Medical Billers and Coders

  The crisis is indeed real. New York is facing a statewide shortage of primary care physicians, and it is nowhere near getting resolved as of now. The Healthcare Association of New York State reports that there are over a thousand unfilled physician positions across New York, of which nearly one-third of the shortage pertains to primary care. A doctor or other licensed medical professional who manages a person’s health care over time. Primary care providers diagnose and treat a wide range of common medical conditions. In 2013, a report published by Robert Graham Center estimated that the state of New York will fall short of at least an additional 1200+ physicians by 2030. According to the American Association of Medical Colleges ( AAMC ), there is a nationwide shortage of physicians, the number of which is estimated to rise up to 90,000 by the year 2020. Growing concerns over this issue have encouraged a team of industry experts at medicalbillersandcoders.com to sum up the fun...

  The lack of primary care providers in the country is a topic that has been hotly debated among many circles and written about vehemently. Not many medical students are ready to enter primary care due to a lack of great financial prospects for the future. This is resulting in even more shortage of physicians and problems when it comes to the reputation of this line of medicine. The remuneration problems along with other difficulties faced by Primary Care Physicians (PCPs) are affecting the revenue of PCPs and bringing a disparity between other physicians who practice other specialties of medicine. Here are numerous reasons for the reimbursement disparities for PCPs and some possible solutions for countering this problem. One of the reasons for the lesser amount of remuneration for PCPs is that specialists who perform routine procedures such as some specific types of surgeries take a lesser amount of time to complete their task compared to a PCP whose case can be of any nature. ...

A Patient-Centered Medical Home (PCMH) is not a particular type of hospital or building but an alternative approach to delivering health care that provides coordinated, continuous patient-centric medical care, managed by a team of individuals led by a physician. PCMHs employ the latest technology available to make optimum use of time and funds in order to deliver the best possible healthcare to patients. Although the concept is not new it has gained recognition and popularity among patients and physicians alike due to the recent health reforms. There are numerous pilots being carried out in various parts of the country and the results are positive and fruitful for healthcare providers and patients. Coordinating Patient Care Primarily, a PCMH integrates care across the healthcare spectrum including specialists, hospitals, therapists, laboratories, druggists, and home health to avoid duplicate care and curtail errors. It aims to assist physicians in keeping up-to-date with the patien...

The shortage of primary care physicians in the United States will soon worsen due to the added pressure on resources because of healthcare policy changes by the government. The rising number of elderly people in the country is also putting tremendous pressure on the services provided by primary care physicians. A white paper by the American College of Physicians examines the parameters of the shortage and its effect on the quality and the cost of care. According to the white paper, the estimated number of people with at least one chronic condition will exceed 150 million by the year 2015, building even more pressure on primary care delivery systems. Moreover, the number of U.S. medical graduates entering family medicine residency has significantly dropped over the last decade which is exacerbating the situation. The government issued a fact sheet on June 16, 2009, about the steps that it plans to take in order to alleviate the shortage of primary care physicians in the country. The ...

The shortage of PCPs in the United States has been a well-publicized and well-documented issue. However, the solutions to the various issues faced by primary care in the country have been obscure even after the implementation of the Affordable Care Act. The complications in finding the solutions to the challenges faced by primary care stem from factors ranging from policy reform to changing demographics. According to a New England Health Institute report, primary care in the country is facing a crisis due to the shortage of PCPs and the increase in demand for such physicians. Factors Complicating Primary Care Physician’s Tasks According to a report by the American Medical Association one of the biggest challenges faced by primary care physicians is the increasing number of visits by elderly patients. The report clarifies that the average visit duration has increased due to the fact that an increasing chunk of the total visits by adults to PCPs is to elderly patients. The report als...

Primary Care physicians (PCP) treat patients with all types of acute physical, mental, and chronic ailments and diseases. The patients form a wide range of patients; people of all demographics, socioeconomic groups, and so on. PCPs are thus expected to have thorough knowledge in multiple areas. The versatility of the physician ranges from seemingly simpler ailments like treating a cold to giving vaccinations to providing healthcare tips like the bane of smoking. Such a variety of treatments needs physicians to be well-versed in carrying out appropriate billing for getting reimbursements. “We Excel in:  Outsource Primary Care Medical Billing Services “ How can Outsourcing Primary Care Help Manage Revenue? Many billing experts work on a one-to-one basis with the staff to increase reimbursements and minimize denials. These billing companies work so well that they assign a professional who actually operates as an extension to the physician’s office. They keep themselves abreast w...

  Diabetes self-management education/training (DSMET) is cost-effective and improves health outcomes as patients maintain better control of their A1C. Diabetes educators provide education/training services and enable  physicians  to provide comprehensive high-quality care for their patients with diabetes and those at high risk of developing diabetes. The primary care practitioner in DSMT  provides general medical care  and is responsible for overall care, including the coordination of medical specialists. Role of Primary Care Practitioner in DSMT Diabetes educators bring a unique skill set to the physician‘s practice and are important adjuncts to primary care. These educators: help patients with diabetes develop the skills for managing their illnesses. increase a practice‘s efficiency by assuming time-consuming patient training, counseling, and follow-up duties. serve as an extension of the physician‘s practice to enhance the quality of care delivered. ...

  Medical Billing a Challenge for Struggling Primary Care Practices Medical billing is a complex process and it’s always been a reason for the struggle of primary care physicians. In addition, their practice is often overwhelmed with constantly changing information, including protocols and billing codes which makes the situation more challenging. When the covid-19 pandemic strains the U.S. healthcare system, primary care physicians were working to educate their patients, employ safety protocols, and handle large volumes of calls. This large volume of calls is creating administrative hurdles and operational challenges. Hence in response, many primary care practices are making changes to their  medical billing processes  to accommodate new patient needs. The recent release of the Medicare physician fee schedule final rule from the Centers for Medicare & Medicaid Services (CMS) contains new hope for struggling primary care physicians and you will get to know about i...

The technique by which Current Procedural Terminology (CPT) codes are developed with the goal that physicians can get paid for the services and procedures they give is an extremely entangled procedure, one that deserves some explaining. Furthermore,   Medical Billers and Coders (MBC)   is effectively occupied with this procedure and advocates for the eventual benefits of its clients, which incorporates improved payment for   primary care   codes and subspecialists under Medicare. Primary Care Codes for Improved Payment CPT codes are utilized to report medical services and procedures performed by physicians and other health care experts. The CPT Editorial Panel meets during that time to audit new and existing CPT codes for approval or updating. Values are assigned to new CPT codes and re-examined for existing codes by the Relative Value Update Committee (RUC), an advisory body that makes recommendations about the value of physician services to the Cente...

Increased administrative hassles and reduced potential for income are two main reasons behind the shortage of PCP in the US. Primary Care Billing and revenue-related challenges have been causing great dissatisfaction among primary care doctors. This has also led to a steady decline in the number of medical students willing to pursue a career in primary care. Around 52,000 more PCPS will be required in the United States by 2025 The total number of office visits to primary care doctors will increase to 565 million in 2025 By 2025, the population in the USA will increase by an estimated 15.2%. There will be a 60% increase in the older-than-65 age group Challenges Faced by Primary Care Doctors PCPs are paid less than surgeons and other specialists. Care provided by them is not appropriately recognized by payment policies and this affects their compensation Due to low income, physicians have no option but to keep the costs down They are forced to attend to a large number of patients on a da...

  Medical billing is a complex process and it’s always been a reason for the struggle of   primary care   physicians. In addition, their practice is often overwhelmed with constantly changing information, including protocols and billing codes which makes the situation more challenging. When the covid-19 pandemic strains the U.S. healthcare system, primary care physicians were working to educate their patients, employ safety protocols, and handle large volumes of calls. This large volume of calls is creating administrative hurdles and operational challenges. Hence in response, many primary care practices are making changes to their  medical billing processes  to accommodate new patient needs. The recent release of the Medicare physician fee schedule final rule from the Centers for Medicare & Medicaid Services (CMS) contains new hope for struggling primary care physicians and you will get to know about it in the following brief. The recent release of the Medic...

Primary Care First Model Options is a set of voluntary five-year payment options that reward value and quality by offering an innovative payment structure to support the delivery of advanced primary care. It will help in prioritizing the doctor-patient relationship; enhancing care for patients with complex chronic needs and high needs, seriously ill patients, reducing administrative burden, and focusing financial rewards on improved health outcomes. Primary Care First Model Options will be offered in 26 regions for a 2020 start date. Background Primary care is central to a high-functioning healthcare system and thus, there is an urgent need to preserve and strengthen primary care as well as a need for support of serious illness care services for Medicare beneficiaries. PCF will focus on advanced primary care practices ready to assume financial risk in exchange for reduced administrative burdens and performance-based payments. PCF also encourages advanced primary care practices, includi...