The Top 5 Obstacles to Physician Billing Services

Physician Billing

One of the major impediments to growth for physician billing service groups seeking to expand their business and increase revenue is a payment system that is disrupted. A consistent flow of cash ensures, among other things, regular availability of funds needed to keep core processes running. In other words, it sustains a business and provides it with the fuel it needs to keep running smoothly.

In terms of medical billing, the healthcare sector in 2021 will undoubtedly present challenges for practitioners and physicians all over the world. The changing social, healthcare, and coding regulations will pose new challenges in the coming years. The Centers for Medicare & Medicaid Services (CMS) proposed changes to the documentation guidelines for evaluation and management (E/M) services. As a result, physicians must assess and prepare for significant billing-related challenges.

The top five obstacles for physician billing services are listed below:

Changes to the Current Procedural Terminology (CPT):

The American Medical Association (AMA) has developed a list of new CPT code descriptors for medical diagnoses, procedures, and other outpatient services (new and established patients). These adjustments will be made relying on the provider’s level of medical judgment (MDM) or the amount of time spent on the encounter. A medically appropriate history and/or physical examination, as well as a specific level of MDM, will be specified by the new code.

Greater claims denials:

Physicians will be burdened more as a result of regulatory changes and changing medical conditions among patients. A minor Physician billing or coding error could result in claim denials, putting a practice’s financial health at risk. As a result, physicians must plan ahead of time for these situations.

Difficulty in Collecting Revenue:

It will take some time to grasp the new insurance payer coverage policy. This could result in claim denials or confusion, complicating the revenue collection process for physicians. Payment may be delayed for practitioners due to the non-coverage of certain services and high deductible plans.

Obsolete EHR interfaces:

The new CMS documentation guidelines will change the way electronic records are kept. All existing EHR interfaces will be rendered obsolete. Physicians will need to use efficient and effective software solutions for record-keeping and billing, or else physician billing services will suffer.

Excessive Administrative Requirements:

Physicians have been juggling between the responsibilities of patient care and medical billing. Physicians are having a hard time preparing their staff for these changes. Increased administrative responsibilities may disrupt a physician’s revenue cycle.

Hence to conclude, the upcoming obstacles in physician billing practices may hurt the practice’s cash flow. As a result, it is necessary to plan ahead of time for all of these challenges and to implement a strategy that will benefit your practice. One of the best ways to deal with all of these issues is to outsource the billing requirements to professionals. Professional billing service providers will handle all billing-related issues while increasing the revenue collection rate.