Family practices lose approximately 10-20% of revenue every year due to coding errors. Due to this, it becomes important to have a team of certified, well-trained coders who are capable of handling coding complexities and collecting revenue from different insurance carriers.
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With government and insurance rules changing constantly, family practices face coding changes every year. In order to manage these changes, family practitioners need to:
- Review the coding changes
- Study the CPT manual carefully
- Follow the documentation guidelines
- Assess the impact of coding changes on their practice
- Create a plan to handle the changes
Family practices will have to do a lot of planning before the implementation of ICD-10 this year. Since majority of revenue for a typical family practice is generated by submission of CPT and ICD-9 codes to third party payers, small coding errors can lead to disrupted cash flow.
Reduced revenue can lead to reduced number of support staff, shrinking compensations and limitation on equipment and supplies. When combined, these factors will not only affect the financial health of family practices but providers will also become unable to hire trained coders or buy the latest EHR.
Is your family practice making these coding mistakes?
If your family practice is missing revenue, there are certain mistakes your coders might be making. These mistakes need to be reviewed and corrected to prepare your practice for future coding challenges.
- As a family physician you must see if the encounter forms of your practice are up-to-date. If the forms have not been updated for more than five years, you may be losing various revenue opportunities. It is a time consuming yet vital task
- You will have to substantiate the medical necessity of the services being provided by your family practice. From selection of ICD-9 code or codes valid for a visit or other service to linking the codes to associated CPT code, the process should involve you along with your coders and billers
- Time will be required to select and document appropriate levels of E/M services which is another challenging task
- Data related to coding patterns will have to be gathered from your billing system to determine whether or not your practice is losing revenue due to under-coding
- As a provider you will have to learn the rules of using modifiers because modifiers can be the difference between denials, full reimbursement or reduced payments
- Make sure that charges are being captured for the services provided
Fulfilling these tasks can be a challenge for family physician due to lack of time, money and resources. Therefore, they seek assistance from a reputed billing company to ensure error-free coding for maximum reimbursements.
Medicalbillersandcoders.com is the largest consortium of trained coders and billers, offering effective billing solutions to family practices across the US. Our coders are certified, updated and they make use of the latest technology to ensure that your practice receives payments on time.