Month: May 2024

How Does Medical Coding Affect the Revenue Cycle?

In today’s value-based healthcare environment where hospitals and healthcare providers are paid according to the quality of their care, even the slightest deviation in documentation could leave huge gaps in revenue. Clinical Documentation Improvement is even more critical as long as Medicare remains the main payer of hospitals in the United States.

The cash flow of a medical practice is heavily influenced by the efficiency of the staff that handles the billing and coding processes. All healthcare professionals place a high priority on providing quality care to their patients. As the number of patients increases, so does the paperwork that ensures payment. However, as long as you complete this paperwork correctly, there is no need to worry.

Effective billing and coding benefit both patients and healthcare professionals. Billing claims in a way that’s effective will ensure a steady income flow for your business and a higher level of client satisfaction.

Understanding Healthcare RCM Key Indicators

Your ability to successfully use KPIs is key to reducing claims denials and maintaining a healthy revenue cycle. When analyzing KPIs in a value-based approach to healthcare, the effectiveness and documentation of medical coding is crucial. These are governed by two main factors:

  • Productivity of Coding: The number of hours is divided by the total number of records. Efficiency is determined by the least amount of work for the most complicated tasks. A good example of a criterion that is acceptable for determining effective coding productivity would be 24 inpatient coding reports per eight-hour workday. The metric may need to be adjusted due to new coding duties, increased organizational complexity, mixed cases, etc.
  • Coding accuracy: To determine accuracy, the number of errors is compared with the number of codes assigned. No variations are desired. It is important to have a policy document that evaluates the correctness of coding levels since an organization will assign coding levels. Online coding tools and official guides serve as benchmarks to improve coding effectiveness.

What are the benefits of efficient medical billing and coding for your practice?

Here are some of the benefits that precision and efficiency in billing and coding can bring:

1. An Efficient Medical Payment System Reduces the Stress on Doctors and Support Staff by:

Overworked medical professionals and healthcare workers make up the majority of healthcare professionals. The majority of staff time is spent on patient care. Workers can be overworked when they have to submit claims. Inevitably, a claim will be submitted incorrectly or without supporting documentation. This leads to denials, which decrease revenue. Billing services ensure that payments are made on time and allow your staff to concentrate more on patients. Unpaid claims and bad debts will no longer be an issue.

2. Helps to Prevent Medical Billing Errors that Could Have Negative Legal Consequences:

When assigning a code to a therapy, a biller should pay attention to details and look for the exact code of the treatment rendered by the provider. Even the smallest mistake in a medical procedure code can lead … Read More..