The systems for medical billing and coding are extremely complicated. Even the most organized billing department may find itself at a loss when faced with a cacophony of codes. What makes matters more complicated is having someone who may be performing some grunt work to file claims, meaning that the likelihood of error will continue to soar. These errors may result in a waste of both time and money on a scale that is difficult to fathom. Unfortunately, even the smallest mistakes in medical coding are responsible for the majority of claims being denied or payments being delayed. Additionally, the relationship with the patients might be affected negatively when errors occur frequently. The question now is how can beginners carry out medical coding in the right way while minimizing errors? To aid with your daily job tasks, we have devised some medical coding tips for beginners.
Medical Coding Tips for Beginners
Here’s how you can prevent medical coding errors and ensure accuracy:
#1-Verify the Benefits That Can Be Availed
If a provider is able to verify the patient’s benefits at the location where the service is being rendered, then a significant number of errors will be avoided. It may be difficult to refrain from using a patient’s previously entered information if the person is a regular. On the other hand, it raises the risk of errors in the event that the patient’s insurance provider, terms of service, and limit of policies are modified. Independently verify and discuss crucial information e.g., approvals, co-payment alternatives, the insurer’s coverage term, and the health care benefits.
#2-Check Inconsistencies in Patient Information
Incorrect information regarding a patient’s name, sex, or birthday might be grounds for the denial of a claim. If the patient is dependent on a primary insurance holder, then it becomes even more important to have matching information that includes the policy and the group number of the patient’s primary insurance holder.
#3- Ensure Accuracy in Diagnosis and Procedure Codes
In order for the insurance company to successfully reimburse a healthcare claim, it is crucial that the procedure code and the diagnosis are both accurate.
The following are some of the situations that could result in claims being deemed invalid:
- The insurer makes certain incorrect or false assumptions
- Use of wrong codes
- Engages treatment when it is not required for medical reasons
- Carries out the process without the necessary approval
Make sure that the employee responsible for billing has the proper training in medical coding. It is absolutely necessary for providers to make use of the most recent coding books as a reference, in order to prevent making costly mistakes.
#4-Make Sure Your Electronic Medical Records Are Correct
It is possible for claims to be turned down if a doctor writes an incomprehensible prescription or in a manner that is difficult to understand. If the workers who are responsible for billing get the impression that the codes are hard to understand, they need to be trained to ask questions. You also have the option of switching to billing systems that are fully automated. On the other hand, insufficient training in using the system could result in more billing errors being made.
#5-Avoid Double Billing
Consider getting an audit done so that you won’t have to deal with the headaches that are associated with double billing in the future. The provision of bills for operations that have been rescheduled or canceled increases the likelihood that the claims will be disallowed. This is among the common blunders that people make. Auditing patient charts regularly can be an effective way to thwart the spread of errors.
Bonus Tip: Submit Complete Data!
When you submit data that is incomplete, you should anticipate denial of reimbursement or a delay in receiving it. Claim processing can be adversely affected if the fourth and fifth digits are skipped, or if there is no link established between the diagnosis code and the Healthcare Common Practice Coding System code or the Current Procedural Terminology code.
Putting these Medical Coding Tips to Good Use – The Psych Biller
We hope these medical coding tips proved useful! The remote medical coding services offered by The Psych Biller are the go-to option for healthcare providers looking to code diagnoses and patient invoices in a manner that is both accurate and efficient. If you are wondering about how to prevent errors in medical billing and coding, you can put your anxieties to rest because the medical coders on our team have years of experience in the industry. Get in touch with us if you are interested in outsourcing your remote medical coding needs!