Medical Coding & Auditing
Overview
Medical coding plays a crucial role in the health care industry. It is a procedure of assigning standardized codes to the medical diagnosis & procedures. It is used in billing and claim submissions to determine how much reimbursement healthcare providers will receive for their services.
To overcome the medical coding errors which can pose compliance risk to the hospital a systematic review and evaluation of billing and coding practices is mandatory. It helps the healthcare industry improve the overall quality by identifying the discrepancies caused by incorrect coding.
Ultimately effective coding and timely audit contribute to the financial success of healthcare organizations.
Our End-to-End Approach
Medical coding and auditing services from MotivityRCM covers the entire process right from patient interaction to compliance verification and enables healthcare organizations to minimize errors and maximize revenue. We emphasize on accuracy and ensure adherence to the highest standards of quality. Our approach to medical coding and audit reinforces the financial well being of a healthcare organization. We have highly skilled and experienced medical coders and a dedicated team to perform regular coding audits to evaluate the effectiveness of billing procedures. Our important features are :
01
Prebilling documentation review
We ensure that every service given by the healthcare service provider is clearly and accurately documented in the patient's record and reviewed before billing.
02
Accurate medical coding
We have certified medical coders who stay up to date with coding guidelines and regulations and are highly skilled.
03
Efficient charge capture
We ensure that all the procedures and services are properly captured to avoid lost revenue caused by manual errors .
04
Specialized coding
We provide customized coding approaches to cater different levels of organizations depending on their unique requirement.
05
Real time coding support
We provide real time coding support and guidance and ensure the healthcare providers with prompt resolutions.
06
Effective coding audit
We proactively perform timely audits to identify inaccuracies before claim submission to maintain compliance.
07
Denial management
We use advanced technology to predict denials and identify denial trends which helps us to quickly resolve current issues and prevent future ones.
08
Analytics and reporting
Our Analytics help in analyzing data and provide insights allowing healthcare providers to make informed decisions in future.
Challenges
Higher denial rates
Incomplete documentation and coding errors are the prime reasons for higher denial rates
Resulting in revenue leakage.
Lack of proper documentation
Inconsistency in documenting the accurate details of patient data,services and procedures leads to lost revenue.
Ineffective claims processing
Due to manual errors in claims submission, the reimbursement process gets delayed and eventually revenue is also decreased.
Ineffective audit and compliance
Lack of regular auditing leads to undetected errors and non compliance can put the organization in financial and legal risk.
Difficulty in analyzing performance
It is a challenge to evaluate the performance and identify errors in traditional revenue cycle management.
Benefits
Increased efficiency: With accurate coding documentation can be streamlined and administrative tasks can be reduced resulting in increased efficiency.
Improved claim accuracy: Precise medical coding can help in reducing denial rate and thereby increasing the probability of claims to be approved on initial submission.
Reduced Denial rates: Proper coding prevents the probability of denials and the need of resubmissions is reduced to a large extent.
Enhanced Compliance: As coders adhere to the guidelines and regulations Organizations financial and legal standing will be protected.
Better Performance tracking: Coding can help in monitoring important factors like denial rates, reimbursements and helps in improving overall performance.
Our Expertise
Coding Excellence
Our certified and professional coders are up to date with all the coding standards and regulations and use automated coding tools .
Proactive Denial prevention approach
With our precise coding techniques we can help reduce denial rates and faster reimbursements and lesser delays.
Advanced compliance
Our compliance team conducts regular audits and takes precautionary measures to detect errors and provides resolution with the help of medical coders.
Comprehensive audit reports
We provide detailed reports with advanced coding analytics and help the organization make informed decisions.
Customized solutions
We provide customized coding solutions which can cater to the specific needs of each healthcare organization.
Enhanced Patient experience
Accurate coding helps patients receive transparent and itemized bill which impacts patience, trust and experience positively.
FAQ's
Medical Coding: It is the process of translating medical diagnosis ;procedures and services in medical codes. Accurate medical coding enables healthcare providers receive appropriate payment for their services adhering to compliance and regulatory requirements.
Medical Auditing: A systematic review of a medical coding process to identify errors and discrepancies and improve overall quality of the organizations financial wellbeing.
Medical coding is vital in the Recycle Management System as it helps in reducing claim denials, ensures accurate reimbursement, increases compliance and optimizes Revenue cycle.
Systematic coding audit helps the healthcare organization identify errors and discrepancies and ensures that they adhere to the regulatory guidelines and protect the reputation and financial stability of the healthcare service provider.