The Importance of Accurate & Efficient Medical Coding Services
Medical coding is an incredibly complex industry – with regulations, guidelines and even the codes themselves changing constantly. Because medical coding is directly linked to claims and billing – having an effective process for medical coding and billing should be a top priority for health care organizations of all sizes and specialties. Unfortunately, too often – medical coding services can get lumped into other job responsibilities – which can allow this critical function to get lost in the shuffle of a busy healthcare billing office.
How Investing in Medical Coding Services Can Improve Your Bottom Line
While some organizations manage medical coding services in-house, more organizations are choosing to outsource medical coding and billing for its numerous benefits. Organizations that partner with a medical coding company that is dedicated solely to ensuring the organization’s medical coding operation is as seamless, efficient, timely and accurate as possible are seeing significant improvements in their bottom line. Just a few of the benefits of outsourcing medical coding services include:
- Scalability – An outsourced medical coding company can scale to your patient volumes – to reflect shifts that are common with seasonality, changes in the economy, etc. without the hassle of modifying your workforce.
- Reduced Overhead & Greater Budget Predictability – Outsourcing saves critical resources needed to cover costly salary and benefits packages. Outsourcing – particularly offshore medical coding can help organizations save money and resources associated with hiring and staffing medical coding teams.
- Revenue Cycle Improvements – Coding backlogs often occur in large practices or health systems, particularly when volumes are high, or there are staffing problems due to coder job vacancies or vacation season. This can quickly result in cash flow problems. Outsourcing medical coding services allows a full-time focus on medical coding – with coders often working in various sites up to 24 hours per day for greater efficiency and speed. Prompt, accurate coding processes can help decrease accounts receivable days and restore healthy cash flow.
Accuracy in Medical Coding is Critical
With nearly 70,000 ICD-10 codes, accuracy in medical coding isn’t easy. It requires constant training, education and focus on the industry. Accurate medical coding has a significant impact on a healthcare organization’s financial performance. That’s why finding a medical coding company whose sole focus is staying on top of the latest changes in the industry and getting it right every time – is of paramount importance. Medical coding specialists who have no other distractions or responsibilities can take the time to assign the appropriate codes based on physician documentation – or to ask questions of the provider as needed. If undercoded, a single error can amount to tens of thousands of dollars in lost revenue. Similarly, if overcoded, penalties of tens of thousands of dollars can be fined under the False Claims Act.
The Use of Technology in Medical Coding
Fortunately, advances in technology have allowed for checks and balances through the use of unique technology to ensure medical coding reflects the actual care delivered, which results in an accurate payment/reimbursement. Finding a medical coding company that uses proprietary technology to verify coding accuracy can help healthcare organizations.
Evaluating Your Organization’s Medical Coding Services
Much like healthcare itself, medical coding has been a complex business since its inception. There are so many considerations in this industry, which is constantly changing. Here are some common concerns to contend with when evaluating your medical coding services or functions.
- Are your coders staying current with the latest code sets? Codes are changing regularly, which requires ongoing education and attention to the latest code sets. Busy healthcare organizations often don’t have the time or resources to send everyone to training, which can result in errors that can lead to delays in payment.
- Are your teams coding at the right level? Coding is an exact science – you always want your coding team to code to the exact level of services provided. Under-coding can cause denials or could leave revenue that your teams have rightly earned on the table. Over-coding can cause a whole barrage of regulatory issues and potential fines. Ensuring your coding team understands medical terminology and can abstract the correct information from the record are the keys to coding accurately.
- Do they know what to do when documentation isn’t sufficient? Unfortunately, the information needed to complete coding isn’t always there – for example, when a provider doesn’t document properly or sufficiently. Your coders should understand when the information in the record isn’t enough to make an accurate coding decision – and should also know how to reach out to the provider to clear up any confusion needed to get the claim out the door.
- Is your coding speed where you want it to be? Your goal should be to get claims coded and submitted within 24 hours to maintain and/or enhance your revenue cycle. The use of large-scale outsourcing operations for medical coding can help organizations scale their coding teams for optimal speed – without the cost associated with maintaining a fully employed on-site team.
- Does your organization have the appropriate checks and balances in place? Let’s face it – everyone makes mistakes. Having processes and technology in place to ensure your coding is at the highest level of accuracy is critical to any health care organization’s continued success. Regular coding audits and the use of intelligent coding workflow software can help ensure accuracies in excess of 95%.
Trust the medical coding services experts
Founded in 2005, GeBBS Healthcare Solutions provides experienced and trusted medical coding services for a diverse assortment of healthcare enterprises. Our clients benefit from:
- 10+ years of hospital and provider experience
- A network of over 4,000 experienced industry professionals
- Corporate security certifications: SSAE 16 Type II, ISO/IEC 27001:2013, and ISO 9001:2008
- Coding over 5 million charts monthly
- Real-time dashboard reporting via GeBBS’ proprietary SaaS technology
- A client-centered focus on achieving maximum coding accuracy through continuous improvement of our people and technology
By leveraging our people, processes, and technology, GeBBS clients reduce operating and capital costs, recover revenue, improve patient satisfaction, and increase productivity. Most important, healthcare providers see improved job satisfaction due to a reduction in their administrative and internal management duties.
For more information on how GeBBS can become your strategic medical coding services partner, call (888) 539-4282 or click here to contact us online.