2022 Changes to Medical Billings Trends and Regulations That Every Physician Needs to Know

Article Highlights

  • Physicians need to be ready to embrace changes in the provision of medical services.
  • AMA has introduced new 2022 CPT codes that could affect your medical billings.
  • The “No Surprises Act” could affect your ability to collect every dollar owed for certain services.

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The schedule for a busy physician can be daunting to navigate on a daily basis. Not only are you tasked with providing a high level of care to your patients throughout the day, but you also need to be mindful of whether your office is supporting billings so that your practice receives payment for services provided.

Unfortunately, many physicians are overwhelmed because of their patient schedule and the time required to monitor billings and revenue collections to make sure the practice is in a good financial position.

Because of this stress, you may not be aware of the latest physician medical billing trends that could impact your ability to collect payment for services. Let’s examine these trends so that you can optimize revenue collections in 2022.

Changes to Medical Billing Codes That Affect Billings

The American Medical Association (AMA) has released a new set of CPT codes for 2022 that could affect the way that your practice bills for certain services that you provide to patients.

The main source of change is the introduction of the COVID-19 vaccine requiring specific codes for each type of vaccine. This may not affect your practice. However, there are many other new codes and code revisions for new and novel areas of medicine.

  • AMA introduced 249 new codes, deleted 63 codes, and revised 93 codes.
  • 43% of the editorial changes are tied to new technology services in healthcare.
  • Other additions to the CPT code set are designed to “respond to the fast pace of innovation in digital medicine services.”

Some of the additions are five new CPT codes to support therapeutic remote monitoring. These codes expand on the remote monitoring codes that were created in 2020 to support the rapid expansion of telehealth services during the COVID-19 pandemic.

At Precision Medical Billing (PMB), we can help your office prepare for the changes to CPT codes by ensuring that your billing matches up with the services you provide to each patient. This will help prevent claim denials and increase the collection of revenue for services provided. 

We can work with your office or take the entire billing process off your team’s plate through our outsourced medical billing service.

Changes to the Healthcare Law That Affect Billings

On January 1, 2022, a new law, “The No Surprises Act,” will take effect that could have a significant impact on billings for providers of certain medical services.

The Act aims to protect patients from surprise billings and other excessive costs for services they receive. While the emphasis is on preventing surprise billing for services received in an emergency situation — such as out-of-network services at the nearest hospital — the bill is designed to protect patients from surprise billings “in both emergency and non-emergency care settings.”

For healthcare providers, the question becomes how do you receive payment for services if the patient’s obligation is reduced? The government agencies responsible for contributing to the new bill have recommended the following plan:

  • Negotiate the payment amount with the insurance provider.
  • If dissatisfied with the amount, then request a 30-day “open negotiation process.”
  • Work toward a final payment offer that could be different from your initial charge and/or the insurance provider’s initial payment offer.
  • If still unable to agree on a fair amount, then you can pursue the federal independent dispute resolution process to help resolve the dispute.

The last step should be viewed as a last resort because the government does not want to increase administrative burden. Both parties in the dispute would have to pay an administrative fee of $50, and the party that does not win the dispute would subsequently be responsible for an additional fee paid to the independent dispute resolution entity.

At PMB, we are learning more about how this new bill will affect medical billings for our clients. We encourage you to reach out to us with questions as you encounter this challenge in 2022.

Contact PMB for Physician Medical Billing Services

We anticipate more billing challenges for physicians in 2022 as the nature of healthcare continues to rapidly change.

You can count on PMB to provide you with reliable physician medical billing services for your practice. By working with PMB, we’ll help you increase revenue, improve accuracy in medical billings, and help you collect every dollar that you are owed.

We stay on top of the latest trends and regulatory changes so that your office can focus on other critical tasks supporting your patients. We’ll help you get back time in your schedule not having to worry about medical billings and revenue collections. Working with PMB, you and your office can focus on providing a higher quality of care to patients.

Contact us today to schedule a medical billing consultation with our team. We’ll show you how we can optimize revenue collections for your practice in 2022 and beyond.