Picture this: You manage a high volume of medical coding on a daily basis, all bills and codes are error-free, your processes are efficient, you submit accurate claims to payers for full reimbursement, and you sustain your revenue cycle. Even the largest of health care facilities and most organized coding departments aspire to achieve this and thus prevent thousands of dollars in revenue loss. Here’s how you can reduce medical coding and billing costs:
Strengthen internal coding and billing processes
The billing and coding process involves many steps starting with assessing patient charts. Ensure you have the required tools, resources, and technology to support the entire medical coding cycle. Issues like lack of skilled coders, wrong patient information, non-compliance to guidelines while processing the bill, and allocating the wrong codes, slow down the process. These are said to together cause 90% of denials.
Institute processes for each step of the billing cycle including reviewing documents before submission to ensure all your claims are reimbursed.
Build a robust data management system
Errors in the medical coding begin right at the onset of the revenue management cycle i.e. while recording patient information. Entering wrong patient data can lead to denial of claims despite using the right modifiers and codes. Other issues accruing to improper data management include coding issues, pending invoices, and itemized bills.
Stay updated on changes in rules and regulations
Incomplete information on medical billing rules and regulations leads to $125 billion in uncollected revenue each year. To avoid such hefty losses, organize frequent training and use the latest coding manuals i.e CPT & ICD-10 codes. Conduct audits before the final submission to insurance companies or payers to ensure correct codes are input.
Outsource to coding and billing service providers
It is difficult to maintain the required infrastructure and resources for medical billing with increased pressure on the healthcare system. A good option here is to outsource to third-party coding and billing providers. These specialists stay current on changes in coding and are thorough with compliances, thereby reducing the chances of any errors.
Install AI-powered solutions
Medical coding is one of the most challenging facets of revenue cycle management. Issues like skill gaps cause wrong coding, thereby disrupting the entire RCM. Yet, you can reduce them by integrating AI into the medical billing and coding process.
AI-powered solutions like Medicodio, when integrated into systems, help with providing the right code. This saves time, reduces massive human effort, decreases revenue loss, and also saves on human resource-related expenses.
Book a demo here (link) to see the transformation in your billing and coding
MediCodio is an AI-powered coding tool that reduces medical coding costs and improves efficiency by up to 45%. A great fit for RCM companies and hospital billing departments, Codio suggests medical codes(CPT, ICD10, HCPCS, modifiers) by reading patient demographic info from EHR systems and Physician Notes/Chart. After the medical coder makes a selection from the list of suggested codes, CODIO sends your codes to the billing system.
Data sources: https://healthiertrajectory.com/medical-billing/