Effective Centricity or EPIC coding is the best way to fight off rising business costs in your medical practice. The CPT and diagnosis codes used when submitting claims determine how much your providers get paid for the work they do. Therefore, it’s essential to ensure your coding procedures are optimized for success. Below are five ways you can begin to code more effectively at your medical practice.
1. Learn from Rejected Claims
If your practice’s claims denial rate is higher than five percent, you need to identify the issue. The most common reasons for rejected claims include missing information, insufficient documentation, coding errors, and late submissions. In order to prevent rejected claims, you need good communication between your Centricity medical billing staff and physicians to ensure the right codes are being submitted to your payers. Keeping the lines of communication open between your practice and your payers can be equally effective too.
Payers also frequently deny claims for services that are deemed “not medically necessary,” either because the diagnosis did not relate to the services or because it is only covered at certain rates. If this is the case, confirming insurance coverage and authorizations before each visit can minimize the number of denied claims. Being vigilant every step of the way, from booking appointments to submitting claims, is necessary to prevent coding error rates.
2. Communicate with Your Patients
Being knowledgeable about your policies and communicating them effectively to your patients goes a long way. With a better understanding and communication of payment policies, your staff can work more closely with patients to verify correct insurance information and submit claims accurately. Being clear about your costs is also important. Always tell your patients what treatments and procedures cost so they can determine if it fits their budget and is covered by their insurance. Check their coverage prior to their appointment as well to factor in all costs into your discussion.
3. Train your Providers
The best way to help physicians improve their Centricity or EPIC medical coding is training. Although your practice should already well versed with ICD-10, staying up-to-date with a new coding system is difficult. You have to make sure you and your physicians are learning and complying with new coding and documentation regulations and standards in order to receive the maximized reimbursement for services. Although it can be frustrating, there’s no reason to let this affect the productivity and profitability of your practice.
4. Monitor Denials and Rejection Trending
If you notice that your medical practice has an increase in denied and rejected claims, taking the time to evaluate what’s going on and identifying if there are trends present is essential. For example, you may find that claims with one particular insurer are rejected more often than others. You may also find that a particular diagnosis code leads to more rejected claims, or that there are insurer requirements and payor-specific edits going unnoticed causing increased denials. Identifying the reason behind the increase in denials and rejections can help your practice adjust policies and procedures to efficiently increase your clean claims rate. Health 1’s Centricity and EPIC billing service uses extensive code scrubbing rules to minimize these types of errors
5. Partner with Health 1!
Proper coding education for your physicians and office staff can mean greater revenue and more efficient operations for your practice. by partnering with Health 1 we can provide the feedback loop necessary to improve coding and increase revenue.
Our mission is to enable your practice to collect the maximum reimbursements for your services, while also supporting the management side. This way you and your fellow physicians, nurses, assistants, and staff can focus on taking care of your patients’ needs.