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New Demands on Medical Coding Professionals: A Look Ahead

Any initiative when taken comes with a lot of challenges. When it comes to medical coding and the process, experts believe that nothing can be more effective than this only if done properly. It has a great impact on the overall revenue cycle and streamlines the documentation process. It speeds up the billing process by reducing the number of returned and rejected claims.

Medical coding services and the associated processes might seem simple. But these are filled with challenges. They seek enormous attention, precision, and detail. According to the professionals associated with the job, medical coding is a two-way process and hence, any error in the documentation adds to the woes. The fault in any of the steps means that the revenue cycle is going to be delayed. This would lead to lost revenue because of paybacks or under-coding.

Specialties that Need Special Attention

Medical coding services play a crucial role for every department. However, some departments like gastroenterology and cardiology are more prone to faults because of the complexity involved in the documentation process. To ease the process, most healthcare providers designate a separate team of expert coders to review the documentation and assign codes to generate bills.

Challenges Associated with the Coding Services

There are several challenges associated with medical coding services. The need of the hour is to figure them out and think of a solution that could positively impact the revenue cycle:

  • Probability of Human Error in Procedure Documentation

Anything that involves manual work is subjected to errors, redundancies, inefficient paper work, and lack of information. In the general process, this information is transcribed and sent out for coding. It is where the coder works on the available information for the clinical documentation.

This is where the problem might arise. Any gap in the documentation and information might affect coding, which would lead to unwanted delays in the coding process. This might result in under-coding and lower revenue.

  • Complexities Involved in Documentation

It is often said simplicity is the key to success. This is applicable to documentation and medical coding services as well. It is seen that complexity in the documentation process raises the error rate in coding to 90%. Therefore, it is often suggested to keep everything up-to-date and precise to evade possible backlogs.

  • Mismatched Service Invoices or Fees

Problems can arise when the team does not work together. In such cases, chances of ambiguity or incomplete documentation increase. This leads to incorrect coding. Experts believe that it is perhaps one of the strongest reasons why claims fail to match. Mismatched bills are returned and asked for reprocessing. However, in the worst-case scenario, it leads to permanent loss of revenue.

  • Chances of Repayment

The absence of enough support system might lead to inaccurate data capture. Data is required to support the claim made. Any flaw in medical coding, due to inaccurate data, could result in compliance issues and minimize the chances of acquiring a repayment of the claim.

Ways to Mitigate the Challenges

Below are some of the ways the challenges associated with the medical coding services can be dealt with efficiently:

  1. Making use of consistent coding programs that would successfully code the severity of any illness.
  2. Deploying quality improvement teams that can work on improving coding and documentation.
  3. A team that would review the quality standards of the medical coding services and raise an alert to the professionals in-charge about the mistakes made.
  4. Stress on reiterating documentation techniques and proper codes that should be used.
  5. Ensuring the person-in-charge stresses on the documentation of secondary diagnoses as well for higher accuracy in the billing.

Conclusion

It should be noted that for the best medical coding services, emphasis should be laid on reducing errors and redundancies. One should take care of the documentation process and make sure that information is present and duly filled in before submission. This will eliminate the delays and above measures that would help address the challenges faced by medical professionals.

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