BusinessHealth and Fitness

Cracking the Code for Finding the best Medical Coding Services out there

Why do clinics hire medical coding services? Coding is the starting point for converting the valuable medical service provided into revenue. Getting the codes right determines how much you get paid for it. At the same time, world of medical codes is quite vast and complex. Finding the code of highest specificity for a diagnosis, treatment or procedure comes with experience and good knowledge about coding.

What makes clinics outsource medical coding services

Doing the coding in-house requires all these following components- certified coders. Additional office space, hardware’s and equipment’s, coding software’s and much more. And as your client volume increases, number of files to be worked on rises too. Your staff might find it hard to cop with the extra work. And you might end up looking for additional manpower. Again, it is not easy to find experienced coders too. To say nothing about the possibilities of getting the codes wrong due to lack of expertise. Which has a very bad effect on you bottom lines.

Checklist to ensure you are hiring the right medical coding services

While outsourcing the coding part to external companies, you certainly have some expectations to fulfill. How to make sure the service provider will be able to match your demands? Here is a list of requirements a good coding service provider should comply to help you achieve your profit.

Accuracy factor

The coding process is all about experience and expertise to find the right code for the right medical scenario. There are a number of errors commonly done with coding like upcoding, miscoding, double coding, unbundling etc. to name a few. Good medical coding services have their process set to avoid all these errors effectively, with coding protocols and repeated audits pre-coding and post coding. Because with coding, quality is key.

Minimal turnaround time

A shorter revenue cycle requires faster claim reimbursements. To submit on time, the coded document should be ready for bill capture at the earliest. Once the patient leaves the clinic after the encounter, the coding process should be started and completed soon enough to have it ready for the billing process. Look for a company that can give you the shortest turn -around time. Look into the manpower they possess to accomplish that.

Qualified staff

Make sure the third -party coding service has employed only certified coders to tackle the process. The coders should be qualified with the coding certification programs and proficient in using the coding software’s to find the right codes and assign them to capture bill. It takes experienced coders to find the codes of highest specificity to elicit maximum reimbursement for the service provided. One should be competent in interpreting medical terminologies in their right sense to get that done.

Adaptability for your requirements

Good medical coding services should be capable of modifying their business process to match the needs of your practice specialty and volume of files. Ask them if they can pitch in more staff and resources to your service when there is a huge inflow of files to be taken care of.

Security and confidentiality

This is a very crucial area to look into while choosing a coding service, when you send your documents to a third party to work on it, make sure they are trustworthy with respect to data handling.

Make sure they are complaint to the HIPPA and patient information confidentiality and privacy protocols so that you don’t get into unwanted legal risks later on.

Compliance training

All the insurance rules and regulations are subjected to periodic revisions. Both the private companies and government payers keep changing the coding protocols and insurance criteria from time to time. One should show constant vigilance to these changes to stay compliant, otherwise the claims will keep getting rejected and denied. Make sure the company you hire train and keep their employees updated on the latest coding protocols and practices.

Coding is the first step of processing a billing claim. Anything that goes wrong at the coding stage, reflects in your claim and billing reimbursement. Employing one of the best medical coding services is what you require to save time, money and focus better on patients. Add power to your task force to get the best out of your practice.

Related Articles

Leave a Reply

Your email address will not be published. Required fields are marked *

Back to top button