In the past year, healthcare providers were identified as having one of their greatest revenue cycle vulnerabilities in clinical documentation and coding. The COVID-19 pandemic was also considered an important vulnerability that negatively impacted claims processing efficiency due to increased value based reimbursement rates across all payers
In 2020 it’s predicted this will be even worse with more than 50% reduction expected on total volume reaching about $500 billion annually because there’s no way businesses can afford such high costs when profit margins started getting squeezed by insurers raising Premium contributions at least twice yearly since 2014 up until now where most employers have implemented.
Medical coding is a very serious business, but it does not have to be difficult. The COVID -19 situations are challenging and require the help of remote coders in some cases. But there’s still hope for healthcare providers who want accurate reimbursement from their medical billings though they may use expert strategies like those discussed here by experts throughout this article about how you can improve your own quality assurance processes with just a few tweaks.
How the medical coding services can improve the coding quality? Let’s find out through some secret ways discussed below!
Incorporate Advanced Technologies
The progress of technology has introduced a new way to record medical data. By converting from paper-based systems, electronic health records (EHRs) have made it possible for providers and coders alike to use consistent coding standards across all patient encounters without error or inconsistency in their workflows while also reducing costs associated with storing paperwork onsite at each hospital location
The EHR provides the backbone behind successful billing practices by keeping track not only about what was done during an encounter but also where information came from so there are no mismatched entries between different documents.
Ensure Accuracy of Information
When it comes to insurance, the last thing you want is for your claim get denied because of an error. To avoid this from happening be sure that all information has been entered correctly and double check spelling before submitting a denial.
Another inaccuracy that may cause issues for medical coding services is double billing. This is a serious problem in the healthcare industry. If you’re not careful, it can get your practice accused of fraud and incur fines from government agencies!
A frequently overlooked way for medical practices to protect themselves against potential liability issues arising out of double-billing are verification procedures such as routinely checking whether or not services have already been billed before attempting charges again on file with either payers (payer) or purchasers/payers who may be relying upon electronic records systems.
Keep Proper Documentation
As coders, we are in charge of coding and billing medical encounters. We need to have all the information from our patients’ charts so that their encounter can be accurately coded with ICD-10 code guidelines (or any other preferred system). If you feel like there’s something missing or seeming off during a visit from your doctor then it would help us out if you communicated this concern as soon as possible; maybe even before leaving for work!
When doctors don’t document patient care very thoroughly – sometimes without providing much detail on what was actually said at each step – charting software programs often lack key details which leads them down an incorrect path when trying put together accurate codes later down the road because they’re not getting everything needed beforehand.
Never Practice Up-Coding
Up-coding is the act of using code to reflect a more severe diagnosis or treatment, and it’s done for higher reimbursement rates. This illegal practice can lead into legal action against providers because up coding goes against federal law “The False Claims Act” – a government entity that offers incentives such as financial rewards if they detect certain types fraudulent activity from healthcare professionals including false billings under Medicare Part B (Hospital outpatient services).
Avoid Non-Covered Charge
Billing errors are a common issue in the medical coding services industry. One of the most frequent billing mistakes that can occur is when healthcare providers fail to verify coverage before rendering services, which could potentially lead them getting unnecessary bills from insurers on behalf for any charges covered by patient’s private insurance or other third party payers such as BlueCross/BlueShield plans.
The General Exclusions section (Chapter 16) within Medicare Benefit Policy Manual offers some helpful guidelines about what kind Chartered should know when providing care under this program.
Say No to Unbundling
Unbundling actually refers to the practice of listing separate charges for multitude of services that should be charged under a single code. These services can be fraudulent and could increase your insurance premiums. Always check National Correct Coding Initiative edits to learn which codes should be billed under a single code, as it may lead you into error or for higher reimbursement rates than expected!
Provide Education & Trainings Related to Medical Coding
Educational and training programs can help improve coding quality. Audit findings are only useful if they’re communicated to coders as soon possible, so that the changes in compliance go unnoticed by them or not enough time has passed for improvement actions taken months earlier be fully effective yet still necessary
Maintaining a strong focus on education is key when it comes down improving medical coding skills through learning opportunities like audits – this will keep your employees engaged while you get valuable feedback about how more attention needs directing towards certain areas before others start having an effect.
Communication is the key to keeping track of coding compliance. With so many updates happening in such a short period, sometimes things slip by for one person or another and it’s important that everyone on board with an update knows what they’re working towards as well- otherwise chaos can ensue!
Always remember that one of the most common ways to improve medical coding quality is through education. You can provide this by using a variety of tools, like webinars and podcasts that give valuable industry knowledge. Another way to educate your team on how they should be doing their job better is with performance management strategies. Use the above 7 secrets for improving medical coding quality in your own organization today! What are some other tips you’ve found useful? Leave them below so we can all learn from each other’s experiences!