Don't Overlook Coding Opportunities For Routine Healthcare Services

Greg Freeman, January 29, 2014

Revenue typically is lost because providers do not have controls in place to ensure complete billing for every patient encounter. Charging fully for all services can significantly increase a practice's revenue.

This article appears in the February 2014 issue of Managed Care Contracting & Reimbursement Advisor.

Optimizing your revenue is an ongoing challenge for any physician practice, and the task only gets harder as the healthcare industry changes and reimbursement is restructured. But one way to improve your practice revenue can easily be overlooked in all the effort to accommodate the new factors: making sure you are charging fully for each service that you already provide and not missing out on payment for activities you think are not billable.

Paying close attention to billing for normal, everyday services can significantly increase revenue, says Brian White, founder of Competitive Solutions, a physician practice consulting company in Franklin, Tenn. He typically finds that physician practices fail to bill for 10% to 12% of reimbursement to which they are entitled.

"This results in a tremendous revenue loss. Practices must make sure they are capturing all that they do before they even think about improving revenue with new services or more profitable services," White says. "So many practices lose money by not charging properly for services like smoking cessation counseling or putting on an elbow brace or a knee brace. There are codes for these things that you may not think about, and you need to make sure you are billing for every single code that you can."

Revenue typically is lost because practices do not have controls behind the scenes to ensure complete billing for every patient encounter, White says. There should be processes that verify complete billing for each patient after the visit, he says.



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