Key Strategies for Improving Medical Coding Accuracy

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Key Strategies for Improving Medical Coding
Accuracy

• Medical coding is a key process of revenue cycle
  management. Whether you are facing a high rate of
  denials and not achieving best-in-class A/R
  outcomes or not receiving timely insurance
  reimbursements, the impact of low-quality coding
  shows very quickly on your practice collections.
  Medical coding not only produces clean claims but
  also helps identify issues associated with the
  clinical documentation, thereby bringing in the
  dollars without compromising on quality.
  Improving medical coding accuracy becomes the
  utmost priority of your practice. In this
  article, we shared key strategies for improving
  medical coding accuracy.
• Key Strategies for Improving Medical Coding
  Accuracy
• Hiring Right Resources
• Medical coding is a complex process requiring a
  lot of knowledge and skill. On top of that
  implementation of revised payer-specific and
  state-specific coding guidelines is yet another
  tedious task that requires talent. Implementing
  revised coding guidelines and evaluating existing
  coding practices also requires the involvement of
  a dedicated coder. Therefore, it is essential for
  practice owners to hire skilled, experienced, and
  knowledgeable resources who can make necessary
  shifts then and there. Hiring unskilled or
  non-specialty-specific coders could result in
  financial losses as well as compliance issues.

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Key Strategies for Improving Medical Coding
Accuracy
2. Adhering to Frequent Coding Updates For
improvement, medical coding accuracy always looks
for payer-specific and state-specific coding
guidelines. Most insurance companies consider
CMS-released guidelines and coding updates as
standard coding guidelines. Still, every
insurance company will have unique coding
guidelines and insurance companies will expect
you to follow them for accurate insurance
reimbursements. You can follow CMS and insurance
companies for the latest coding updates. You can
also frequently login into your provider portal
to check any coding updates applicable to your
practice. In case of any coding updates, every
insurance company will notify providers well in
advance. Insurance companies will also assist you
with suggested codes and documentation
requirements for the smooth implementation of
these coding guidelines. The insurance company
also asks for your opinion on proposed coding
updates to understand the potential implications
of such updates. So, always stay connected with
insurance companies for billing and coding
updates. 3. Conducting Quality Audit
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Key Strategies for Improving Medical Coding
Accuracy
Coding quality audits can streamline revenue
cycle processes, reduce the number of claim
denials, and ensure adherence to federal and
state healthcare regulations. Performing a coding
audit will help to evaluate a sample of charts
for individual coders and their recorded codes,
thereby, ensuring the quality of clinical
documentation. Many practices get assistance from
medical billing companies for scheduled coding
audits and annual coding compliance audits to get
the expertise they lack internally. Coders are
empowered to use standardized codes and follow
appropriate guidelines to interpret clinical
documentation properly. The entire revenue cycle
process can be streamlined through quality and
compliance audits for coding that could help
decrease the number of denials. 4. Conducting
Frequent Training Conducting frequent coding
training definitely helps in improving medical
coding accuracy. You can conduct coding denials
reviews with your coding team periodically, at
least once a month. Look at the top 10
coding-related denials and identify the root
cause. Often, it may be because of a lack of
understanding of the correct codes for a
particular procedure or inaccurate clinical
documentation maintained in the practice. A
brainstorming session can prepare the coders
about the correct codes and rectify many coding
issues you currently face.
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Key Strategies for Improving Medical Coding
Accuracy
5. Opening Communication Channels Whether
internal or external, a coding audit is a key
strategy for improving medical coding accuracy.
But just conducting an audit is not enough,
practice owners should communicate audit findings
and any changes in coding compliance with the
coding and billing team as soon as possible.
Communicating with the complete billing team will
enable coders to alter workflows immediately to
improve coding quality. Communication also
ensures coders are on the same page with updates
to coding compliance, especially when the
unexpected happens. Communicating audit results
and coding compliance changes with clinicians can
be especially beneficial since they are the ones
documenting clinical encounters, which will then
be translated into claims for reimbursement.
Ensuring high-quality medical coding is important
for capturing revenue. 6. Avoiding Coder
Burnout Due to the shortage of qualified medical
coders, most healthcare organizations have an
understaffed coding team. The lack of skilled,
knowledgeable, and medical specialty-specific
coders has led to unrealistic productivity
expectations from the coding team. In most cases,
the consistently high workload has led to coder
burnout. Hiring enough qualified coders can help
you balance the coding teams workload, set
realistic productivity goals, and improve morale,
resulting in improved medical coding accuracy.
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Key Strategies for Improving Medical Coding
Accuracy
Outsourcing Coding Outsourcing your revenue
cycle management functions to a medical billing
company can be a practical strategy for improving
medical coding accuracy. Finding an in-house
medical coder could be a challenge for any
healthcare practice due to skilled manpower
shortage and payroll burden. With such an
in-house coder, you constantly have to invest in
training and certification charges. Medical
billing companies not only provide you the
skilled manpower but also they can offer
customized coding services as per your practice
requirements. If your practice requires a
full-time coder then the billing company can
charge you on FTE (Full Time Employee) basis
otherwise they will charge you only for work done
(either chart-wise or submitted claim-wise). As
medical billing and coding are such companies
core competencies, they can assign skilled,
experienced, and medical specialty-specific coder
who is well versed with coding guidelines for
various payers in your area. Such outsourced
coding resources will not only take care of
compliance issues but also look for
revenue-maximizing opportunities for your
practice. Medical Billers and Coders (MBC) is a
leading medical billing company providing
complete revenue cycle
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Key Strategies for Improving Medical Coding
Accuracy
management services. As a practice owner, if you
are facing the challenge of hiring a skilled
coder or dedicating time to medical coding and
billing operations, outsourcing can be a great
option for you. Whether you are looking for a
full-time skilled coder or need coding for a few
charges, we can provide coding services as per
your practice requirements. To know more about
our medical billing and coding services, email us
at info_at_medicalbillersandcoders.com or call us
at 888-357-3226.