Trends to watch: More hospital-centered billing & coding


There’s an interesting article in a recent Physician News Digest about the medical billing & coding challenges that are occurring as more and more physician practices are being centralized under the auspices of hospitals or larger health care organizations. When it comes to the discipline of medical billing and coding, outpatient vs inpatient have very different challenges. Plus, bigger isn’t always better. Author Michael G. Callahan explains the dilemma that centralization can create:

“A fact providers should be aware of, however, is that in many cases there is a lack of physician-oriented coding experience in the facility settings where highly skilled coders in inpatient and/or outpatient services are typically found.  The facility coders themselves are feeling the pinch, too.  They are facing new challenges by tackling the physician pro-fee cases.  Mistakes in pro-fee coding can negatively impact the practice’s bottom line as well as create potential compliance problems, especially in the tangled virtual environment of transmittals, “Change Requests” and official guidelines issued by the Centers for Medicare and Medicaid Services (CMS) for federal claims.”

This trend is an important one for healthcare documentation professionals to note.  As healthcare reform provisions kick in, look for more medical billing & coding job opportunities to be situated in hospitals and regional healthcare organizations.

Related: AHDPGTM  Medical Billing & Coding Programs