Today, pain treatment centers have a lot of room to develop. According to the American Academy of Pain Medicine, over 100 million Americans suffer from chronic pain. About 50 million people suffer from chronic pain, according to a recent report by the Centers for Disease Control and Prevention (CDC). It represents 20.4 % of the adult population, or one out of every five people. This is far higher than the overall number of patients with heart disease, diabetes, or cancer.
New state and federal laws, on the other hand, have posed some specific obstacles to pain management services in recent years. Pain management billing practices have found it more difficult to raise sales due to payer payment plans and coding updates. However, once you recognize some of the barriers the practice faces, you can introduce techniques to counter them and start increasing sales despite these obstacles.
How to Improve Revenue despite the Challenges?
- Recognize New Codes and Rules
First and foremost, ensure that the whole team, including front-desk employees and doctors, is aware of the latest payer rules and codes. Staff members must be up to date with the current CPT and ICD-10 codes. One of the most common causes for denials in pain treatment procedures is coding errors, so make sure that everyone on staff is up to date on the new codes and laws.
- Have a Diverse Patient Population
While you should make sure your pain management practice caters to Medicaid and Medicare patients, appealing to a variety of patient groups will help you expand your practice. This entails expanding the practice to include patients with workers’ compensation and commercial insurance.
Many pain management billing procedures can generate substantial revenue for your practice. Moreover, if you have a diverse patient base, it can help you remain competitive while fueling growth and increased revenue.
- Knowing the cost of complex procedures
Your pain management billing service should help consider and monitor the costs of more complicated treatments. Weighing if the reimbursements you’ll get can cover the costs. Be aware of how procedure costs will differ depending on whether the procedure is done in a surgery center or a pain clinic.
- Verifying the documents
One of the most common reasons for pain management claims being rejected is a lack of documentation. So make sure the documentation is correct and full before sending claims to payers.
Hence, to avoid issues with payer approval, it’s important to display documents during a hospital visit, and doctors must keep up with keeping well-documented operative notes.
Physicians must know how to fit new techniques into EHRs. Particularly when there isn’t a template for certain a service provided inside a pain treatment facility since most practices use EHR systems.
- Negotiating contracts
When negotiating contracts, it’s vital to offer a thorough understanding of the real costs of the different treatments being offered. When it comes to negotiating contracts with payers, knowing the local market, financial analytics, and handling the corporate side of pain management is critical. In certain cases, experienced negotiators will help you get the best possible reimbursements from payers by stepping in and negotiating on your behalf.
- Outsourcing Billing and Coding
The process of Pain management billing services is extremely complex and sophisticated. If done incorrectly, it can lead to expensive denials. It’s important to keep the sales cycle going if you want to expand your practice. Hence, outsourcing you’re billing and coding to a specialist company is one of the best ways to avoid claim denials.
Therefore, it can be said that it’s imperative to find out the best pain management billing services that specialize in billing and coding. Thus making sure that the exact codes are used to optimize per code range and reduce denials. Resulting in increased revenue and keeping you floating in this competitive global market