Top 3 Medical Billing Challenges in 2023

Every year brings new medical billing challenges for practices. If these challenges are not appropriately addressed, these can lead to an administrative burden, staff burnout, and delays in reimbursement.   

Addressing these billing challenges effectively can help you:  

  • Improve cash flow.  
  • Reduce denials.  
  • Increase patient satisfaction.  
  • Ensure you are getting paid for your work.   

The 2023 billing changes regarding the CMS Physician Fee Schedule and the CPT E/M codes changes demand that medical practices know these updates to bill for their services appropriately.   

These changes are summed up by the lack of expertise of the billing staff and the struggle with technology adoption to improve billing processes as the primary billing challenges for practices this year.  

1. Stay up to date with billing changes  

Medical practices must be ready for new code and guideline changes regarding CPT Evaluation and Management (E/M) and the 2023 CY Physician Fee Schedule (PFS).   

Coding is one of the most critical functions of the billing process. Therefore, your billing staff must be aware of these changes to get adequately paid for your rendered services.   

Firstly, the 2023 E/M code changes, the American Medical Association (AMA) released the guidelines, including 225 new codes, 75 deletions, and 93 revisions.   

Read more about these guidelines in our blog Get Ready for the CPT E/M Codes Changes in 2023.   

On the other hand, the CY 2023 MPFS updates include changes regarding telehealth services and expanded coverage for colorectal cancer screening, behavioral health, and other covered services.   

Read more about these updates on the blog What you need to know about the 2023 CMS Physician Fee Schedule  

2. Address the expertise billing staff shortage  

Medical billers are essential for your payment collection process. Billers calculate and collect payments for medical procedures and services. They are responsible for submitting, following up on, and appealing claims to insurance companies.   

However, a lack of expertise in your medical billing staff can lead to increased denials and payment delays. Also, the billing staff often doesn’t have the time or expertise to audit and analyze the entire claim lifecycle.   

Medical practices must conduct frequent billing training, so their staff is aware of updates and changes in the billing process. It is also essential to do audits at every specific time to make sure that the process is going as smoothly as it can be.   

Certainly, outsourcing  your medical billing can be a great option from a logistical and financial standpoint. Moreover, outsourcing this process can help you make more money faster, minimize overhead expenses, compliance and guideline adherence, and more.   

Read more about the benefits of outsourcing your medical billing on our blog Five Benefits to Outsourcing Your Medical Billing in 2022 

3. Take advantage of technology for your billing processes 

Automation in medical billing, data collection, medical coding, revenue tracking, and business monitoring can help you improve your KPIs and RCM. With medical billing technology, billers can quickly process accurate payments for physicians.   

Technology can also help streamline workflows, save time, reduce manual errors, and identify mistakes that can affect the medical billing process.   

Implementing medical billing technology can also help you reduce paperwork and minimize the risk of data loss.   

Overall, taking advantage of technology in your billing process can lead to enhanced productivity, decreased denial rates, promoted accuracy, faster claim processing, and more.   

At AdvantEdge, we understand the importance of the medical billing process for your practice. 

AdvantEdge offers your group practice or hospital comprehensive medical billing services, including telemedicine billing services. Our entire company is focused on achieving superior results for clients, including ClientFirst service and fully transparent operations.  

To learn more about navigating these challenges by outsourcing your medical billing, get in touch with an AdvantEdge expert or stay up to date on company and industry trends by visiting our Linkedin page.