Mr. Alee has watched fee schedule updates come and go without much drama that is happening nowadays in medical billing, but this one’s different.
“This goes beyond ordinary billing issues,” he says. Codes that were being paid consistently three months ago are now getting denied, and many practices haven’t identified the reason behind these sudden changes.
That’s the real problem, not the update itself, but the lag. The claim is rejected weeks later due to an outdated code that was just retired, and there’s a pile of denials waiting on the shelf by the time anyone realizes it was for the new code.
One of the clients had one retiring code that used to affect 15% of their monthly WC volume, Alee says. That is no minor update; it’s a revenue issue.
His fix isn’t complicated: retrieve your 20 most-billed WC codes and compare them to the current OMFS schedule; don’t count on June’s codes being available in September! It’s the kind of thing Doctor Management Services builds its whole billing process around, catching the change before it becomes a denial, not after.
“Codes change every quarter somewhere,” Mr. Waqas Alee quoted. “The practices that stay ahead of it aren’t smarter. They’re just paying attention.”
Better length? I can dial it up or down from here for the rest of the series.
