What plays an extremely important part of any sized medical practice is the effectiveness of their medical coding. When medical coding is done accurately, healthcare providers are paid in a quick and proper manner, and patients will get a good understanding of what expenses cost and why. If mistakes are made in the medical coding process, all parties involved face serious financial issues.
Even if you feel that your medical practice can make no mistakes, there is always a way for it to improve how it codes in some fashion. Here are five tips to improve medical coding procedures in your office or hospital.
Review any Denied Claim
When insurance providers reject a claim, they may have any reason to do so. There is usually a mistake in the medical billing that will cause the claim to be rejected. The claim could have missing information or documentation, contain a coding error, or could be submitted past the agreed-upon deadline.
Denied claims should be taken care of by having a specialized in-house employee or outsourcing medical billing personnel to review them. Reviewing each claim will ensure that you will not have any mistakes to be found when you submit it to the insurance providers. Reviewing claims can also give your employees a chance to learn how to spot mistakes and correct them. Outsourcing medical billing services to another company will mean your office will not have to deal with such problems.
Verify Coverage before every Appointment
In some instances, claims are denied because they are proclaimed to be medically unnecessary or are not covered by a patient’s insurance plan. These rejections are justifiable, but they are also rejections that can be avoided in advance. Simply confirming each patient’s insurance coverage before their appointment will make it much more likely that their claim will get approved by their provider.
Describe the Costs to Patients
Because the medical coding and billing takes place behind the scenes in a hospital or doctor’s office, most patients are not aware how medical coders come up with their figures on their bills. In many cases, patients will be very confused with all the services and expenses that their appointment and/or procedure require. This really frustrates patients who have to abruptly pay in larger amounts than expected.
This frustration can be greatly reduced by simply being upfront about costs and procedures that must be undertaken. You might think that patients will be appalled by having to pay hefty bills, but telling them what they need to pay weeks in advance will give them plenty of time to prepare their financials accordingly.
There are times where you may not know the exact cost of a visit, or your patient won’t be able to know what is covered as far as insurance goes so you can still explain what could be involved at the very least to help the patient know what to expect.
Outsource your Medical Billing
Medical billing software and terminology changes every few years and it can simply be too hard for some people to keep up with the most recent of coding practices. If you have a person that takes care of this task, it can also eat into the office’s productivity if he or she is taking more time coding than necessary. Luckily, there are professional companies that specialize in medical coding, so it is their top priority to code each and every medical claim flawlessly. Your staff will also enjoy one less task they need to do each day so that they can focus on more important work.