Pain management specialists deal with patients who are suffering, and they know how important treatment is—but payers are often extremely critical of billing for pain treatment when the cause isn’t something that shows up on an x-ray or has a disease diagnosis. Recent regulations have increased scrutiny of medications used for pain and the penalties for misuse to the extent that many doctors refuse to practice pain management.
With these inherent hurdles to deal with, it becomes even more important that practitioners aren’t burdened by pain management billing issues. Across all fields of medicine, institutions are cutting costs and payers are looking for ways to reduce what they pay, including being very particular about billing and coding errors, which result in claims being rejected or denied.
Billing Challenges for Pain Management Practitioners
An examination of the most common issues in pain management billing revealed these common challenges.
Claim Denials:
Rejection or denial of claims for the tiniest errors is common. Every letter must match the patient record exactly, and payers do not even try to determine what was meant if something seems amiss. The medical billing and coding process relates to every aspect of patient care from patient intake information to payment collection, so there are innumerable errors that can be made in entering just the right information.
Administrative Delays:
Many pain management practices manage claim denials by a very laborious manual process done by in-house staff. This results in slow claim re-submission and increased labor costs. Outsourcing medical billing and coding to a team of specialists can significantly improve claim denial resolutions, case mix performance and the time claims are in accounts receivable.
Increased Financial Responsibility of Patients:
An analysis conducted by Trans Union Healthcare in 2017 found that patients’ healthcare costs had increased by up to 11%. Rapidly increasing patient costs mean it is more important than ever to fully inform patients about their financial responsibility prior to treatment. The increased costs are also making it more difficult for pain management practices to collect the amount due to them.
Inaccurate Coding:
Coding errors are by far the biggest source of problems in pain management billing. This is true for other specialties as well, but pain management procedures have many unique billing codes, requiring familiarity with many more details than may be encountered in other practices.
The Solution to Pain Management Billing Issues
Medcare MSO takes care of revenue cycle management (RCM) from beginning to end, allowing pain management doctors and staff to focus on patient care, knowing that the necessary billing and coding is getting done. The extent of services includes not only what would be assumed to be part of pain management billing, but also payroll costs, revenue increments, ensuring compliance and more.
Outsourcing medical billing should not be seen as a cost burden for your practice, but as a service that will free up practitioners and staff to focus on patient care, while increasing revenue by efficiently filing claims, managing rejections and denials, and avoiding up coding and down coding errors. We even take care of annual payer adjustments, completing the revenue cycle.
As specialists in medical billing and coding, Medcare MSO keeps up with the annual code changes as well as the various rules and billing practices that are constantly changing. Because we have customers of all sizes, in every major field of medicine, or coders are kept up to date and trained on the specialized codes of each specialty they work with. Get a free demo today and see how we can help you and your practice run more efficiently.