Top 3 Physician Medical Billing Services Challenges to Look Out for in 2021

The Covid 19 pandemic had exposed physicians’ offices to multiple administrative challenges such as claims submission, payment collection, patient registration, and many more. Physicians faced a hard time to prioritize between their frontend job which was to assist the influx of patients infected by the virus and backend tasks such as medical billing. This created additional pressure on them which resulted in serious errors in physician medical billing services. While a section of medical practitioners has started stabilizing the process by outsourcing a major part of to third party experts, challenges will persist and will disrupt physician medical billing services through 2021. Here’s a look at the top 3physician medical billing serviceschallenges in 2021:

OutdatedEHRThis year, the American Medical Association introduced new changes in the form of codes 99202—99215 in the CMS medical record documentation guidelines. This 2021 change states that a medical history or an exam will no more be the criteria for coders to select a medical service. This indicates the fact that it will bring considerable changes in the electronic medical record keeping. Physicians must proactively calibrate their existing electronic health record interfaces according to the new code changes. Failure to do the same will result in serious medical billing issues.

Current Procedural Terminology (CPT) changes: For 2021, AMA introduced two new changes in CPT codes (33995 and 33997) and four revised codes (33990-33993). These code reforms reflect vascular diagnosis and surgical procedures. Introduction of these CPT changes will entail more specificity and appropriateness in creating a medical history. This will include every specific detail of medical decision making and the total time spent by a physician with the patient. This will create an immense burden on physicians who are anticipating an influx of patients in 2021 with another wave of the pandemic hitting countries.

Patient’s Data Privacy Issue– The healthcare industry was held completely off guard by the Covid 19 pandemic that triggered a sudden surge of medical emergencies. As a lesson, most of the physicians are banking on patient data to create forecasting models that can predict a patient’s illness or even forecast a pandemic. However, as data takes the forefront in healthcare through 2021, HIPAA strengthened its focus on patient data safety. In the beginning of this year, HIPAA had announced changes in its privacy rule which is aimed at letting patients know the way their protected health information is being used.  An essential part of physician medical billing services will be to display estimated fee schedules on their webpages for an individual’s access to PHI. This is expected to create additional burden on the existing staff which will ultimately impact their medical care.

Parting Note

Battling a surge in demand for emergency medical care against the backdrop of Covid 19, physicians will find it increasingly difficult to balance both the billing tasks and medical care. Individual practitioners do not have the bandwidth to maintain an in-house department to deliver physician medical billing services. Expert third-party medical billing services providers are expected to be in the front-foot in the healthcare industry to deliver error-free and expedited services despite these looming challenges.

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