​​Experience Matters: RCM and Internal Medicine Billing and Coding

Just like the internal medicine specialty, successful internal billing and coding requires experience. The practice of internal medicine hinges on understanding a wide range of medical diagnoses and their attending complexity. An internist must be able to take a patient's symptoms, compare them to the person's overall health, and pinpoint the correct diagnosis despite persistent uncertainty. Internal medicine is like detective work where the stakes are especially high.  

When it comes to medical billing for physicians, you need a partner with equal parts experience, awareness, and accuracy. Medical Billing Specialists (MBS) has more than 30 years of experience working within the revenue cycle management (RCM) industry. We are experts in the field of internal medicine billing and coding guidelines, and our combination of software solutions and consulting services will help you maximize your practice's billing revenue, reduce rejected insurance claims, and give you significant ROI on your evaluation and management (E/M) process. 
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The role of the internist

Internal medicine is the art of diagnosis itself. As a specialty, internal medicine requires the provider to balance the patient's overall healthcare picture with the treatment of new and pronounced medical symptoms. It requires a detective's eye for detail and the ability to sort through a large amount of complex information from different sources, quickly and efficiently. In that regard, an internist's job isn't so far removed from an RCM consultant's. Both work with vast amounts of information, pulling critical data from large data sets while acting decisively. 

According to the Bureau of Labor Statistics, there are more than 50,000 internists currently working in the United States alone. Medical billing for physicians of this type requires RCM solutions that are equally broad yet robust. MBS has the specialized experience to help you conform to all necessary internal medicine billing and coding guidelines.

Medical billing and coding for physicians

Whether you work in the larger hospital context, or you are an internal medicine specialist operating in a smaller, private practice or physician's group, capturing revenue effectively is crucial to the long-term prosperity of your practice. Independent practices in particular have seen the cost of doing business increase more than 13% over the last half a decade. That's why a staggering 59% of all independent practices choose to outsource their billing and revenue capture activities to a third-party consultant such as MBS.    

Internal Medicine Billing and Coding

In terms of internal medicine billing and coding, it is important to have a consulting partner that understands not only the complexity of the internist's field, but also the complexity inherent to capturing accurate billing documentation during the E/M process. It is our job to know the steps that you employ when evaluating a patient —and the stress points where errors, insurance rejections, and other damaging pitfalls may occur.

Internal Medicine billing and coding guidelines

E/M codes form the basis for a large part of the internist's billing schemata. Therefore, accuracy in documentation is extremely crucial when it comes to internal medicine billing and coding. To that effect, internal medicine practitioners nationwide follow a common process when evaluating patients. That process consists of four separate steps:

• Evaluating the patient's chief complaint
• Reviewing their complete medical and family history
• Conducting a thorough examination
• Engaging in medical decision-making

There are pitfalls and difficulties inherent to each step in the process. Those pitfalls can potentially derail timely revenue capture if not properly attenuated. For example, when evaluating the patient's chief complaint, the internist must be careful to record the reason for the visit in depth, with as much attendant detail as possible within their billing/ EMR system. Otherwise, they run the risk of a rejected insurance claim —and a messy collections process.
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When reviewing medical and family history in the pursuit of effective medical billing for physicians, it is essential that the correct coding and modifiers are used to capture the complex nature of the billable work that the internal medicine practitioner has provided. Similarly, during the examination phase, careful documentation, with a focus on the appropriate scope and level of treatment, is essential. All doctors, including internists, walk a narrow line when it comes to under-documenting their work. Through our experience and expertise, MBS can help translate your boots-on-the-ground work into the correct codes and modifiers to help you maximize your RCM practices.

capturing your revenue through internal medicine billing and coding

At its heart, the practice of medicine is like a puzzle. It takes equal parts experience and equal parts knowledge, paired with the right tools and the right partners, to effectively care for your patients. Care and treatment are the proof of your care and commitment. So are accurate billing practices.

Medical Billing Specialists has the experience, knowledge, and superior tool set to help you streamline your revenue capture and maximize your RCM process. From our backend RCM software to our specialized consulting services, we're here to help your practice succeed while your patients enjoy better outcomes.  

Contact us today by phone or web to start a discussion about your Internal Medicine practice's specific needs and revenue improvement goals.

CONTACT MBS TODAY