Enhancing Accuracy in Medical Coding and Billing

Accuracy is one of the critical factors when it comes to medical coding and billing. A minor error, even the smallest, can result in claims rejection which is not good for healthcare organizations. This not only results in payment delays, cash flow disturbances, and lost revenue but some mistake coding can also cause legal troubles.  Furthermore, coding alterations and updates need to be clearly understood and applied by your coding team. This will help in eliminating over-coding or under-coding due to incorrect codes and implementation.

When any healthcare services provider chooses medical billing and coding solutions for outsourcing, you will get a team of coders who have skills and expertise in various services such as coding, billing,  auditing, revenue management and recovery, denial reviews and prevention, and physician coding/billing. VLMS Global Healthcare proudly offers services 24/7 with cost-effective services for every organization’s needs.

Let’s go deep into some of the tips to improve your accuracy in medical billing and coding:

• Ensure you are updated as per the recent changes

Medical billing and coding are changing in nature. Time-to-time training and development of billers and coders can help in retaining a win-win situation along with a reduction in errors and flaws. Medical connects a patient’s visit to the healthcare provider or clinics into an electronic format that payers utilize to process claims for reimbursement. If a billed claim is incorrect, outdated, or missing codes, then the claim will not be approved.

With every day-evolving and changing code used in billing, medical coders need to be aware of the latest information. Earlier, coders would depend on manual coding directories to refer to the right codes, but today, with the use of digital encoders and digital coding libraries, everything is easy

• Double-check before submission

It is important to double-check the codes that were used to make sure that they are correct. As in any complicated business environment, coding errors are normal, and double-checking can help in finding those errors which may result in high loss in the future. Taking a deep, line-by-line review of each claim before submission will result in errors that can be found and fixed before they become a big risk for the organization. 

• Correct patient information

It is again mandatory to make sure that patient details are correct and relevant in order to avoid errors. The details include demographic information and insurance coverage.

• Ensure the right documentation

Your team has to make sure that medical records are complete, correct, and credible. Coding accuracy highly depends on the quality of documentation.

• Audit claims management policies to find loopholes

It is important to conduct frequent audits of the medical coding and billing processes to pull out any loopholes. Evaluation and reviewing claims that are denied or rejected can help in identifying any patterns that could be the reason for errors in the billing and coding process.

This helps in finding recurring issues with under and over-coding, using redundant and retired codes, non-compliance, and inefficient documentation. You should maintain strong, quality data and documentation to make this process easier.