Showing posts from November, 2022

Outsourcing your medical billing protects against fraud

There are many reasons why you should outsource instead of trying to perform your medical billing in house with employees.  One big reason, is fraud protection.  Your hourly employees are only invested in their paycheck.  If they can't figure something out, they have no incentive to find the answer since they don't gain anything by taking the time to get a single, complicated claim paid.  And, they don't care enough to check for fraud risk.  LEVEL Medical Billing is motivated to work EVERY claim; and one of the screens LEVEL has is against fraud.  If we see a claim that has abnormal or potentially fraudulent data, we notify you to make sure there's not a discrepancy.  This saves you time and money against RAC audits, medical record reviews, and legal fees.

How Time-Based Billing Impacts Physician Reimbursement for E/M Visits

  For 90-minute new patient E/M visits and 45-minute return patient E/M visits, annual physician reimbursement was $409,894 under time-based billing and $188,065 under medical decision-making-based billing. Time-based billing was associated with higher physician reimbursement for longer evaluation and management (E/M) visits, while billing based on medical decision-making (MDM) led to higher reimbursement for shorter visits, according to a  study  published in  JAMA Network Open. Under a fee-for-service model, physicians are reimbursed for E/M services based on the number and complexity of problems addressed during a patient’s visit, known as the medical decision-making method. However, physicians may spend time on tasks that are not reportable under  MDM-based billing , such as medical record review, coordination of care, and documentation. This can lead to one to two hours of unreimbursed work for physicians. Time-based billing is an alternative method that reimburses physicians base