Between scheduling a visit and receiving payment for the care provided, there’s a lot that goes on, and there are many opportunities for processes to slow down or back up.
Since you are laser-focused on receiving proper payment for the care you provide, make it your priority to regularly review the “quiet” areas of your revenue cycle—the areas that “squeak” only when they are truly broken. Coding is definitely one.
Long-term, or short-term, or even within a specialty, staff shortages mean you’re not meeting goals for charges out the door.
A partner who truly acts as an extension of your coding operations will take time to learn about your organization, staffing models, and policies. They will already be fluent in the specialities you need. Case in point, at MediRevv, we’re constantly cross-training coders behind the scenes, so that we’re ready to step up to any need at the precise time a request is made.
An excellent outsourced medical coding operation not only relieves staffing and quality stressors, but also streamlines processes and creates efficiencies for the whole revenue cycle.
Coding-related denials are a serious issue, because not working them costs you money. They are a challenging aspect of the coders’ responsibilities and often at the bottom of the list of priorities.
But correcting any inefficiencies in your coding workflow is vital to resolving anything that is slowing down reimbursement.
It’s always much easier to complete a task correctly the first time than to go back and make revisions later. With time being our most valuable and limited resource in the workplace, finding enough of it to get through our current list of daily tasks is challenging. In terms of the revenue cycle, when claims are denied, it takes time to process them.
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There are many reasons to audit your coding operation, especially for compliance. For instance, CPT, ICD-10 and HCPCS code sets are updated and published annually so the need to audit for compliance is continual — and that’s without even mentioning the time-consuming, difficult task of keeping up with Medicare and other payers’ medical policies.
Hiring an external source to audit for coding compliance will uncover any issues with current regulations so they can be corrected or prevented proactively. An external audit will also reduce the risk of improper documentation and mistakes, minimize the risk of fraud and ensure that Medicaid and Medicare standards are being met, among other important goals.
A coding compliance audit is an imperative step toward continuous improvement of your coding operations.
There is understandably a lot of confusion around proper COVID-19 diagnosis and treatment codes, when to use modifiers and which ones to use. This pandemic has thrown a curve ball to providers, payers, and regulators simultaneously.
For revenue cycle leaders, early uncertainty led to improper documentation and coding, and the outcomes were quickly evident—denials, improper payment (especially underpayment), and more. But this doesn't have to be your story.
We can become part of your COVID-19 dream team, or we can start by simply arming you with information. Our COVID-19 Coding Guidance will help ensure you're getting clean claims out the door quickly amid our national public health emergency.
Get COVID-19 Coding Guidance
I have had the pleasure of working with MediRevv for the past two years in a variety of projects.
Their coders have a vast array of knowledge and experience in many different specialties and have been able to step in and assist Unity Point with complex auditing and coding reviews. They are timely and thorough and have been able to provide in-depth reports and analysis.