Billing, coding, and practice management: a primer for today's reproductive medicine professional

Fertil Steril. 2021 Jan;115(1):22-28. doi: 10.1016/j.fertnstert.2020.11.023.

Abstract

Despite years of recognition that many physicians are woefully unprepared to face challenges regarding the business of medicine, marginal progress has been made. In this piece, we aim to provide the contemporary reproductive medicine physician with an understanding of billing, coding, and, most importantly, cost containment for a typical fertility practice. It is critical for modern practices to not forego hard-earned revenue to insurance companies or not be aware of critical rules and regulations. While running a successful fertility practice requires good medical care, a profitable practice is necessary for overall long-term success. This article provides a brief history of medical insurance and billing, explains the process of updating billing codes, and reviews the revenue cycle, cost containment, and contract negotiations with insurance companies.

Keywords: Billing; coding; practice costs; profit margins; revenue cycle.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Clinical Coding / economics
  • Clinical Coding / history
  • Clinical Coding / organization & administration
  • Clinical Coding / trends
  • Financial Management* / economics
  • Financial Management* / history
  • Financial Management* / organization & administration
  • Financial Management* / trends
  • Health Occupations / history
  • Health Occupations / trends
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Insurance, Health, Reimbursement* / economics
  • Insurance, Health, Reimbursement* / history
  • Insurance, Health, Reimbursement* / trends
  • Practice Management / economics
  • Practice Management / history
  • Practice Management / organization & administration
  • Practice Management / trends*
  • Reproductive Medicine* / economics
  • Reproductive Medicine* / history
  • Reproductive Medicine* / organization & administration
  • Reproductive Medicine* / trends