Medical Billing In General Practice Vs Specialty

Home > Medical Billing In General Practice Vs Specialty

August 16, 2017 | Aptus Associates

There are many differences between general practitioners and specialty physicians, and medical billing is no different. Billing is determinately different among different medical practices so it’s easy to see why it may be a big change to go from one to another. Let’s talk about the billing differences.

Codes

Coding is one of the most complex parts of billing. Depending on the diagnosis, the procedure, and the patient, codes can vary greatly. But in a specialty practice that only deals with certain areas of the body and specific treatments options, there are a limited number of codes to choose from. A biller may use the same code 15 times and only one or two others in the course of a day. However, in a general practice that deals with everyone and all types of conditions, there are thousands and thousands of codes to choose from.

However, in a general practice that deals with everyone and all types of conditions, there are thousands and thousands of codes to choose from. It’s true that a general practice may use the same code several times a day, especially during peak cold and flu season, but there will be many incidents where a biller will use a code for the first time.

Insurance

Many insurance plans cover only certain treatments, many of which are given in general practices. A specialist may have to work extensively with the insurance company or do without insurance payout for their services while most general appointments are covered under insurance, usually with a small co-pay.

Each office internally has their own unique system so the differences are even more varied taking this into consideration. Either way, billing is an interesting aspect of the medical field that many don’t think about.