The field of medical coding has a significant effect on medical facilities of all sizes. When everything goes smoothly, patients know what their share of the bill will be, and doctors get paid on time. The effectiveness, profitability, and patient happiness of medical practice, are all negatively impacted if this process is poorly executed.
Although some medical facilities have good coding processes, nearly all of them could improve in this area. Here are five guidelines that could enhance your practice’s coding processes and, in turn, the quality of care you provide to patients.
1. Evaluate All Denied Claims
In most cases, insurance companies have valid grounds for rejecting claims. They could make a mistake once in a while and unfairly deny a claim. Usually, however, something wrong leads to a claim being turned down. For instance, it could be incomplete, lack necessary documentation, has an incorrectly coded section, or be submitted late.
An individual whose job is to examine claims that were initially denied should be assigned to this task. Claims that should have been paid to your practice but were incorrectly refused can be caught with a thorough review of all of them. It also provides an opportunity for your practice to identify and address the underlying issues leading to repeated rejections. Claims reviewers can assist your practice in making improvements, for example, if they see the same information consistently being left off of claims.
2. Verify Insurance Before Each Appointment
There are situations when claims are rejected because they are either not covered by the patient’s insurance or are deemed medically unnecessary. These are reasonable objections, but they can be circumvented. These refusals can be drastically reduced by verifying each patient’s current health insurance coverage before each appointment.
3. Describe The Claim Procedures And Treatment Expenses
Most patients don’t know how to claim filings and a medical coding company works because they occur behind the scenes. Patients frequently have no idea what the services they are receiving are called or how much they will cost. Patients are understandably frustrated as a result, as they often struggle to set aside money for doctor’s visits and are occasionally hit with hefty, unexpected fees.
By being forthright and honest, practices can alleviate much of the frustration patients have with billing. Patients will be better able to plan for their care’s financial burden if they are aware of the claims process and expected expenses in advance.
It is not always possible for practitioners to determine in advance all costs associated with an appointment or to understand the extent of a patient’s insurance coverage. However, clinics can at least explain the process and keep patients up to date as more information about the potential costs that a patient will be responsible for becomes available. Patients will value honesty, even if it doesn’t result in full disclosure of all relevant data.
4. Invest In Your Future Through Constant Learning
The transition to the new ICD-10 system has been completed at this stage. Understanding the newest technology is only part of staying abreast of advancements in your field.
Medical coders need to take their continuing education needs seriously. Coders can better adapt to shifts in the industry if their employers monitor their CEU compliance and send them to relevant training. They’ll be better able to handle problems as they emerge and keep the code in your practice functioning as smoothly as possible.
5. Consult An Expert Billing And Coding Service
For any medical practice, billing and coding are essential components that drive patient care as well as the financial health of a practice. As medicine continues to become more complex and sophisticated, it is increasingly important for practices to rely on a professional billing and coding service. With so many regulatory changes taking place regularly, this service can assist in streamlining the process while ensuring accuracy and compliance with all standards.
A professional medical billing and coding service provides experienced personnel who understand intricate details of insurance rules, regulations, medical codes and claims processing for various companies. This allows practices to save time and money by outsourcing these tasks rather than hiring their staff to handle them. Not only does this help reduce operational expenses, but it also helps in improving overall efficiency when handling patient records.