Years ago, a PhD in medicine meant respect, knowledge and honor. Today, medical doctors are having a harder time with insurance company's respecting them for their expertise. Insurance companies are cracking down on medical doctors and blood labs. The new ICD-10 allows them to do that. Under ICD-9, a doctor could tell the insurance company that their patient needed two blood tests that week without having to explain a whole lot. The medical biller would simply put in the code and the doctor would expect a check in the mail a couple of weeks later. Today, this is not the case. Insurance companies are constantly asking the question of why. Why should I write you a check because you are claiming that your patient needed two blood tests? They want you to document why this was necessary before paying you.
The problem is not as bad as many people think it is. The reason for the slowdown of payments all has to do with understanding the ICD-10 requirements. It asks for more information such as how your patients are improving in their treatments with you. Insurance companies want to know why they should be paying you to begin with. Today, you need to have a good certified ICD-10 coder working for you. If you can't find one, then outsource your billing to a company that handles this. It is a wise choice if you are trying to earn more money for your practice. Doctors today are often only seeing 70% of their claims submitted to the insurance companies. Many insurance companies today are sending you a check for 50% less than you asked for. It is a tough time for doctors and anyone working in the healthcare industry.
Most people don't know that you need to learn 5 times as much information now than you did under ICD-9. You better believe that more study and experience is required. You need to document everything when you submit it to the insurance company. Insurance company's want to know why you are sending them a bill for a certain amount of money. Why should they pay you for the services that you performed? Was the service really necessary in the first place?
The new ICD-10 codes are already showing hard times for doctors. Doctors are seeing their payments being slow from insurance companies. They are often see far less reimbursement from the claims that they are submitting. This is a problem since doctors rely on insurance companies to pay their salary. Most patients cannot afford to write their doctor a check for $200.00 or more dollars every time that they visit them. If the insurance company is not paying for the treatment, then who is?
Medical billers today should understand a lot about anatomy and how conditions are treated. In order to send in a correct claim to the insurance company, the biller must know how to do it correctly. Document what had to be done in detail. Today, the more detail that you give the insurance company the better. You will often see a higher return on your claims in the end. It requires much more work. However, this is why you need someone to do this full time for you. Forget ICD-9. It is a thing of the past. Instead, focus your attention on what needs to be done.
The problem is not as bad as many people think it is. The reason for the slowdown of payments all has to do with understanding the ICD-10 requirements. It asks for more information such as how your patients are improving in their treatments with you. Insurance companies want to know why they should be paying you to begin with. Today, you need to have a good certified ICD-10 coder working for you. If you can't find one, then outsource your billing to a company that handles this. It is a wise choice if you are trying to earn more money for your practice. Doctors today are often only seeing 70% of their claims submitted to the insurance companies. Many insurance companies today are sending you a check for 50% less than you asked for. It is a tough time for doctors and anyone working in the healthcare industry.
Most people don't know that you need to learn 5 times as much information now than you did under ICD-9. You better believe that more study and experience is required. You need to document everything when you submit it to the insurance company. Insurance company's want to know why you are sending them a bill for a certain amount of money. Why should they pay you for the services that you performed? Was the service really necessary in the first place?
The new ICD-10 codes are already showing hard times for doctors. Doctors are seeing their payments being slow from insurance companies. They are often see far less reimbursement from the claims that they are submitting. This is a problem since doctors rely on insurance companies to pay their salary. Most patients cannot afford to write their doctor a check for $200.00 or more dollars every time that they visit them. If the insurance company is not paying for the treatment, then who is?
Medical billers today should understand a lot about anatomy and how conditions are treated. In order to send in a correct claim to the insurance company, the biller must know how to do it correctly. Document what had to be done in detail. Today, the more detail that you give the insurance company the better. You will often see a higher return on your claims in the end. It requires much more work. However, this is why you need someone to do this full time for you. Forget ICD-9. It is a thing of the past. Instead, focus your attention on what needs to be done.
About the Author:
We are a professional medical billing and coding company in the United States. Our clients depend on us for facility billing services and other types of billing. We offer products such as verification of benefits and utilization management.
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