If your practice worked with a medical coder prior to 1980, it’s likely that they would have been responsible for manually transcribing patient information relating to their visit to your clinic into an electronic code that was then stored in a database for insurance claims and other information.
As you can imagine, this would not only have been time consuming, it would have been a very inefficient way of processing this type of information, which led to several problems occurring when submitting claims to insurance companies (which would have been submitted via mail or fax). Common issues that arose with this old school system included incorrectly billing patients or miscommunications between insurance companies and clinics.
Of course, this has evolved greatly in the past few decades with technological advancements. Now, user friendly web based software, system interfaces, patient driven data entry, clearinghouses are more are used to gather and process this information.
But it’s not just about the technology in medical billing and coding that’s changed, it’s the entire systems and processes around handling this for your clinic that’s changed.
Relying on just an practice management system (PM) isn’t the best option
Relying just on your PM system to manage medical billing and coding is a risky business. Not only are medical coders important in keeping correct and up-to-date claim data for patients, but they also need the right medical procedures and terminology to stay on track. And change is constant. Technology continues to advance rapidly in the healthcare profession, so that means there are going to be changes in the way medical billing and coding is handled.
Simply having access to a PM System isn’t going to support you in these changes.
Certified medical coders that are current and up-to-date with the latest technology are hard to come by, which is why it’s important that you only work with those who have current qualifications to match the ever-changing environment that is the medical billing and coding industry. In addition, they need the right attitude and skills for learning new technology.
But what if your systems and processes don’t update to stay in line with the fast, changing pace of the medical billing and coding industry? What if what you’re currently using was inefficient and open to errors? Too ‘old school’ for insurance companies to work with effectively…
Perhaps now is a good time to consider upgrading your system and software options.
Where the right technology can help
Medical billing is complex and always changing, which can make it difficult for any healthcare practice to effectively stay on top of billing and coding changes. This can lead to errors in billing, delayed billing (aka delayed income), and having staff who are not adequately equipped to work with complex medical billing and coding standards. All of this ends up costing where it hurts the most. Your bottom line.
And while system edits and patient driven data collection will never fully replace humans in the medical billing and coding functions, they can reduce errors in patient information collection and lower the cost of healthcare.
With the right technology partner and qualified medical billing and coding professionals, your clinic can save money in the long run.
If you’re a specialty medical clinic, it’s likely that you’re running at more than 20% in 90 days+ A/R. Working with the right medical billing company could see you enjoy less than 10% average in overall 90 days+ A/R.
What would that mean to your bottom line?
Why working with a certified medical coder is essential
The US Bureau of Labor Statistics states that the medical coding profession is set to grow by 8% between 2019 and 2029, one of the fastest-growing job markets. And with such a demand for this profession, it’s important that your clinic works with properly certified experts who understand the process from start to finish, including the right software to streamline the process.
Certified coders review your provider coded claims and validate the correct coding. This serves two purposes: to get the claim paid AND to give feedback to the provider so they know how to code the same claim in the future. Overtime, many of the mistakes will fade as providers learn how to code correctly. In addition, your AR volume will drop so staff have fewer rejections and denials to work. This result in more productive providers with fewer support staff with higher revenues.
Working with a certified coder is more important than ever.
Is it time to update your medical billing and coding practices?
By now it should be obvious that using the right medical billing and coding company is a great benefit to any healthcare practice. Medical bill and coding is an important aspect of your business, which is why you want to make sure you’re minimizing errors and reporting data correctly.
Using the right technology partner will soon pay for itself, particularly when you see your billing denials go down.