medical treatment that they provide. In light of this, the following information should help shed some light on some of the most formidable physician medical billing services:

CPT Code Changes

CPT Code 99201, the Revised Evaluation and Management Codes Some of the most significant modifications to the codes that were implemented in the previous year include the codes becoming obsolete and the elimination of physical and historical criteria for code selection. Because of this, it was burdensome for individual practices to educate themselves on the code amendments and appropriately apply those reforms to claim documentation. Because of the unprecedented number of patients brought on by the pandemic, medical professionals are unable to keep up with the rapid pace of these changes. These are reflected in erroneous claims documentation, which insurers are swiftly rejecting because they are promptly getting rejected by insurers.

EHR that is out of date

The American Medical Association added new numbers 99202–99215 to the CMS medical record recording rules just the year before. According to this modification, coders will no longer take into consideration a patient’s exam or medical history when selecting a medical service. Because of this, there were several adjustments made to the way electronic medical records are kept. In order to embrace the new codes, it was necessary for doctors to recalibrate the electronic health record interfaces that they were already using. Because of the delay in doing so, there were billing problems, which ultimately led to the denial of the claim.

The Loss of Employees

The epidemic has caused mobility limits, health problems, and regular burnout, all of which have contributed to an attrition of employees across a large number of physician offices. They are having a hard time coordinating the surge of patients with the administrative activities that need to be completed at the same time. Both of these activities are suffering as a result of this. Finding billers and coders with the necessary level of skill takes more than a month to complete. In the meantime, the growing number of claims that have not been handled is drawing revenue away from physicians.

Problems With Data Security

The HIPAA data security guidelines were updated and revised the year before last to assure the continued protection of patient information. Because of the change, medical practices are now required to tell patients about the uses that will be made of their health information. This resulted in fresh challenges for clinicians, who were previously allowed to make their own decisions regarding how to use patient data. They made predictions about the patient’s future health problems by running predictive analytic models based on the data.

A Note Before We Go

It is anticipated that the appearance of newer Covid 19 versions will bring about more difficulties in the administrative responsibilities associated with medical treatment, while also turning medical care into a possible warfare. It’s going to be a bumpy ride ahead for doctors who have to provide patient care while also balancing intricate billing responsibilities. In addition, independent practitioners typically lack either the necessary financial resources or the necessary amount of time to engage in an in-house staff to carry out medical billing services. In circumstances like these, contracting out for this service is your best option. Physicians are able to get the job done by specialists at prices that are affordable. These specialists assume complete responsibility for the billing chores and require as little as possible of their customers’ participation in the process.