Primary care and internal medicine are booming in New York. However, finding an internist can be challenging for many patients, as most offices are handling a higher-than-normal patient volume. This often presents another issue: the coordination of numerous insurance plans and complex coding challenges. It requires extensive knowledge of medical terminology and documentation requirements. Typically, internal medicine practices run into trouble when relying on inefficient in-house billing, as it can lead to an onslaught of errors, delayed payments, and increased overhead costs.
Fortunately, there is a smart solution that can help busy medical practices get back on track. By outsourcing to a specialized New York medical billing service like StarkBilling, they can benefit from accurate coding, timely submissions, and improved cash flow management. Let’s explore the challenges that internal medicine practices deal with when using in-house billing and why outsourcing to a specialized partner can help.
Common Challenges of In-House Medical Billing in NY Internal Medicine Practices
In-house medical billing is often used in hopes of saving money, but in the long run, it can have the opposite effect for many practices. While in-house billers may be experienced and good at their jobs, other responsibilities crop up. Here are the specific challenges that make in-house billing difficult and inefficient.
Increased Administrative Burden
Increased administrative burden is a significant challenge for internal medicine groups in New York. As practices grow, the number of administrative tasks related to medical billing skyrockets.
In-house billers must manage patient records while keeping up with changing insurance requirements, billing codes, and regulations. For in-house staff, this means splitting time between providing patient care and dealing with medical billing, leading to inefficiencies and burnout. Unfortunately, this unrealistic juggle can result in billing errors, delayed payments, and even claim denials, affecting the practice’s revenue cycle.
Frequent Coding Errors
Internal medicine providers like primary care are often the first point of care but offer more complex services, such as preventing, diagnosing, and treating diseases. For the inexperienced, internal medicine can often seem like a maze of codes that requires a deep knowledge of medical terminology and a clear understanding of insurance policies. The constant updates to coding standards like ICD-10, CPT, and HCPCS add to the challenge. Even small mistakes can result in claim denials or underpayments, impacting the practice’s revenue.
Lack of Expert Billing and Coding Knowledge
Billing for internal medicine is notably challenging. It requires understanding medical codes in various fields, insurance requirements, and regulatory guidelines. Unfortunately, while proficient in basic billing tasks, many in-house teams may not possess the skills to handle internal medicine details. Without the proper knowledge, practices are at risk of coding errors, underbilling, overbilling, and compliance issues, which can lead to delayed payments, audits, or even fines.
Time-Consuming Billing Processes
Internal medicine providers often manage patients with multiple chronic conditions, which require a wide range of diagnostic tests, procedures, and ongoing treatments. Each service must be carefully documented and accurately coded for insurance reimbursement. However, the large volume of codes and the challenge of distinguishing between similar procedures make the billing process highly time-consuming for any biller, especially for in-house staff responsible for other tasks.
Moreover, internal medicine frequently involves coordinating with multiple insurance providers, each with its own rules, policies, and coding preferences, further complicating and lengthening the process. Tasks like verifying patient eligibility, managing pre-authorizations, and keeping up with frequent coding updates, such as changes in ICD-10 or CPT codes, can add to the workload, making internal medicine billing more labor-intensive and time-consuming than in many other specialties.
Limited Access to Advanced Technology
Many smaller practices, especially those without dedicated IT resources, may not have the budget to invest in newer billing software. Advanced billing systems have features like automated claims submission, real-time insurance verification, and built-in compliance checks that help reduce errors and streamline the medical billing process. Unfortunately, without these resources, practices often run into issues, as in-house billers often rely on manual processes, which are prone to mistakes.
Fortunately, New York internal medicine providers and staff no longer need to rely on outdated technology. By partnering with specialized medical billing services like StarkBilling, internists can streamline billing, minimize errors, and significantly reduce administrative burdens.
The Financial and Operational Benefits of Outsourcing Medical Billing
Outsourcing medical billing to a specialized partner can be a big step for many New York internal medicine practices. The StarkBilling team understands that a practice’s priority is ensuring that billing is done correctly and quickly while addressing the myriad challenges. With over forty years of experience in the medical billing and coding industry, StarkBilling can provide substantial financial and operational benefits to your internal medicine practice.
Reduced Overhead Costs
Hiring and training an in-house billing team, maintaining outdated software, and keeping up with regulatory changes can be costly and time-consuming. StarkBilling helps practices address these common challenges by reducing overhead costs up front. They no longer need to invest in as many salaries, benefits, or expensive software and can alleviate the stress of ensuring accurate billing. By partnering with StarkBilling, your practice can experience reduced administrative expenses and improved revenue management, enabling you to focus more on delivering quality patient care.
Fewer Denials and Rejections
Internal medicine involves a broad spectrum of services and treatments, requiring accurate coding to ensure proper reimbursement. StarkBilling’s team is highly skilled in internal medicine coding, which helps minimize common errors, such as incorrect or incomplete codes, that often lead to claim denials. Additionally, they have systems in place to catch potential issues before claims are submitted, ensuring that claims are accurate and meet the specific requirements of various insurance providers.
The team also keeps current with the latest regulatory and insurance changes, helping practices navigate tricky coding adjustments and avoid rejections due to outdated information.
Ensured Compliance with Changing Regulations
While internal medicine groups are ultimately responsible for complying with changing regulations, StarkBilling offers invaluable guidance to help ensure adherence to the latest standards. With frequent updates to coding requirements, insurance policies, and regulatory frameworks like HIPAA and Medicare, the team stays fully informed about these changes so they can provide proactive support to clients. They can help identify potential compliance issues and offer detailed guidance on addressing them, reducing the risk of errors and assisting practices in staying on top of changing regulations.
Access to Advanced Technology
StarkBilling provides internists across New York with better billing technology, a significant advantage over outdated or inefficient in-house systems. Its software can automate many aspects of the billing process, from claim submissions to real-time insurance verification and denial management.
This reduces the time that in-house billers spend on manual data entry and minimizes the risk of error, leading to faster claim processing and more accurate reimbursements. Additionally, the software can provide insights into revenue cycles, allowing for better financial decision-making.
Conclusion
In-house billers in busy New York internal medicine offices can easily become overwhelmed by the sheer volume and complexity of codes required for accurate billing. Constant updates to coding standards and the need to differentiate between similar procedures can cause errors, leading to claim denials and delayed payments.
Outsourcing to a specialized partner like StarkBilling ensures that billing is handled by experts who understand the challenges of internal medicine. Practices can quickly reduce errors, improve revenue flow, and start focusing on what matters most: patient care.
Capture more revenue and grow your internal medicine practice in New York with the help of a specialized medical billing partner that has in-depth knowledge of the unique billing needs of internal medicine practices. Our tailored solutions aim to enhance coding accuracy, reduce denials, and expedite payments. Schedule a free consultation now.
