Primary Care Physicians Can Earn More with Outsourcing

2. 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 that were 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. Researchers from Brigham and Women’s Hospital and Harvard Medical School used national survey data to conclude that a single 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 having to navigate 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 plays a dominant role in how primary care and other physicians are paid.

3. Primary Care Physicians Can Earn More with Outsourcing • However, core features of primary care, first-contact care that is continuous, comprehensive, and coordinated are poorly matched with visit-based payments • Earn More with Outsourcing • TheCenters for Medicare & Medicaid Services (CMS) is aware of this issue and added billing codes for these aspects of primary care including preventive services and for coordination services. But many of these codes have been characterized by low rates of adoption, 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 to earn more, some of the benefits of outsourcing as listed below: • Avoid under-coding: As discussed above, most PCPs fail to code for preventive and coordination services as they fear payer audits. They prefer to be under code rather than receive more reimbursement for delivered services. With outsourcing, specialty-specific medical coders will assign accurate codes with modifiers (where ever applicable). It will help to receive accurate insurance reimbursements for delivered services. • Avoid in-house billing: Most PCPs prefer to handle medical billing operations all by themselves.

4. Primary Care Physicians Can Earn More with Outsourcing • 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. • Team of experts: Medical billing company has a team of experts in various functions of medical billing like 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 along with no fear of payer audits.  • Insurance coverage report: Medical billing companies also share eligibility and benefits reports. You can use this insurance coverage report to find the exact patient’s responsibility. In the case of non-coverage of insurance, patients are well informed, in advance, about their portion i.e., patient responsibility. • MedicalBillersandCoders(MBC) is a leading revenue cycle company providing complete medical billing services. We can assist you in receiving accurate insurance reimbursement while following billing guidelines and payer reimbursement policies. To know more about our primary care billing and coding services, contact us at info@medicalbillersandcoders.com / 888-357-3226