Just when you thought medical billing couldn't get any more complicated, the new ICD-10 codes came out on October 1, 2015. The codes are a lot more complex than ICD-9. A lot of doctors are scratching their heads over it and asking themselves how they are going to get paid. A lot of doctors' offices are seeing audits by the insurance companies and a constant rejection of the claims that they are submitting to them. Doctors are often asking themselves, what gives?
Now, medical practitioners know that those days are over. In the past, this is how things were done. In today's world, insurance company's want to know specific details about what you are trying to claim. Are you in fact trying to "get over" on them? Do your patients really need the services in which you are claiming?
When your patient gives you their insurance card, are you purposely making them do extra tests so that you can make money off of them? Insurance companies are asking these questions and many more. The new way of medical billing in 2016 and beyond is to document everything. Be honest with yourself and your patients. If your patient is in shape and has normal blood work, do you really need to send them to the lab again a second time in the same week? As crazy as it sounds, some doctors do. This has gotten the entire industry in rough shape now. Many insurance companies have stopped working in certain states because they felt that there was too much fraud going on.
Licensed Medical doctors often have to go to school for 8 years or more. Their expertise for patient care should be enough for insurance companies to write them a check when they take care of a patient. However, this is not the case. Some doctors are even refusing to take any insurance at all. Many prefer to have their patients do cash pay. Many doctors complain that they must do this in order to keep their practice open. The insurance battle will only get worse.
Through the years, insurance companies have written checks to doctors because the system was set up that way. You tell the insurance company the ailment using correct codes and they submit a check back to you within a couple of weeks. Now, you must document everything to the insurance company. Your coder must know what to put down. Are you documenting the success or your patients or just submitting a claim for reimbursement? It is clear that insurance company's today wants to know more about your patients and if you are healing them. Many insurance companies are asking the question of why? Why does your patient need 2 x-rays instead of one? Why do they need 2 follow up appointments instead of the standard 1? It The system is basically forcing doctors to be more honest and open with why they are treating a patient to begin within a certain way.
Now, medical practitioners know that those days are over. In the past, this is how things were done. In today's world, insurance company's want to know specific details about what you are trying to claim. Are you in fact trying to "get over" on them? Do your patients really need the services in which you are claiming?
When your patient gives you their insurance card, are you purposely making them do extra tests so that you can make money off of them? Insurance companies are asking these questions and many more. The new way of medical billing in 2016 and beyond is to document everything. Be honest with yourself and your patients. If your patient is in shape and has normal blood work, do you really need to send them to the lab again a second time in the same week? As crazy as it sounds, some doctors do. This has gotten the entire industry in rough shape now. Many insurance companies have stopped working in certain states because they felt that there was too much fraud going on.
Licensed Medical doctors often have to go to school for 8 years or more. Their expertise for patient care should be enough for insurance companies to write them a check when they take care of a patient. However, this is not the case. Some doctors are even refusing to take any insurance at all. Many prefer to have their patients do cash pay. Many doctors complain that they must do this in order to keep their practice open. The insurance battle will only get worse.
Through the years, insurance companies have written checks to doctors because the system was set up that way. You tell the insurance company the ailment using correct codes and they submit a check back to you within a couple of weeks. Now, you must document everything to the insurance company. Your coder must know what to put down. Are you documenting the success or your patients or just submitting a claim for reimbursement? It is clear that insurance company's today wants to know more about your patients and if you are healing them. Many insurance companies are asking the question of why? Why does your patient need 2 x-rays instead of one? Why do they need 2 follow up appointments instead of the standard 1? It The system is basically forcing doctors to be more honest and open with why they are treating a patient to begin within a certain way.
About the Author:
We are a medical billing company in Fort Lauderdale Florida. We have physicians billing services for treatment centers, rehabs, hospitals and clinics. When a doctor decides to outsource their billing to us, we give a great approach to getting higher returns. Our customers tell us that we get them faster returns on their claims. We also offer services such as revenue cycle management and utilization.
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