Author Topic: Billing for different specialities  (Read 1650 times)


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Billing for different specialities
« on: March 05, 2016, 10:02:21 PM »

Is it easy or difficult to do billing for different medical specialties? For example if I start off billing for a cardiologist, what are the challenges if any to bring on a next client who is a podiatrist or in physical therapy. These are just hypothetical examples but the main question is are there logistical (software, regulation...etc) challenges to working with many different types of specialities?

Thank you all again...greatly appreciate the insight here


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Re: Billing for different specialities
« Reply #1 on: March 06, 2016, 12:29:27 PM »
From a software standpoint, I would say it is easy. Most decent cloud-based billing softwares are made to handle any specialty, because they either come with all CPT/ICD/modifiers, or you can easily add any you may need. Kareo, for instance, fits that bill. As do several others I have used/use.

After that, I think the challenges become a matter of what type of client you sign on, and exactly what you as the biller are providing for that client.

You can have a client in a "difficult to bill" specialty such as podiatry, but the client and their staff are very knowledgeable about coding, ICD-10, LCD's, modifiers, and any other regulation/billing specifics. Everything runs smoothly with the billing.

Then you can have a client in a "easy to bill" specialty such as internal medicine, but they and their staff are not educated in coding, ICD-10, LCD's, modifiers, etc, and you end up doing a lot of work in getting the most basic claim paid.

Or the client somewhere in the middle of these two situations, which oddly enough can sometimes be the hardest to deal with. They have a basic understanding, yet also insist on things being done a certain way, which is usually incorrect, and you have to "correct" their way of doing things, to make them compliant, etc.

What you offer as a billing service/company will have a lot to do with how much of a challenge it will be for you to go from billing a relatively easy specialty such as internal medicine, to billing a more difficult one like podiatry. Are you "just" entering the billings? Following through to the end of the revenue cycle? Entering demographics? Doing insurance verification? Pre-auths? Education to providers/staff on modifiers, ICD-10, CPT, PQRS, MUE, LCD's, compliance, etc? Credentialing? All of those things and more come into play, depending on what you are contracting with them to do.

You are asking a great question, but it is hard to give a definitive answer, because of all the variables. From a personal standpoint, I went from billing podiatry exclusively for twenty years to last year also billing internal medicine, and it was/is like night and day, in terms of ease. It took me maybe one or two weeks to get comfortable with internal medicine, versus podiatry, which took me months or more to get comfortable with(granted, I was new to billing then). Most people would probably think the opposite would be the case, based on the scope of practice between the two specialties. Yet that is not the case at all, due to those variables I mentioned.


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Re: Billing for different specialities
« Reply #2 on: March 07, 2016, 05:13:50 PM »
Generally it's fairly easy to bill for multiple specialities. I bill for M.D., D.C., O.D., and N.D. Billing is generally pretty easy, it's the posting of payments to the ledger (especially with primary, secondary, and tertiary insurances) that's my biggest problem. Following up on denied or unpaid claims, is sometimes a hassle too, though not as much. Every office is different, so be cautious and allow yourself time to learn how to do each office well before you take on additional work, don't bite off more than you can chew!  :)   


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Re: Billing for different specialities
« Reply #3 on: March 08, 2016, 11:20:03 AM »
We have never had any trouble.  For the most part billing is billing.  However different specialties do have idiosyncrasies that you must learn.  For example, podiatry uses a lot more modifiers than some specialties.  Mental health has only a handful of cpt codes that are used.  Etc.  As far as softwares go, most can handle any specialty.  There are a few that were made specifically for one specialty, but I would avoid those, unless of course you are only going with one specialty.

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