The procedural and diagnostic codes used to submit claims for reimbursements mandate 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 four ways you can begin to code more effectively at your medical practice and improve your Centricity Medical billing or your EPIC Medical Billing.
4 Ways to Improve Medical Coding
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 medical billing and coding staff,and physicians to ensure the right codes are being put on claim forms. Keeping the lines of communication open between your practice and insurers can be just as effective too.
Related: Improve Medical Billing Collections by Front Desk – 5 Tips
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, clearly explain the coverage policies of each plan, 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 STAFF
The best way to help physicians improve their coding is additional 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 TRENDS
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.
Related: 2 More Metrics To Measure Medical Billing Financials
Our mission is to enable your practice to collect the maximum reimbursements for your services by managing your Centricity Medical billing or your EPIC Medical Billing. This way you and your fellow physicians, nurses, assistants and staff can focus on taking care of your patients’ needs. We promise to effectively communicate with you and your practice, and go beyond your expectations. Contact us today for more information on our revenue cycle management services.
Leave a Reply