Quality Improvement Interventions to Enhance Physician Billing: A Systematic Review

Physicians encounter several challenges with current billing processes. The current Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided systematic review identifies and characterizes quality improvement (QI) strategies to enhance physician billing. MEDLINE, EMBASE, HealthStar, and Web of Science were searched for studies that described QI interventions targeting practicing or trainee physicians and outcomes including improved efficacy, enhanced efficiency, accurate billing code selection, or increased satisfaction. Fifty-six of 11,621 studies met the inclusion criteria. More than 40% of studies utilized more than 1 intervention and over 60% of studies included an educational intervention. Revenue-related outcomes were commonly reported among included studies (n = 30, 54%), followed by accuracy or error rates (n = 22, 43%), and billing completion rates (n = 14, 25%). QI interventions to enhance physician billing tend to be lower on the hierarchy of intervention effectiveness. Future work should explore the durability and generalizability of interventions and their impact on physician and patient outcomes.