I can still remember when I was first taught how to bill. Every doctor who taught me seemed to have their own unique interpretation of the schedule of medical benefits. I witnessed enormous practice variation with dramatic differences in code selection and subsequent pay for the delivery of very similar patient care. Many staff had never heard of billing codes that others used frequently. We had guidelines to inform our clinical decisions yet our billing decisions were the wild west.
After starting as a staff emergency physician I immediately stopped receiving meaningful feedback on my billing practices. I aimed for the 50th percentile but I was largely in the dark about how I compared to my peers outside of the odd watercooler conversation. I took an interest in improving my billing practice and quickly learned that much of what I was taught in residency was categorically incorrect. For example, as a trainee I was often told that if I examined two body systems (i.e.auscultation of cardiac and respiratory systems) I could bill a comprehensive visit code. Listening to two systems is mentioned absolutely nowhere in the schedule of medical benefits. The definition of a comprehensive visit is a fair bit more nuanced and complex. I quickly learned that this code is dramatically overbilled. Similarly many ER doctors are billing critical care codes when no treatment for a critical diagnosis has been provided - also categorically incorrect. I hope my mentors and teachers are never subject to an audit as I worry about substantial earnings being clawed back (with interest)! On the flip side, there were many codes that staff were underbilling. For example the administration of tetanus shots, peripheral ultrasound guided IVs or eye exams were often underbilled leading to missed revenue opportunities for work performed. Other professions such as lawyers or accountants almost never miss a legitimate billing opportunity and yet doctors don’t seem to pay the same attention to detail as perhaps we should.
Doctors need feedback on both their clinical practice as well as their billing practice in order to improve. We all want to be paid fairly for the work we have done. No one wants to earn dramatically less than a colleague that has the same level of training and is performing the exact same work. Similarly 99% of physicians have no interest in overbilling. We don’t want to take advantage of a broken system and overcharge the government (and ultimately the taxpayers). We want to do honest work for honest pay. The problem is that until recently we had no way to compare our billing practice to that of our peers. Doctors want to bill the correct codes at the correct time. We all want to hit roughly the 50th percentile of pay. We want mean regression but it’s hard to regress to the mean when you don’t know where the mean lies.
My frustration around disparate billing practices was one of the foundational motivations behind building ResolvMD. While most billing agencies provide little to no feedback or practice changing insights, at ResolvMD, we have designed our system from the bottom up to provide real actionable value for physicians. ResolvMD functions as a virtual billing coach that feeds back key stats about your billing practices and provides benchmarking against your peers. Our purpose built software provides high level metrics such as your average dollars billed per day or per hour and also feeds back specifics such as codes you bill at high percentiles compared to peers. We provide customized insights and tips based on your billing practices and speciality. We find codes that are used by your peers that you don’t use and feed this back to help you hone your practice. We teach you how to ensure you are paid fairly and in line with both the schedule of medical benefits and your peers.
No longer do physicians need to be left in the dark to hope they are billing correctly. With the power of modern software we can finally receive the feedback we need to improve our billing practices and ensure an honest day’s work comes with a fair and equitable paycheck for all.
ResolvMD is an experienced full service medical billing company that empowers physicians to bill more efficiently through data-derived insights and democratized knowledge. We believe you should be as confident and competent in your billing as you are in your practice. Our proprietary Physician Insights Portal harnesses the power of data to deliver customized insights directly to you in real time. No more second guessing or feeling like you don’t have the transparency and accountability that you deserve. Paired with the most modern and secure platform on the market, you can rest easy knowing that we are taking care of all your billing needs while fine tuning your ability to understand best practices and earn what you deserve.