Key Strategies for Improving Medical Coding Accuracy

2. 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.

3. 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

4. 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.

5. 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 team’s workload, set realistic productivity goals, and improve morale, resulting in improved medical coding accuracy.

6. 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

7. 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@medicalbillersandcoders.com or call us at: 888-357-3226.