Part B Insider (Multispecialty) Coding Alert

Published on Fri Apr 19, 2013 PDF

Breaking the communication between billers and practitioners could cause your income to plummet.

The cornerstone of any successful relationship is communication, and that applies to the relationship between the physicians providing services in your practice and the billers collecting payment for them.

Maintaining communication between physicians and billers often is a challenge, because both parties are so busy. But it can be done -- and it will make a big difference to your practice’s bottom line.

The first thing a biller must do is figure out the best way to communicate with the physicians in your practice. It may be in person, or email, or notes written on the chart and placed in his stack of charts to review, or even a phone call or page if it’s really important. The key is to find something that works and stick with it. Physicians like consistency.

Another good way to keep physicians and billers working together is to hold monthly or quarterly meetings between the two. These meetings can be used to address large issues, such as having physicians explain a new procedure or having billers explain a change to the code for an existing one.

These discussions are extremely important, because they illustrate to the physicians how vital it is that they communicate with billers. For example, say a cardiology practice hires an electrophysiologist and doesn’t tell the billing office. EP services often get denied for medical necessity. How is the billing office going to work those denials if they don’t know anything about what EP is, or even that EP exists? Further, if the EP physician doesn’t understand what a claim denial is, he probably won’t be able to document appropriately to support an appeal.

Another effective communication tool involves regular financial reports. The biller should periodically produce reports on things like the top five payers, the top five drugs/procedures being used and procedure analyses on a new code. Most practitioners seem to really appreciate reports that give them financial or statistical data for their practice.