Common Billing Challenges & Solutions for Physician Hospital Charges

Problem

Solution

Waiting on Operative Notes

Generally not necessary to attach operative notes to a claim form for most payors; Exception: Using the -22 modifier or billing an unlisted procedure code; Develop proper communication system with doctor to bill charges without using the operative note.

Poor Communication Between Doctor and Billing Staff

Improve current communication methodology; Success will often depend on cooperation of physician; Consider using a scribe to follow doctor, having doctor carry miniature charge cards, or recording charges onto a hospital/surgical charge ticket when he or she arrives back in the office.

Personnel

Poor personnel can lead to billing problems; Knowledge of CPT, ICD-9, medical terminology, and billing rules requires a special individual; Be careful during the hiring process.

Delay in Doctor Dictation

Some offices just want to rely on a medical record to do their billing; Claims get delayed in these situations when the doctor is behind in his or her dictation; Best solution is tying financial figures to the problem-i.e. Showing the impact on cash flow due to doctor delays.

Holding Claim Forms

Some practices hold claim forms so the facility or possibly another health care provider will get assessed the patient’s deductible; Should not be necessary if proper patient communication tools and practice policies are in place; Attempt to collect at time of regular office visit or preoperative visit once insurance has been verified.