Billing is one of the more time-consuming administrative tasks for spine surgeons, but some have employed strategies to make the process smoother for everyone.
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Editor's note: Responses were lightly edited for clarity and length.
Question: What are your strategies to streamline billing at your practice?
Rachel Bratescu, MD. Weill Cornell (New York City): Spine surgeons in particular face a number of reimbursement and billing challenges, including those presented by insurance pre-authorization and at times more complex coding practices than other surgical subspecialties. Obtaining pre-authorization for surgeries is not only a hurdle for office staff, but the burden falls on the surgeon as it is their responsibility to ensure comprehensive and detailed documentation to justify the medical necessity of a procedure. In some cases this entails accounting for multiple codes to reflect different components of a single procedure during a single OR visit.
To maximize reimbursement utilization, modern billing software and continuous education regarding coding are strategies that can be employed, which may include staying up to date with the latest ICD-10 and CPT codes, or related courses/reference material.
Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (West Bloomfield, Mich.): 1. Implementing electronic billing systems: Using electronic billing systems can help streamline the billing process by automating tasks such as claim submissions, tracking and payment processing. This can help reduce errors, speed up the billing cycle and improve overall efficiency.
2. Outsourcing billing services: Outsourcing billing services to a third-party company specializing in medical billing can help neurosurgery practices focus on providing patient care while ensuring that billing processes are handled efficiently and accurately. This can also help reduce costs associated with hiring and training in-house staff.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: Our billing is done in-house, but our collections is outsourced to our EMR company. All of my employees are cross-trained in billing and coding and act as a second set of eyes for our claim issues. With all of my staff versed in coding and billing, we have a very efficient system. I also go to coding updates to make sure I am versed in the latest coding updates.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): The practice of billing, like all other facets of healthcare delivery, has become more intricate of late and requires constant interaction with both billing and coding staff to forego any potential mishaps. For this practitioner and our staff, the most critical issue potentially impacting billing and reimbursement is demonstrating a relatively strict confluence of proposal and performance of the proposed surgical procedure. Disparities from the original surgical proposal are usually scrutinized by the gatekeepers and, in many cases, may lead to denials and further administrative milieu. Initial submissions of codes and prospective procedures are paramount to a smoother process of billing and reimbursement.