Top 7 Ways to Improve Medical Coding for Your Practice
When it comes to ensuring potential claims and enhancing revenues, medical coding plays a crucial role in the entire process. It significantly impacts the RCM performance that decides the accuracy of claims that are submitted to the insurance payers. So, it is indeed imperative for medical practices to take their time to analyze and choose their coding experts.
Medical coding not only produces clear claims but also helps identify issues associated with the clinical documentation, thereby bringing in the dollars without compromising on quality. However, it is also important for coders to regularly carry out effective corrections to ensure that coding-related issues do not reappear. Appointing the right coding team can help reduce coding-related denials and increase your first pass ratio, which is an essential aspect of any healthcare practice.
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Here are seven ways to incorporate into your practice in order to improve medical coding quality:
1. Right use of technology
The digital era has brought several convenient solutions that paper-heavy systems lacked. The emergence of Electronic Health Records (EHR) has brought about a drastic uplift in revenue processing for the healthcare sector. Technology has proven its efficacy not only in healthcare but also in all the business sectors. Therefore, leveraging the right technology for medical coding processing, issue rectifications, and approval could take your practice’s growth to new heights. Every practice should look for an EHR that integrates coding as part of the process, and on the other hand every EHR should enable the users to choose the right set of codes based on the documentation. Computer-Assisted Coding System (CACS) is a good example of an effective software that helps healthcare organizations to introduce an efficient coding system by identifying gaps in medical documentation and improving coder productivity and accuracy.
2. Hiring the right resources
Medical coding is a tedious process that requires a lot of knowledge and skill. On top of that implementation of standard coding is yet another complex task that requires talent. Evaluating the existing coding practice also requires the involvement of a dedicated coder.
Therefore, it is important for practices and revenue cycle leaders to choose medical coders who can oversee the training and make necessary shifts then and there. Medical coders must also adhere to the organization’s coding standards and make required transitions at any point if required.
3. Frequent Guidelines and Coding Updates
Make sure that your EHR follows all latest coding updates. If not, take steps to align the system to the required standards. Update coding standards and guidelines on the go to ensure complete transparency and to enhance the EHR/PMS compliance with the latest guidelines.
These are important aspects to update so that your practice does not end up in incorrect application of coding guidelines resulting in increased denials.
4. Conducting compliance audits
Accurate coding is the keystone of a highly profitable healthcare practice. Coders are empowered to use standardized codes and follow appropriate guidelines to interpret clinical documentation properly. They must support the quality compliance programs initiated by the healthcare practice.
Performing a coding compliance audit will help to evaluate a sample of charts for individual coders and their recorded codes, thereby, ensuring the quality of clinical documentation. Healthcare facilities these days are seen to substantially turn to a third party for coding compliance audits to overcome the audit expertise that they lack within their practice.
The entire revenue cycle process can be streamlined through compliance audits for coding that could help decrease the number of denials.
5. Accelerate your Documentation process
The efficacy of the medical coding process majorly depends on the accuracy of the documentation. It is also the easiest way to attain efficiency of the coding process, thereby increasing reimbursements. If your practice is failing to obtain proper documentation, then consult a Clinical Documentation Improvement (CDI) specialist to help attain the level of precision that documentation must possess.
6. Adhere to EMR workflows
Handling claim denials takes time and entails a lot of research, editing, and resubmitting. Analyzing your claim denial data can assist you in identifying coding problems that occur frequently.
Review coding denials with your coding team regularly, at least once a month, if not twice a month to determine the root cause of the top 5 to 10 coding-related denials. It’s frequently due to a lack of understanding of the proper codes for a procedure or incomplete clinical paperwork in the hospital. A brainstorming session can educate coders on proper coding practices and help you resolve many of the existing coding challenges.
Creating system-driven validations will help you avoid making the same mistakes over and over again while also speeding up cash flow.
7. Outsource your coding team
Outsourcing the RCM process is currently a prevalent routine followed by several medical practices to uplift their revenue cycle productivity. The current manpower shortages for coders have led these organizations to shift their coding game to expert hands. An outsourced coding team accelerates the quality of the entire revenue cycle.
On top of these, an additional tip that could contribute to the enhanced productivity of your coding team is to right-size them for a proper balance of workload and to set realistic goals to improve morale.
To address coding quality issues, you’ll need to take a comprehensive look at your coding team’s structure, methods, and systems. And for that, practices need to follow the correct ways to achieve success in the coding strategy.