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How to Grow Rheumatology Practice with Correct Medical Billing

August 2, 2018

5 Tips Provider CerdentialingIn a healthcare landscape that’s changed to value-driven healthcare, the way rheumatology practice managers and physician managers run their practices is changing. Patients are facing bigger out-of-pocket expenditures on their healthcare, and they’re becoming pickier than ever about the doctors they choose. With this in mind, if you want to grow your rheumatology practice, it’s important to start treating patients as customers, working hard to meet their expectations and win their loyalty as a patient. 

“Customers” NOT “Consumers”

Most practices are aware of the shift healthcare has taken towards consumerism, with consumer-directed health plans jumping drastically over the past few years. Patients have more choices than ever, and they’ve become more careful about choosing their doctors, especially when it comes to choosing specialists, such as rheumatologists. According to Cameron M. Cox, who recently gave an address at the National Organization of Rheumatology Managers conference, it’s important to look at patients as “customers” not “consumers,” since it is customers who purchase a service or commodity. 

Cox noted that one of the main reasons “customers” or patients leave a practice is due to indifference, and around 67% of customers will leave a business because they don’t like the treatment they received. However, most rheumatology practices never ask, “what do our patients/customers want?” What your patients want can vary based on their ages, diagnosis, and other demographics. In order to meet the expectations of your patients or potential patients to grow your practice, you must start viewing patients as customers, focusing on offering a better customer service experience when they’re in your office. 

Using Telemedicine as an Engagement Tool 

Are you looking for ways to engage patients and better meet their expectations with your rheumatology practice? Consider using telemedicine as an engagement tool. While many have questioned whether telemedicine would work in hands-on specialties, such as rheumatology, recent studies have shown that tele-rheumatology has the ability to increase access to effective arthritis care, particularly in rural regions. It also has the ability to provide more patients with the care they need more quickly. Many rheumatology practices have long waiting lists for new patients, and telemedicine makes it possible for practices to care for even more patients. 

Different rheumatology practices are implementing the use of telemedicine in many ways. Because rheumatology is a hands-on specialty, it’s very common for physicians to have the first visit scheduled face-to-face. The differential diagnosis is best done face-to-face whenever possible, since there’s often a significant important for touch by the rheumatologist to make the correct diagnosis. However, after deciding on an appropriate treatment regimen, telemedicine visits can be used for follow-ups, particularly for patients who have busy schedules or those who live far from the practice. 

While many physicians worry about telemedicine billing and reimbursement, it’s important to look at telemedicine as an engagement tool that can play an important part in patient retention. Keeping loyal patients by offering them options like telemedicine visits has a big payoff for your practice, and if your practice is not engaging your patients, another practice is going to work for their loyalty.    

Facilitating Better Access to Care for Patients

The healthcare industry is the only one in which the schedule is designed only for the doctor. To improve patient retention, facilitating better access to care is essential, finding better ways to accommodate patients and their busy schedules. Other specialties have already implemented patient-oriented scheduling with great success, giving patients the ability to access schedules online along with wait time information. Rheumatology practices can learn from this, adapting patient-oriented scheduling to better accommodate patients. Since many patients prefer to check in for their appointments without the need to talk to front desk personnel re-configuring the front desk to allow for virtual check-ins is another option that is especially attractive to millennials. 

Rheumatology practices often book appointments far in advance, and while your practice may reserve a couple slots for patients that have an urgent need, this may not be adequate as the slots become taken by new, follow-up, or wait listed patients. Studies show that rheumatology patients report they have inadequate access to their provider for urgent concerns, and this often leads to more emergency room visits and a decrease in satisfaction with the practice. One way that some rheumatology practices have addressed this issue was to set up a weekly urgent care clinic for patients unable to wait until their next appointment to be seen. This option improved satisfaction in patients, improved their confidence that their needs would be met in a timely manner in the future, and reduce emergency room visits. 

Improving Rheumatology Billing and Coding 

Making sure your practice gets paid is an important part of growing your practice, and billing and coding can be a bit more complex for rheumatology practices. Improving your billing and coding game can help you make sure you’re getting reimbursed fully for your services, reducing problems with denials that disrupt your revenue cycle. Since rheumatologists see a lot more specific diagnoses that require more details, such as causation, anatomical location, and laterality, it’s essential to make sure your practice is on top of your game with coding. 

Read More: Specialty-Specific Medical Billing Service Advantages

For example, ICD-10 has heavily impacted rheumatology practices and if your practice isn’t providing documentation to support the details necessary for complaint rheumatology coding, you may be losing money. A few tips to remember to ensure compliance include: 

  • For gout, specify the laterality, anatomic location, and specific type. 
  • For rheumatoid arthritis, document the laterality and specific anatomical location. 
  • Distinguish between lupus with organ or system involvement and drug-induced lupus. 
  • Beware of conditions that have expanded under the new guidelines of ICD-10, such as ankylosing spondylitis and psoriatic arthritis. With the greater laterality and anatomical specificity of ICD-10, these diagnoses and others have been expanded from a single code to multiple codes. 

Since rheumatology billing and coding rules are very specific and often complex, it’s important to make sure you have experts working with you on your billing requirements. Ignorance in coding guidelines can put your practice at risk financially. Many rheumatology practices choose to outsource their billing to an experienced company that is up-to-date on all the current practices to avoid audits and maximizes revenue flow for their practice. If your practice is interested in outsourcing, contact M-Scribe today to learn more about our billing and coding expertise and how we can help you improve billing and coding for your rheumatology practice. 


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