One of the most critical components of operating a successful medical practice is correct medical coding. Improper coding can result in the loss of revenue and have legal and financial consequences for a medical practice.
Mednet focuses on assuring that our clients bill for and get paid for every dollar they are entitled. We stay focused on the financial aspects of proper coding so you can focus on your patients.
But how do you know when your practice needs help coding? Here are three signs:
Reimbursements are Less than They Should Be
As a doctor, you know how many patients you see each day and the services you provide. While you may not be able to guess the exact amount of revenue you’re bringing in, you have a general idea.
Common coding errors, like missing information or incorrect procedure codes, may result in a lack of payment to your practice. You may also be failing to recognize a billing opportunity, which can also affect the revenue you earn.
Have ever reviewed your monthly or quarterly numbers and thought, “Wow, I thought the revenue for this last period would be higher?” You may want to trust your gut and review your coding procedures to ensure that you are collecting the correct amount on every service you provide.
Payments Are Delayed, Reduced, or Do Not Occur
This next sign is often the main culprit of loss of revenue. When you submit claims with incorrect coding, payment for those services is most likely going to be delayed or reduced, if they happen at all.
Insurance companies wil not pay for services that are not covered in their contract. And it is always difficult to collect from patients who thought their insurance covered a service provided by your practice.
This is why proper coding is so necessary to your revenue cycle. You want to correctly document services rendered for the patient so that insurance companies reimburse you in full for everything that you do.
Productivity of Entire Practice is Lessened
This last sign may very well be the most insidious because it is the hardest one to recognize. If insurance companies are denying claims because of improper coding, then you will have to have someone on your staff rework that claim. But there is an opportunity cost to this. For every claim you have to revise, there is a task that may be delayed or not done at all.
A lot goes into operating a successful practice. If you spend too much time redoing work that should have been done the first time correctly, you are losing out on ways to improve how your practice operates.
These are no easy metric to recognize or quantify, so it may be weeks or even months before you understand why your practice is not operating as smoothly as it should. This is another “trust your gut” situation. If there are projects or tasks not being completed, or if you recognize one or both of the first two signs, then chances the overall productivity and revenue of your practice is suffering.
Incoming revenue is the lifeblood of your practice. You need it to pay your staff, for the office, for supplies, and everything else that goes into operating your practice. To keep the revenue flowing at the maximum level, you need to ensure your coding is correct.
If you see any of the signs listed above, then you must investigate, or you can risk the long-term success of your practice.