Medical BillingKnowing how to do something doesn’t mean you have to do it. Many people know how to ride a bike, put a puzzle together, move furniture around the house, or mow the lawn; but you don’t necessarily do these things yourself. This same logic applies to medical billing and coding. Let’s face it, medical billing and coding can be a time-consuming, repetitive process that you don’t want to do. In fact, it would not be in your best interest to do medical billing, as your time would be better spent doing something else (for physicians, this would be seeing and treating patients). However, if you are a medical professional, it is in your best interest to understand medical billing and coding, since, after all, it affects your bottom line. Xyber Med specializes in oncology Medical Billing, orthopedic medical billing, physician, and hospital medical billing, and freestanding emergency services medical billing. Below, we will detail the reasons why you, as a physician, need to understand medical billing and coding.

REASONS TO UNDERSTAND MEDICAL BILLING

Bottom line money. The vast majority of services provided by physicians are paid for by insurance companies. The process of collecting claims from insurers is known as revenue cycle management or medical billing. Understanding how to bill for services is crucial to the survival of medical practice, whether you do your own billing or outsource medical billing. If you underestimate the coding of services (a common occurrence in specialty practices, such as oncology and orthopedic surgery) for fear of overcoding, you could be leaving money on the table. In addition, not knowing what services you offer to charge for (e.g., office visit versus a quick 10-minute consultation at the hospital) can also greatly affect your revenue. Your practice is a business. Most physicians do not enter the medical field to achieve financial freedom. They enter the medical field to care for people, help them, and ultimately make their lives easier. Even if you enter the medical field for altruistic reasons, you have to make a profit to survive. You have to pay your staff, a fund for your facilities, and probably a family to support. Plus, you can help more people when the lights don’t go out due to unpaid electric bills. Maximizing your practice’s revenue cycle is the key to keeping your doors open.

TIPS FOR MAXIMIZING YOUR REVENUE CYCLE FOR PHYSICIANS

Perform medical coding yourself. Entrusting medical coding to your staff, who may not be committed to your practice and could change positions, often results in underbilled services and errors in medical billing submissions. In addition, only you and the patient know exactly what happened in the exam room. You should have some role in the medical billing process, either as a general supervisory role at the end of the day or by assigning codes yourself for services. Familiarize yourself with the Current Procedural Terminology (CPT) for Evaluation and Management (E&M) Services. The CPT manual explains in detail how to determine the difference between coding procedures, such as the difference between a patient visit and a consultation. Knowing how to determine the level of service, how to document it, and how to code it is key for physician practices, especially when it comes to Medicare and Medicaid billing. Invest your time in online courses and webinars. There is a wealth of information on the Internet about medical billing practices and articles. Take advantage of newsletter subscriptions, articles, and even online books to learn more. Take courses. Probably the last thing you want to do is go to school anymore. But when it comes to financial solvency, a short class here and there will pay off in the long run for the long-term viability of your medical practice. You can take short seminars or attend classes as an alternative to full classes to gain a basic understanding of medical billing and coding. Learn about authorization practices and prescription drug coverage. While it can be very frustrating to meet authorization requirements for procedures (especially in the fields of oncology and orthopedic surgery), as well as knowing which prescription drugs are covered by which insurance, this knowledge is important to the patient. The patient is concerned about his or her costs. Physicians can get carried away with the best treatment options. However, if there is a treatment that is a step below the best but considerably cheaper, this is knowledge the patient needs to know.

Read your reports

A professional medical billing company such as CHRM provides monthly reports on your revenue cycle. Details are provided such as what procedures were submitted, how many claims were denied, how many claims required additional information, as well as the total amount collected and what is outstanding. This information is vital for medical practices looking for ways to maximize their revenue cycle. These reports can tell you the overall health of your business, as well as give you insight into your own productivity. You can learn which office practices are efficient and which can be tightened. A physician has to be interested in the business side of his or her practice, despite any doubts. Ultimately, the physician(s) are responsible at the end of the day for the success or failure of the practice. When a physician learns how to code effectively so they can charge for the legitimate services they provide, the revenue cycle will be much more efficient and timely. XyberMed offers support to our clients in the medical billing and coding process. We can visit your practice and help train and educate your staff on the entire revenue cycle management process. In fact, we encourage an initial training session to help your staff understand our processes and how to make communication between our team and yours seamless. We are always open to our client’s questions and/or issues about their medical billing. CHRM wants to partner with you in the success of your practice and ultimately be considered an extension. When your focus is on your clients and not on billing issues, we have been successful. Contact us today to get started with all your medical billing needs.