Accurate Medical Billing and Coding Service – Importance and Benefits
Accurate medical billing and coding service is important and associated with many benefits. Delivery of superior and quality assured healthcare solutions depend on accurate and timely capture of medical data. This holds true whatever the specialty a physician or medical practice handles – cardiology, emergency room, allergy and sleep medicine, neurosurgery, ophthalmology, urology or any other. Providers of these healthcare back office processes usually adopt a three-tiered and stringent process of quality auditing to ensure that there are no errors in the output.
Medical Coding Errors Can Land a Physician in Trouble
If a physician is not thorough with Medicare guidelines, he could land in trouble. Suppose he is of the opinion that it is medically essential to see a patient in an expert nursing center three to four times a week and Medicare allows only two visits. Then, he runs the risk of an overbilling accusation. A red flag can be raised if there is up-coding pertaining to the services provided by a particular physician. Up-coding means claiming that the medical products or solutions given to the patient were of a superior quality than those really provided. Unbundling is another area that can land a physician in difficulty. If one physician incorporates a separate fee for a medically required service which three or more physicians don’t separately charge for, he would have to explain his action.
Advantages of Accuracy
Accuracy in medical billing and coding service is beneficial in several ways:
- Helpful for Insurance Reviews – Insurance companies often perform arbitrary reviews to confirm that the charges are valid. Supportive coding documentation provides proof supporting validity.
- Supports the Medical Indispensability of Treatment – Coding validates the medical necessity of treatment. Supportive documents would explain the nature of services that were given to the patient.
- Useful for Appeal Denials – Insurance vendors may deny claims if they feel that treatment was not mandatory or that the claims were erroneously coded. In such instances, the healthcare provider can put forward substantiating coding records that explain why specific codes
- Ensures Accurate Reimbursement – Accurate medical billing and coding makes the insurance payer aware of the treatment given to the patient so that the healthcare provider can be suitably reimbursed for it.
- HIPAA Compliance – Many good measures would be taken by the service provider in this respect such as ensuring that the staff sign agreements of non-disclosure, installing up-to-date anti-virus software and firewalls, 24 x 7 security personnel and 256 bit AES encryption.
- More Collections – Owing to fewer denials and accurate reimbursement, your practice benefits from more collections.
- Faster reimbursement
- Considerable Savings – You would save by at least 30 percent when compared to in-house handling of the process.
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Medical Billing and Coding Cannot Be Compromised
To conclude, precision in medical billing and coding service should not be overlooked in any way.
About The Author
Outsource Strategies International (OSI) offers medical billing services, focusing on every aspect of the medical billing / patient cycle. Our medical billing company is staffed with skilled and experienced billing specialists, coders, and other service personnel, having extensive experience in providing accurate results.
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