A thorough examination of your medical coding department is absolutely necessary to improve revenue cycle performance. Using this route, you may be able to recover money that was not properly charged for discharges or reduce denials caused by incorrect coding. To improve coding quality, medical coding analytics by organization or provider can help you uncover important documentation concerns.
Everybody wants to maintain a steady stream of incoming revenue. But the coding-related problems you find during your initial analysis and modifications can often lead to high-level solutions. On the other hand, you must continue to investigate your coding quality and make structural improvements in order to prevent the flaws that have been detected from resurfacing.
We’ve included some of the insights we’ve learned from creating high-quality coding programs in the hopes that they’ll help your medical coding company improve its revenue cycle.
Table of Contents
1. Getting the appropriate people on board
Medical coding is a time-consuming task that necessitates extensive training and experience. It’s not just writing code that’s difficult; it’s also implementing coding standards. It is also necessary to involve a dedicated coder in the evaluation of the current coding process.
Choosing medical coders who are capable of supervising the training process and making immediate modifications is therefore critical for practises and revenue cycle executives. Medical coders must also follow the organization’s coding standards and make necessary transitions at any time.
2. Conducting compliance audits
The basis of a successful medical practice is accurate coding. Coders have the authority to utilize standardized codes and guidelines to correctly evaluate clinical material. The healthcare practice’s quality compliance programs must have their support.
An audit of coding compliance can help determine the quality of clinical documentation by looking at a sample of charts for specific coders and their recorded codes. Increasingly, healthcare facilities are relying on third parties to conduct code compliance audits because they lack in-house auditing experience.
Compliance audits for coding that could reduce the number of denials can streamline the overall revenue cycle.
3. Using technology in the right manner
Owing to the digital revolution, paper-heavy methods have been replaced by more efficient and convenient alternatives. The healthcare industry’s revenue processing has seen a dramatic increase because of the advent of Electronic Health Records (EHR).
In addition to healthcare, technology has shown to be a valuable tool in all industries. Because of this, the right medical coding processing, issue rectification and approval technology could help your practice grow to new heights. Coding must be a component of the process in every EHR, but it should also allow users to select certain codes based on the documentation they have on hand.
For healthcare businesses, the Computer-Assisted Coding System (CACS) is an excellent example of an effective software that helps discover gaps in medical documentation and improve the efficiency and accuracy of medical coders.
4. Implement Effective Strategies
The next piece of advice is to put some time management techniques into action. You must begin each day with a certain objective in mind. In order to be on top of things, you must use this strategy. Afterwards, you’ll take stock of your accomplishments for the day.
Breaking down your coding work into manageable chunks might also help you improve your productivity. Taking this step will aid you in categorizing your jobs more quickly and accurately.
Moreover, accurate documentation is critical to the medical coding process’s ability to work. The coding process can be made more efficient, resulting in higher reimbursements, by using this method. Consult a Clinical Paperwork Improvement (CDI) specialist if your practice isn’t obtaining the precise documentation it needs to operate properly.
5. Comply with EMR procedures
It takes time and effort to deal with claim denials, as they necessitate extensive research, editing, and resubmission. Claim denial data can be used to discover coding issues that occur regularly.
At least once a month, if not twice a month, review coding denials with your coding team to identify the core cause of the top 5 to 10 code-related denials. A lack of understanding of the necessary codes for an operation or insufficient clinical paperwork in the hospital is typically the cause. Many of the current coding issues can resolve through the use of a brainstorming session to instruct coders on correct coding techniques.
In order to prevent repeating the same slip-ups over and over again, you should use system-driven validations. This will also aid in moving up the cash flow.
Additional Tip: Outsource your coding team
Today, it is common practice to outsource medical coding activities, including continuing coding and quality assurance programs. In these days of the revenue cycle labor crisis, it can be tough to find certified and experienced coders. If you’re looking for industry-specific expertise in coding, it can be even more difficult.
Outsourced coding can also help you speed up revenue cycle innovation because the partner you work with can make many changes to your coding workflow and thus increase the overall quality. Overall coding quality can improve by using their playbooks for various specialties and revenue cycle systems.
Low-quality coding can have a significant influence on your revenue cycle KPIs, regardless of whether you are dealing with a high rate of coding denials or a lack of skilled coders.
Many of the issues that lead to a high number of coding denials can eliminate by a group of professional coders. Accurate reimbursements are dependent on high-quality medical coding. Claims denials, unnecessary compliance concerns, and financial ruin can all be the result of medical coding mistakes.
Your coding team’s structure, processes, and systems must be re-examined in order to improve the quality of your code. It is possible to build a long-term model for providing high-quality coding services through the use of coding audits and a skilled team of coders and analysts.