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August 8th, 2007

Is simpler medical billing possible?

Posted by Dana Blankenhorn @ 8:38 am

Categories: General, Medical IT, Medical Office IT, Medical Records, Payment Processing, Physician Information

Tags: Medical Billing, Billing, Dana Blankenhorn

Physician billing codes by C.M. Schneider for the AAFPIn response to my recent note on getting paid, Benjamin Atkinson makes a key point:

My building contractor bills me by the job. He gives me an estimate +/- a small percentage. I can accept that. He knows what materials, time and labor are going into the job. Doesn’t my doc?

(The picture by C.M. Schneider is from the American Association of Family Physicians.) Atkinson is talking here about ICD-9, the International Classification of Disease. When you bill through ICD-9, you’re billing based on what is wrong with the patient.

The alternative is CPT, the Current Procedural Terminology. When you bill through CPT, you’re billing based on what you do for the patient.

In practice, you use both. In practice, with all these codes for what’s wrong and what’s done, which are constantly changing, billing is so complex that an enormous industry has developed to help professionals get paid.

Is it possible to simplify all this, just a little? Should the most important person in a medical office be the doctor or the payment specialist?

A personal note. My chiropractor’s assistant is a whiz with these codes. My pediatrician, not so much. Should my chiropractor make more than my pediatrician as a result?

Because that’s what is happening, as the mess in medical billing just gets messier.

Dana BlankenhornDana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994. See his full profile and disclosure of his industry affiliations.

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  • Talkback
  • Most Recent of 3 Talkback(s)
RBRVS
[url=http://en.wikipedia.org/wiki/RBRVS]fyi on Resource-Based Relative Value Scale[/url].

RBRVS--A common method for Insurers to determine and set reimbursement rate schedules by cpt when paired with a diagnosis.... (Read the rest)
Posted by: D. T. Schmitz Posted on: 08/08/07 You are currently: a Guest | | Terms of Use
It's never gonna change  Rick_R | 08/08/07
It's pretty simple in the US...  BitTwiddler | 08/08/07
RBRVS  D. T. Schmitz | 08/08/07

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