Most doctors didn’t choose their careers based on a desire to master paperwork. Unfortunately, the ins and outs of account management are a necessary part of keeping your practice viable so that you can pursue your true vocation—medicine.
Submitting claims efficiently and effectively is a vital part of maintaining a healthy practice. According to the American Academy of Professional Coders, every denied claim is lost revenue because, even if the claim is resubmitted, the delay—along with the time it takes to redo the work of submission—takes away from your bottom line. In addition, delayed claims can also frustrate and anger your patients, damage your reputation, and potentially expose you to the risk of an audit. Here are some quick tips on how to optimize your coding process.
On target coding. Some medical billers can be tempted to up-code to a more severe diagnosis for greater compensation or under-code by lessening the severity of a diagnosis to ensure payment. Both approaches can hurt your credibility with insurance companies. Always code with accuracy.
Keep it together appropriately. Some billers like to code services separately is an effort to gain greater returns. If there is an appropriate code that encompasses all the components of a service, use it. This practice of unbundling is fraudulent and can expose the practice to unnecessary risk.
Training should be consistent. There is a tendency to fall into a routine when it comes to billing. Although consistency is important, awareness of the changing landscape is even more important. Make sure that the practice takes the time to train staff about coding with regularity.
Before the patient even enters the office. One wrong piece of information or one missing element and a claim will be denied. Verifying and confirming insurance coverage and patient information is something that can be started when the patient makes their appointment. The schedulers in your office should work off a script or checklist to make sure they have all the information upfront that is required. This information can then be verified again when they arrive for their appointment.