How to Retain Your Coders & Revenue in 2013?

The scenario where the upcoming ICD-10 in 2014 will replace the existing 17,000 codes with over 150,000 diagnosis and procedure codes, along with the enhanced granularity – clearly reflects the importance of retaining coders in 2013 to help in the eventual revenue procurement.

Even though improved patient care is expected eventually, initially the ICD-10 mandate is bound to disrupt existing healthcare operations, making it imperative for physicians to realign their operations along with staff requirements.

Industry Standards

Hence retaining coders & revenue becomes an imperative step for the physicians

Why the urgency to retain coders?

Coder’s relevance & expanding role amidst changes

• Upcoming ICD-10 makes accurate medical coding imperative to achieve the right financial equation
• Experienced medical coder knowledge is not only required for enhanced productivity but also for potential red flags and other nuances that can affect reimbursement

Additionally ICD-10 will also impact coders and lead to - Higher number of physician queries, Decreased coder productivity, More delays during authorizations, Increased number of claim rejections and denials, Inaccurate reimbursement and Reduced cash flow

Industry Challenges while retaining coders

• Even though the total number of coders may be adequate yet experienced coders are highly difficult to find and retain
• BLS projects average job growth levels to rise 20% by 2018 much higher than average- hence shortage of experienced coders is also predicted to increase considerably
• According to AAPC 28% of their 100,000+ members are over 50 years; while only 5% are 25 years or younger, depicting an inevitable gap of experienced coders soon

Industry challenges on revenue & billing

• Revenue is also impacted due to the CMS Recovery Audit Contractor (RAC) Program. The AHA’s February 2011 report depicted an aggregate of $86 million in claims denied via RAC with the most prominent reason being incorrect coding
• Billing issues are also poised to increase as the aging population grows and more individuals move to government-supported programs. However generally with Medicare and Medicaid the reimbursement received under these categories is considerably lesser than the cost of care

These challenges depict that coders being high in demand may be willing to shift either to organizations that offer higher pay, or that offer slightly lower pay but fewer coding complexities.

Avenues to improve Coder Retention & Revenue:

• Involving coders in the ICD-10 transition will help coders achieve higher satisfaction
• Evaluating the coding team’s strength which is useful in strengthening skills
• Working with the coding team to set up - Coding-related training, anatomy training, code set training along with training on the specific technologies
• Additional support systems for coders to ensure appropriate quality control measures
• Organizations will need to do advance planning by creating new staffing models
• Recognition for work well done can serve well in retaining good employees

The multi-year, costly process of ICD-10 implementation comes at a time when many healthcare organizations are already grappling with financial issues. Moreover physicians short of time to implement all the steps may benefit by appointing a billing service to increase their revenues

Retain your revenue with MBC’s Billers & Coders

MBC‘s billing experts are already preparing for the challenges to ensure optimum revenue by:

The above findings highlights the need for proper training and support of experienced coders, MBC has been assisting in revenue maximization for over a decade now for physicians across the 50 US States, with the help of our highly qualified medical billers and coders.