The Smart Medical Practice

The Dark Side of In-House Billing


The Dark Side of In-House Billing

Doctors just want to take care of their patients, but everything you do – or don’t do when it comes to coding, determines what you’ll get paid. So our question to you is this: Is the lack of clinical documentation knowledge killing your bottom line?

Under-coding represents the number one area of lost revenue for physicians. We find three main reasons doctor prefer to under-code:

  1. To avoid payer hassles. Payers already challenge everything you do, constantly denying claims and making you prove medical necessity.
  2. To avoid audits and repayments. This is good, as no one has time for audits or repayments.
  3. Doctors are not trained as medical coders, and so goes the old saying, you don’t know what you don’t know.

Coding to the highest level of specificity requires detailed coding knowledge. Often, when medical coders attempt to code accurately, they find don’t have the type of detailed documentation they need to code to the highest level of specificity. So even your biller ends up choosing lower-paying codes, when more specific ones of possible higher value would have gotten paid.

Anecdotally, revenue cycle expert Merrilee Severino says: “Practices often under-code because they get their advice from someone who learned from the person before them and so on, or even worse—the salesperson who sold them the software.” She goes on to say, “Medicine is dynamic, but practices don’t typically educate their staff… why would a practice think a biller/coder doesn’t need continuing education?”

Guilty of leaving money on the table? Have you ever wondered whether a team of billing and coding experts fighting hard on your behalf might improve your bottom line? Here’s the truth: Every doctor could benefit significantly from an expert coding and billing team that fights tenaciously for every hard-earned dollar they deserve.

Find out today, in dollars and cents, how making PracticeSuite your revenue cycle management partner will help you optimize your front-office processes, upgrade your clinical coding, and increase your overall collection levels by 12-17%.

 

Is Your Claim to Collections Rate 95%?


Last Updated on

Leave a Reply

Your email address will not be published.