What Is a Hospitalist? (+ Medical Billing Tips for This Specialty)

July 26, 2022 by Antonio Arias, MBA, CHBME

Topics: Medical Billing, Revenue Cycle Management, Practice Management

While some areas of medicine aren’t apparent in their titles—such as a nephrologist, who deals with the study of kidneys—other areas give a better starting point for understanding what that field might entail in their name. 

One example is that of a hospitalist, someone who, you guessed it, handles treating patients in a hospital environment. However, like most things in the field of medicine, there’s more than meets the eye with this specialty and there are particular medical billing challenges that hospitalists face.

Keep reading to learn more about this relatively new area of medical expertise and gain some of our top medical billing tips for hospitalists!

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What Is a Hospitalist?

This specialty known as a hospitalist refers to someone who is a physician dedicated to the care of those staying in a hospital. In the grand timeline of the field of medicine, this specialty is relatively new and was first mentioned in a 1996 Journal of New England Medicine article by Robert Wachter, MD, MHM. 

At the time, hospitalists were defined as “specialists in inpatient medicine…who will be responsible for managing the care of hospitalized patients in the same way that primary care physicians are responsible for managing the care of outpatients.”

A year later in 1997, the Society for Hospital Medicine was founded by two hospitalists, John R. Nelson, MD, MHM and Winthrop F. Whitcomb, MD, MHM with the mission to “promote exceptional care for hospitalized patients.” 

We’ve established that hospitalists focus on caring for patients in a hospital environment, but what does that actually look like? A hospitalist might be involved in a variety of manners, including:

  • Direct patient care
  • Research
  • Professional development within the hospital
  • Leadership and networking within the hospital
  • Teaching or mentoring other medical professionals
  • And more!

Hospitalists can take on many roles beyond delivering great care to hospitalized patients, however, this isn’t always the same as a traditional internist that you find working within hospitals.

Hospitalists play a vital role in the field of medicine

Hospitalist vs. Doctor: What's the Difference?

Hospitalists are often interchangeably referred to as internists—those who practice internal medicine—which is understandable given that both specialties fall under the umbrella of internal medicine.

One cornerstone distinction between the two is the setting in which they work: hospitalists are naturally working out of hospitals while internists can practice in hospitals and/or outpatient centers.

Furthermore, internists have the potential to develop a long-term patient-provider relationship with their patients and treat them for their whole life whereas hospitalists only see their patients within the hospital setting. Of course, if someone has a chronic condition that necessitates frequent hospital stays, then the hospitalist will see them more often, but this isn’t always the case with hospitalized patients.

These foundational differences are important for understanding the layers of a hospitalist’s role in the field of medicine and setting the stage for their medical coding and billing challenges.

Medical Billing Challenges for Hospitalists

As any other specialty within the field of medicine comes to learn, there are medical billing and coding challenges that hospitalists must deal with; some of these pain points include:

There Are Multiple Types of Medical Codes to Keep Track Of

Hospitalists might treat a patient on Medicare, another with private insurance, and one without insurance all in one shift; each of these patients would require their respective medical billing codes, forms, and billing processes to be handled accurately and promptly. Keeping track of these various medical billing codes can be overwhelming for practices with medical billing teams, let alone an individual hospitalist.

A Relatively New Specialty Means Legislative Adjustments Are on The Way

As long as government programs and advocates for legislative initiatives continue to champion efficiency, accountability, and a plethora of other measures, there will continue to be legal measures that hospitalists will need to pay attention to. These legal changes might be pertaining to Medicare coverage, insurance billing regulations, or some other program, and it’s critical to stay in compliance with these new measures when they happen. However, government documents and legislative efforts aren’t exactly easy to follow or understand, which means hospitalists have to dedicate time to researching them.

Hospitalists Don’t Have the Time to Handle Medical Billing on Their Own

When you’re balancing multiple patients, attending leadership meetings, doing research on your patient cases, updating patient records, mentoring medical students or young professionals, and more in any given day, there’s hardly time for handling mountains of paperwork, too. The medical billing and coding department within a hospital might not include a hospitalist’s work, depending on the contract between physician and organization, which means this burden falls on the individual’s shoulders.

Check out these top medical billing tips for hospitalists

Top Medical Billing Tips for Hospitalists

When it comes to mitigating these medical billing challenges for hospitalists, be sure to check out these tips:

Documentation Is Paramount for the Medical Billing Process

How can you keep track of your patients and ensure you utilize the most accurate, specific medical billing codes for your claims? Document everything. Not only is this beneficial to your patients’ care, but also it makes your process of filling out claims easier since you can review your documents and code to the closest degree of accuracy.

Keep a List Handy of Your Most-Used Medical Billing Codes

Over time, you’ll start to notice which medical billing codes you use the most as a hospitalist. Keep a list of these codes nearby when you’re sitting down to do your medical billing so that you can optimize this workflow and save yourself the frustration of looking everything up each time you’re filling out claims.

Partner with Your Specialty-Specific Medical Billing Firm, NCG Medical!

If you’re wanting a comprehensive, effortless way to manage your medical billing and coding processes, then look no further than partnering with a medical billing firm! With a team of friendly, knowledgeable medical billing experts by your side, you won’t have to stress about keeping up with legislative changes or dedicate hours of your time to reworking rejected claims.

Instead, you can focus on what matters most: your patients.

The team here at NCG Medical knows that the billing process is intricate, complicated, and overwhelming. That’s why we’re here to help! Your success is our success; partnering with us means you’ll enjoy an optimized revenue cycle, more time and energy back in your day, and prompt payments.

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