decisionhealth Newsletters, Part B News - 2013 Issue 9 (September)
6 tips to avoid patient pushback when billing E/Ms with preventive services
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Article Overview
This premium article focuses on patient communication and office workflow for preventive services that may overlap with evaluation and management billing. It is aimed at medical billing, coding, and practice management staff, as well as clinicians and front-desk teams who need to set expectations before, during, and after the visit. The guidance covers how to explain preventive visit scope, how to present billing policies, how to address patient concerns, and how general Medicare and insurer considerations can affect office messaging.
Why This Topic Matters
Preventive visits that also include problem-oriented care can lead to patient confusion and dissatisfaction if expectations are not set clearly. This article helps practices manage those conversations proactively while aligning staff communication with common billing and compliance concerns.
Article Sections
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Setting patient expectations before the visit
This section discusses the importance of explaining preventive visit scope in advance and using written communication to reduce confusion. It frames the issue as a patient-relations and practice-management concern.
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How practices can explain billing policies
This section covers staff communication, written notices, and how practices can describe the possibility of separate billing when additional services occur during a preventive encounter. It also addresses when and where patients should receive this information.
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Handling scheduling and follow-up communication
This section outlines approaches for scheduling conversations, front-desk messaging, and responses to patient questions after the visit. It emphasizes maintaining a clear and consistent office process.
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Documentation and separate service considerations
This section discusses the need to distinguish preventive care from another service that occurs in the same encounter and the role of supporting information. It also references Medicare and common office examples in broad terms.
What You Will Learn
- How practices can prepare patients for preventive visits that may include additional services
- How front-desk and clinical staff can coordinate patient communication
- How offices can structure written notices and post-visit responses
- How preventive visit billing issues intersect with general Medicare and payer communication
- What kinds of workflow considerations help reduce patient pushback
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Front-desk staff
- Physicians and advanced practice providers
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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