The document provides 7 strategies for minimizing coding claim denials:
1. Code claims correctly the first time by ensuring coders have proper training in coding and specialty areas.
2. Understand submission requirements of top payers and Medicare as a standard. Improve communication between coding and billing departments.
3. Use triage methodology to identify and prioritize common denial reasons like registration errors or incorrect codes/modifiers for targeted training.
4. Expect some unavoidable denials and work to appeal denials of medical necessity by verifying documentation supports the claim.
5. Maintain strong audit protocols and educate providers to minimize EMR claim errors.
6. Ongoing training, certification, and specialty
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Presented by Aimee Heckmann
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Structuring Your Contracts for the Current ClimateKareo
Learn about the evolution of revenue cycle management and how to best structure your contracts now that patient responsibility is on the rise. Additionally, Aimee will walk through how to have tough conversations with clients when they are not being compliant.
Presented by Aimee Heckmann
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Kareo’s Billing Subject Matter Expert, Terri Joy, MBA, CPC, CGSC, COC, CPC-I, shares the 10 medical billing KPIs you need to know to prevent your practice from losing money.
Lean Strategies in Healthcare Revenue Cycle ManagementInvensis
Did you know? Revenue cycle inefficiencies accounted for 15% of 2.7 trillion spent on healthcare, or about $400 billion. Join Dr. Steven M Wagner to understand how to align continuous quality improvement through lean method for staff and management to overcome income obstacles in healthcare and help them to learn and experiment with strategies to address them.
Healthcare Industry Highlight: Revenue Cycle ManagementCascadia_Capital
In our most recent Healthcare Industry Highlight Report on Revenue Cycle Management, we outline the trends driving consolidation and increased market activity and make predictions on the outlook and future of the RCM ecosystem.
Claims Management - Edge through Efficiencyneetamundra
The objective of this paper is to talk about the current state of the claims process and how an efficient and ideal claims system should be. This document is most relevant for the Indian insurance industry.
HIPAA & OIG Compliance for Medical Billing Company OwnersKareo
The success of your business relies on timely billing and accurate coding. Whether you’re managing the billing for one provider or 50, it’s a complex job that must meet a variety of regulations, making it easy for medical billing companies to be the target of false claims and fraudulent crimes. As healthcare fraud continues to be a growing issue in the industry, medical billers are increasingly being held liable for their role in the submission of fraudulent claims.
Executive Director of American Medical Billing Association, Cyndee Weston, CMRS, CMCS, CPC, will provide an in-depth analysis of what can be considered fraud when submitting medical claims, how the government is enforcing guidelines, and what you can do to help protect your business as well as your practices.
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If you are a healthcare provider, it is almost inevitable that you will have to navigate through denials and payer audits. However, there are certain practices that can be implemented to better manage your denials, improve your claim quality, help you manage and track the challenges of audits, and reduce the overall chances of an audit and manage those you must undergo. If you don't know these best practices already, how could you?
On Thursday, June 7th at 11 AM EST, Etactics and Medical Record Associates hosted the webinar, Are Denials and Payer Audits still impacting your bottom line? It featured host Ray Dalessandro, Etactics' Regional Sales Manager, and special guest, Charlie Saponaro, the CEO of Medical Record Associates.
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In this webinar, Dr. Paul DeChant will:
-Review the manifestations and drivers of burnout and how you can reduce their impact
-Help you develop a plan, including building teamwork and solutions to problem-solve
-Show you how to improve efficiencies through changes to EHR office visits and in-basket workflows
-Explore how using technology in your practice can save time and remove barriers to better connect with your patients
What are the latest payment trends impacting the healthcare vertical? From electronic presentment and payment to mobile payments and beyond – what can we expect to see over the coming years?
In this live webinar, Valora outlines the three main stages of starting a medical practice:
1) Planning - creating a business plan, setting a budget and outlining your timeline
2) The Nuts and Bolts - finding a location, credentialing, administrative setup, and choosing the right technology for your needs
3) Opening - hiring staff and activating your marketing plans
2010 07 BSidesLV Mobilizing The PCI Resistance 1cGene Kim
Properly Mobilizing the PCI Resistance: Lessons Learned From Fighting Prior Wars (SOX-404)"
I have noticed that there is a growing wave of discontent and disenchantment from information security and compliance practitioners around the PCI DSS. Josh Corman has been an effective voice for these concerns, providing an intellectually honest and earnest analysis in his talk “Is PCI The No Child Left Behind Act For Infosec?”
The problem are well-known and significant: too much ambiguity in the PCI DSS, Qualified Security Assessors (QSAs) and consultant using subjective interpretations, existing guidance either too prescriptive or too vague, scope missing critical systems that could risk cardholder data, overly broad scope and excessive testing costs, excessive subjectivity and inconsistency, poor use of scarce resources, no meaningful reduction in risk of data breaches, and so forth.
For years, I have been studying the PCI DSS compliance problem, as well. I have noticed many similarities to the PCI compliance challenges and the “SOX-404 Is The Biggest IT Time Waster” wars in 2005. I was part of the leadership team at the Institute of Internal Auditors (IIA) where we did something about the it. We identified inability to accurately scope the IT portions of SOX-404 as the root cause of the billions of dollars of wasted time and effort, while not reducing the risk of financial misstatements.
I propose to present the two-year success story of the IIA GAIT project and how we changed the state of the IT audit practice in support of SOX-404 financial reporting audits. We defined the four GAIT Principles, which could be used to correctly scope the IT portions of SOX-404. We mobilized over 100K internal auditors, the SEC and PCAOB regulatory and enforcement bodies, as well as the external auditors from the 8 big CPA firms (e.g, Big Four and other firms doing SOX advisory work). In short, we made a difference, in a highly political process that involved many constituencies.
I am attempting to do something similar with the PCI Security Standards Council, through my work as part one of the leaders of the PCI Scoping SIG (Special Interest Group). My personal goal is to find a “third way” to better enable correct scoping of the PCI Cardholder Data Environment, and create a risk-based approach of substantiating the effective controls to ensure that cardholder data breaches can be prevented, and quickly detected and corrected when they do occur.
My desired outcome is to find fellow travelers who also see the pile of dead bodies in PCI compliance efforts, and work with those practitioners to catalyze a similar movement to achieve the spirit and intent of PCI DSS.
Business Risks discussed: #1 Claim/Problem, Telecommuting, Signage, Age of Connectivity, OSHA Visit, IT Firm Insurance, Power Failure: Spoilage, Business Auto Policies
Eight strategies to get paid - Revenue Cycle ManagementJames Muir
Join revenue cycle management expert Elizabeth Woodcock & James Muir to dissect the eight strategies for surviving and thriving in today’s turbulent reimbursement environment. This webinar will empower you with solutions to make your practice a top performer. In addition, attendees of this live webinar can quality for CEU credits.*
After this session, you’ll be able to:
Evaluate payer contracting opportunities and pitfalls
Determine contract management procedures to ensure appropriate payment
Implement effective methods of setting patient’s expectations for payment – before the visit
Apply time-of-service collections techniques
Develop denial prevention and management procedures
Assess technologies to support efficient revenue cycle management
Identify staffing needs for successful revenue cycle management
Differentiate the elements of reporting key performance indicators for revenue cycle management
Common challenges faced by Physicians and Practitioners with Medical Billingjennyvergeese
Medical billing refers to the process of filing and following up on claims with health insurance companies / providers in order to receive payments for the healthcare services rendered to patients by the practices / physicians. Medical billing serves as an effective channel between medical service providers and insurance companies.
Content marketing is a great way to build your brand online. With the right kind of content, you can build and optimize your brand on the Internet so that it brings more traffic to your website and more sales to your business. More importantly, it can improve the overall image of your business and results in more sales, referrals, and consequently, more website traffic. The cycle goes on and on.
HIPAA & OIG Compliance for Medical Billing Company OwnersKareo
The success of your business relies on timely billing and accurate coding. Whether you’re managing the billing for one provider or 50, it’s a complex job that must meet a variety of regulations, making it easy for medical billing companies to be the target of false claims and fraudulent crimes. As healthcare fraud continues to be a growing issue in the industry, medical billers are increasingly being held liable for their role in the submission of fraudulent claims.
Executive Director of American Medical Billing Association, Cyndee Weston, CMRS, CMCS, CPC, will provide an in-depth analysis of what can be considered fraud when submitting medical claims, how the government is enforcing guidelines, and what you can do to help protect your business as well as your practices.
Are denials and payer audits still impacting your bottom line?Matt Moneypenny
If you are a healthcare provider, it is almost inevitable that you will have to navigate through denials and payer audits. However, there are certain practices that can be implemented to better manage your denials, improve your claim quality, help you manage and track the challenges of audits, and reduce the overall chances of an audit and manage those you must undergo. If you don't know these best practices already, how could you?
On Thursday, June 7th at 11 AM EST, Etactics and Medical Record Associates hosted the webinar, Are Denials and Payer Audits still impacting your bottom line? It featured host Ray Dalessandro, Etactics' Regional Sales Manager, and special guest, Charlie Saponaro, the CEO of Medical Record Associates.
The value of pre adjudication in healthcare claims processing - banc tec's wh...Jone Smith
BancTec provides Healthcare payers and benefit administrators with pre-adjudication technologies thus replacing error-prone human process and providing application for document management, PPO network management etc.
Optimize Your Care Delivery to Prevent Burnout and Boost Your Bottom LineKareo
In this webinar, Dr. Paul DeChant will:
-Review the manifestations and drivers of burnout and how you can reduce their impact
-Help you develop a plan, including building teamwork and solutions to problem-solve
-Show you how to improve efficiencies through changes to EHR office visits and in-basket workflows
-Explore how using technology in your practice can save time and remove barriers to better connect with your patients
What are the latest payment trends impacting the healthcare vertical? From electronic presentment and payment to mobile payments and beyond – what can we expect to see over the coming years?
In this live webinar, Valora outlines the three main stages of starting a medical practice:
1) Planning - creating a business plan, setting a budget and outlining your timeline
2) The Nuts and Bolts - finding a location, credentialing, administrative setup, and choosing the right technology for your needs
3) Opening - hiring staff and activating your marketing plans
2010 07 BSidesLV Mobilizing The PCI Resistance 1cGene Kim
Properly Mobilizing the PCI Resistance: Lessons Learned From Fighting Prior Wars (SOX-404)"
I have noticed that there is a growing wave of discontent and disenchantment from information security and compliance practitioners around the PCI DSS. Josh Corman has been an effective voice for these concerns, providing an intellectually honest and earnest analysis in his talk “Is PCI The No Child Left Behind Act For Infosec?”
The problem are well-known and significant: too much ambiguity in the PCI DSS, Qualified Security Assessors (QSAs) and consultant using subjective interpretations, existing guidance either too prescriptive or too vague, scope missing critical systems that could risk cardholder data, overly broad scope and excessive testing costs, excessive subjectivity and inconsistency, poor use of scarce resources, no meaningful reduction in risk of data breaches, and so forth.
For years, I have been studying the PCI DSS compliance problem, as well. I have noticed many similarities to the PCI compliance challenges and the “SOX-404 Is The Biggest IT Time Waster” wars in 2005. I was part of the leadership team at the Institute of Internal Auditors (IIA) where we did something about the it. We identified inability to accurately scope the IT portions of SOX-404 as the root cause of the billions of dollars of wasted time and effort, while not reducing the risk of financial misstatements.
I propose to present the two-year success story of the IIA GAIT project and how we changed the state of the IT audit practice in support of SOX-404 financial reporting audits. We defined the four GAIT Principles, which could be used to correctly scope the IT portions of SOX-404. We mobilized over 100K internal auditors, the SEC and PCAOB regulatory and enforcement bodies, as well as the external auditors from the 8 big CPA firms (e.g, Big Four and other firms doing SOX advisory work). In short, we made a difference, in a highly political process that involved many constituencies.
I am attempting to do something similar with the PCI Security Standards Council, through my work as part one of the leaders of the PCI Scoping SIG (Special Interest Group). My personal goal is to find a “third way” to better enable correct scoping of the PCI Cardholder Data Environment, and create a risk-based approach of substantiating the effective controls to ensure that cardholder data breaches can be prevented, and quickly detected and corrected when they do occur.
My desired outcome is to find fellow travelers who also see the pile of dead bodies in PCI compliance efforts, and work with those practitioners to catalyze a similar movement to achieve the spirit and intent of PCI DSS.
Business Risks discussed: #1 Claim/Problem, Telecommuting, Signage, Age of Connectivity, OSHA Visit, IT Firm Insurance, Power Failure: Spoilage, Business Auto Policies
Eight strategies to get paid - Revenue Cycle ManagementJames Muir
Join revenue cycle management expert Elizabeth Woodcock & James Muir to dissect the eight strategies for surviving and thriving in today’s turbulent reimbursement environment. This webinar will empower you with solutions to make your practice a top performer. In addition, attendees of this live webinar can quality for CEU credits.*
After this session, you’ll be able to:
Evaluate payer contracting opportunities and pitfalls
Determine contract management procedures to ensure appropriate payment
Implement effective methods of setting patient’s expectations for payment – before the visit
Apply time-of-service collections techniques
Develop denial prevention and management procedures
Assess technologies to support efficient revenue cycle management
Identify staffing needs for successful revenue cycle management
Differentiate the elements of reporting key performance indicators for revenue cycle management
Common challenges faced by Physicians and Practitioners with Medical Billingjennyvergeese
Medical billing refers to the process of filing and following up on claims with health insurance companies / providers in order to receive payments for the healthcare services rendered to patients by the practices / physicians. Medical billing serves as an effective channel between medical service providers and insurance companies.
Content marketing is a great way to build your brand online. With the right kind of content, you can build and optimize your brand on the Internet so that it brings more traffic to your website and more sales to your business. More importantly, it can improve the overall image of your business and results in more sales, referrals, and consequently, more website traffic. The cycle goes on and on.
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It promises you modern and foolproof security and is best suited for anyone who values modern lifestyle while enjoying homely environment.
Imagine boarding a sailing ship of the Dutch East India Company in the 1700s and heading through the English Channel bound for the Indies. Your ship is the Diemermeer, a heavily armed cargo vessel that the Vereenigde Oost-Indische Compagnie (VOC) built at its shipyards in Amsterdam.
Claim denials are costly. Learn the basics of establishing a strong denial management process and strategies to place your focus on denial prevention. Learn to reduce your costs associated with collection on your claims, reduce your days in AR and maintain a healthier Revenue Cycle.
Denial Management in Medical Billing.pdfalicecarlos1
Medical Billers and Coders (MBC) is a leading revenue cycle company providing complete medical billing services. Our medical specialty-wise RCM experts ensure all the denied claims are addressed properly to receive accurate insurance collections.
It is now time for physician practices to get revenue cycles in order to improve financial performance. The entire process is complex in nature and often results in errors that negatively affect an organization’s profit margin.
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Common Challenges in Dermatology Billing and How to Overcome.pptxalicecarlos1
Common Challenges in Dermatology Billing and How to Overcome?
Dermatology billing faces challenges like incorrect coding, denied claims, and changing insurance policies. Ensure staff are trained in dermatology-specific codes and use robust systems for checking claims before submission. Stay informed about insurance updates and communicate clearly with patients about their financial responsibilities. Medical Billers and Coders (MBC) can help by ensuring accurate coding, timely claim submission, and effective follow-up on denied claims, allowing you to focus on patient care.
Read more about How to Overcome Challenges in Dermatology: https://shorturl.at/D7ANX
#DermatologyBilling #MedicalBilling #RevenueCycleManagement #HealthcareBilling #BillingChallenges #MedicalCoders #MedicalBillersAndCoders
How to Prevent Medical Billing Claim Denials?
MGSI provide best Anesthesia medical billing Services in united states. https://www.mgsionline.com/anesthesia-billing.html
Top 5 Challenges Faced by Medical Billing Services and How to Overcome ThemOmniMD Healthcare
Let us understand some common challenges that medical billing services face and how to overcome them. This will ensure optimized and consistent revenue streams for the healthcare facility or organization. For more details kindly visit us our website.
Navigating Dermatology Billing Common Mistakes and Best PracticesRM Healthcare
Explore the intricacies of dermatology billing in the United States with our comprehensive article, "Navigating Dermatology Billing: Common Mistakes and Best Practices." Dive into the world of dermatology billing services and discover the most prevalent mistakes that can impact your practice's financial health. Learn about the best practices and strategies to avoid these pitfalls, ensuring efficient and compliant dermatology billing processes. Whether you're a dermatologist seeking to enhance your billing practices or interested in the nuances of US medical billing, this article provides valuable insights to help you navigate this complex terrain effectively.
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For property and casualty insurers, the persistent and vexing problem of claims leakage can be effectively curtailed by applying digital technology with cutting-edge clarity.
Drastic electronic overhauls are revolutionizing dental practices and improving the ways offices record and track patients. However, with all this new technology, many dentists still find tracking patient health a primary challenge in maintaining their billing process. Another factor is getting paid.
Drastic electronic overhauls are revolutionizing dental practices and improving the ways offices record and track patients. However, with all this new technology, many dentists still find tracking patient health a primary challenge in maintaining their billing process. Another factor is getting paid.
Maximize your healthcare practice’s revenue by mastering denial management. Discover top strategies to reduce rejections and improve claim approvals.
https://mgsionline.com/healthcare-denial-management.html
1. Coding Denials: 7 Strategies
for Maximizing Cash
By Chris Klitgaard, CEO
with Kimberly Vegter, CPC, CPC-I, AAPC Certified ICD-10 Trainer
2. 1
There are really only a handful of possible
outcomes when a claim is being processed.
It may be paid correctly, be paid incorrectly or go unpaid.
And, of course, it may be denied altogether.
Denied. Let’s face it. There are many reasons a claim might be
denied. No coder or coding department is exempt from having
claims denied. It happens to the best of the best and to the rest.
So the true question is, given that the average claim denial
costs $251
, how can we minimize the loss that results from
coding claim denials? In fact, nearly 30% of total filed claims
are denied due to minor errors in coding and technical aspects2
.
That doesn’t take into account the many more that are denied
due to registration or billing issues.
Code It Right the First Time
The most obvious way to keep denied claims below the MGMA
benchmark of 4% is to send out a “clean claim” the first time,
and that entails more than just attention to detail3
. It requires
making sure the right people with the right training are in the right
positions. Coders should have focused training not only in coding,
but also in the particular specialty in which they are coding. The
coding discipline is both comprehensive and layered, so while all
coders must comply with the same set of general guidelines, each
specialty also has its own set of rules.
To complicate matters further, each payer has its unique claims
submission requirements as well as its own proprietary medical
policies. It’s very difficult to understand—and apply—every rule for
every payer. Just thinking about it can be maddening. Here’s an
alternative: understand the provisions for your organization’s top
five payers and remember Medicare sets the standard.
Rules and policies aside, communication among departments
within an organization can also affect the volume and frequency
of coding-related denials. Coders speak a language different
from their colleagues in patient accounting and claims processing
departments. Yet, when they understand the interdependence of
their roles as well as their intrinsic value to revenue cycle as a whole,
working toward the same goal—payment of claims—becomes
clear. When departments communicate clearly and regularly, claims
are submitted correctly and paid more quickly, more often.
Try Triage as a
Methodology
Sounds serious, doesn’t it?
The term triage is defined as
“the assignment of degrees
of urgency to wounds or
illnesses to decide the
order of treatment of a
large number of patients.”
Typically, triage is used in
reference to patient care
but it’s just as important
to the revenue cycle,
especially when there is
backlog of denials.
When a systemic problem
with denials exists, try
triage. Identify the barriers
to claims processing and prioritize those areas. For instance, if
several claims are held or denied for registration issues such as
incorrect ID, eligibility, coverage termination or group number, then
training is needed for the staff responsible for intake. If claims are
rejected for modifier usage, specificity or sequencing, then training
is needed for your coding department. Denials also occur for
failure to pre-certify or preauthorize, fee schedule issues, duplicate
claims and so on. These are general billing issues that are handled
by your patient accounting office.
Clearly, there are many ways to go wrong. Identifying areas
of concern and addressing them with training and education
will minimize denials that would otherwise slow down your
revenue stream.
TRAINING TIP
Everyone from intake to collections
plays a role in creating a “clean claim.”
TRAINING
TIP
Not everyone
processes
information in
the same way.
Incorporating a
variety of learning
styles into your
coding training
model can prevent
a coder from being
left behind.
3. 2
a problem does arise. Big picture aside, painstaking attention
to detail is a desirable trait among coders. Why? Because
transposing a number when entering a date-of-birth or insurance
ID causes claim rejection just as easily as using the wrong
modifier or ICD-9 code.
Precertification is another small step in a larger process that
can have a detrimental effect on your A/R. Most managed care
organizations necessitate approval for certain procedures and
admissions; without it, payment will be denied. Be sure you have
a process in place so that neither precertifications for admissions
nor prior authorizations for procedures fall through the cracks.
All That Said, Expect Denials
There are some denials that are destined to occur no matter how
diligent you are in submitting clean claims. Without question, the
most dreaded denial is “not medically necessary.”
Stay on top of these denials by taking steps to appeal them as they
occur. First and foremost, make sure the claim is indeed medically
necessary. This may require some research on the part of your
coding staff or even a query to the provider. Once you have verified
that the coding is correct, the documentation is adequate and the
medical decision-making is appropriate, proceed with filing the
appeal. Supply the appropriate medical records and, if necessary,
include articles, images or even a letter from the provider to
support the reason for the service.
Another common source of denials occurs when providers submit
claims directly via their electronic medical record (EMR), thinking
that their claims are being submitted accurately. In truth, that’s
often not the case, but these occurrences can be minimized by
having a strong audit protocol in place. When coders and providers
work together, a clean claim is more likely. Further, educating
providers on documentation practices can enhance best-practice
coding methods.
Train, Train, Train
Educating the coding team is a never-ending process, as the
discipline is constantly changing. Failure to keep up will result
in paying for these deficits in more ways than one: reduction of
revenue, penalties for noncompliance, pre-payment audits and
post-payment audits.
And that’s why credentialed coders are critical to every
team, regardless of size and scope. Coders actually reduce an
organization’s risk because they understand coding conventions
in various code sets and because they are required to take
continuing education credits annually to maintain their credentials.
One survey indicated that only half of the medical billers and coders
are certified; however, considering the increasing competition and
coding regulations, certification is expected to become a necessity
by 2020 with employers expecting applicants with certifications
before hiring.4
Among many coding credentialing entities, the American Academy
of Professional Coders (AAPC) and the American Health Information
Management Association (AHIMA) are nationally recognized and
considered the standard for coding.
While certification and continuing education are vital to keep up
with edits, regulations and changes in payer policies, it is also
essential to have specialty-specific training. Staying current with
the changes unique to a specialty will help maintain the efficiency
of the revenue cycle.
Stop Making Silly Mistakes
Denials received from payers are inevitable. To minimize avoidable
denials and improve turnaround time, focus on decreasing the
number of “little” mistakes, as they have far-reaching effects.
Again, making sure you have well-trained staff who see the big
picture—the role of coding in the revenue cycle—is paramount.
Coders must understand the importance of entering patient data
correctly into the system and know how to trouble-shoot when
OF PROVIDERS
DON’T HIRE
CERTIFIED CODERS5
OF CODERS ARE
EXPECTED TO CODE
OUTSIDE THEIR
SPECIALTIES6
26%
31%
TRAINING TIP
There are three main types of adult
learning styles: visual (seeing), auditory
(hearing) and kinesthetic (touching).
Incorporating all three into your
training model for coders is optimal.
4. 3
Not allowing a coding denials backlog to build is definitely best
practice, yet many coders find themselves struggling with too
many denials—or simply too much coding work in general—and
too little time.
Attack Backlog—NOW!
What if you are way behind? If you are drowning in coding-related
denials, you have multiple options: lighter fluid and a match,
prioritizing your work or asking for help.
While most coders would be more than happy to eliminate their
denials via fire, this approach is actually not recommended.
Acknowledging the awfulness of working coding denials, though,
is the first step in making them manageable.
It’s common practice among coders to address denials last—
after coding and submitting charges, after answering emails and
phone calls, and after every other assigned task, including a walk
down the hall or around the block for an afternoon latte. Working
coding denials is just plain undesirable. But, it’s still important to
the revenue cycle because it quickly brings in revenue that would
otherwise be lost. Paying attention to corrected claim timeframes,
appeals deadlines and timely filing limits keeps denials moving
toward the overall goal: payment.
Try these tactics to force coding denials work back to the top of
the to-do list:
• Block out time daily to work backlogs.
• Break down the sheer volume of coding denials into manageable
chunks to make the task more palatable and attainable.
• Measure results at the bottom line. If you track the payments
received as a result of coding denials worked, you’ll find
validation in making this tough task a priority.
Knowing when to ask for help is also critical. If daily prioritization
of coding denials isn’t enough, consider a proven coding partner
to manage this aspect of your revenue cycle.
Share the Workload
According to a 2014 report in LinkedIn Pulse, “more providers will
outsource their billing in 2015 than ever before.” (Harold Gibson, 2014)
More and more providers are looking for proven partners to serve
as extensions of all or a portion of their revenue cycle operations,
and coding is no exception. Knowing when and why to consider
an external partner is important, because even if one is not the
right fit for your organization today, it may be in the future.
An honest look at the sheer volume of coding work is a good
place to start, and backlogs are a primary indicator. Also,
consider whether there have been significant staffing changes,
or if coding is generally understaffed. Finally, pay attention to
increases in the number of providers, both sudden and gradual.
If growth in coding has not mirrored growth in providers, coding
will inevitably fall behind.
0%
Strongly
Agree
11%
Agree
47%
Disagree
37%
Strongly
Disagree
5%
10%
20%
30%
40%
50%
7804 RESPONDENTS
Physician(s) in my office have a solid
knowledge of coding and compliance rules.7
91%
82%
WHILE ONLY
of coders said accuracy
of coders said productivity
When asked about the prime directive
of the manager8
: