Internal Medicine Billing Services
Internal Medicine Physicians are specialties who apply clinical expertise and scientific knowledge for the diagnosis and treatment of adults that includes health concerns to complicated illnesses. Internal Medicine physicians are called as internists, the term was coined after Sir William Osler who is the father of internal medicine in the United States.
Internal Medicine Physicians usually work as consultants on patient’s diagnoses, this makes internal medicine billing complicated compared to other practices billing. Internal Medicine physicians or Internists who advise specialty physicians on patient health usually go through the complete process of diagnosis to treatment; hence it becomes imperative to maintain complete documentation of patient health.
“Internal Medicine is complex, with regulations across the state boundaries we have private insurance companies that have rules for internal medicine billing. This results into payment delays and documentation scrutiny if a slight discrepancy appears. Legion Healthcare Solutions (LHS) has certified coders of billing internal medicine but during post-payment analysis, we realize that a part payment could be done for a certain diagnosis that is not covered under insurance. Here prior authorization from payers becomes important because internists and we would know where the payment come from rather waste time.”
– Medical Billing Managers at LHS
LHS believes that Prior Authorization and documentation will lead the for internal medicine billing, patients’ underlying condition needs to be documented and coding for complicated conditions need to be uniformly coded.
Prior Authorization and Documentation
Patient condition usually determine the amount every internal medicine physician is going to be paid. At Legion, we communicate at every stage with you to determine the patient's condition, insurance number, and path forward if other specialty physicians will be involved.
Legion employees certified Internal Medicine coder, coders who come with CIMC credentials have demonstrated over the years that they carry a particular domain knowledge to complete coding.
Claims in general surgery are categorized based on two categories: With prior authorization and without prior authorization. With prior authorization rarely need a claim audit as an insurance company is informed about the procedure, however at the without prior authorization involves coding and billing audits by Legion billing managers.
Internal medicine physicians usually see a patient repeatedly, this means each patient visits repeatedly either with the same underlying condition or with a different condition. Such a condition may require immediate attention, however, billing may be complicated if the payer refuses to reimburse based on the patient's insurance policy. Legion in such cases coordinates with patient payment schedules.
Evaluation and Management Codes
E&M has four revised CPT codes and two new codes for interprofessional internal consultation. 99446: Interprofessional telephone/ Internet assessment and management service provided. 99447, 99448 and 99449: are time-based consultations and reviews. Legion trains its coders on various updates and keep track of regulations.