Medical Billing and Coding Services
Facilitating quality medical care is the primary objective of any practice. However, collecting payments for the medical billing and coding services provided is equally important. Coding, billing and payment collections is the fundamental trifecta a medical practice rests on. The staff needs to follow proper guidelines to ensure smooth sailing and a streamlined revenue stream.
The billing and coding team in a practitioner’s office or hospitals work in tandem. Sometimes billing, coding and collection tasks are performed by the same person even though these are three different domains. Which often results in high workload and low quality output .
Medical coding brings stability to the entire billing procedure through strict ICD and HCPCS codes. Assigning diagnosis their appropriate procedural codes make it easier for insurance agencies to identify the diagnosis and treatment rendered.
Coding of diagnosis and procedures accurately is not the only concern for the medical billing and coding services provider. A mistake during coding order may result in denial. The very first code represents the specific reason for the patient’s visit even if he is suffering from multiple diseases and so follows the order .
The medical billing and coding services process begins the moment a patient schedules an appointment with a physician. It is essential to verify the patient’s insurance before their visit so as to have a cost breakdown of the services that will rendered .
It is necessary to examine all the information provided on the insurance document and verify its eligibility for what services are chargeable.
The procedures and treatments not covered under the insurance umbrella should be pre-authorized from the agency. It will save you time and in turn revenue. The payments that are due from the patient’s side should be discussed and collected prior to providing services. Co-payments should also be cleared by the patients in order to avoid issues post treatment.
Patient balances are left unpaid due to a variety of reasons . Sometimes a patient may refuse to pay for services rendered or it could be due to a denial of claim submitted. This is why it is important to have a professional billing and coding team in your office. If the team and the patient tend to their respective responsibilities beforehand, the rate of denials will be less.
There might be a need for clarifications or explanations if the staff appeals for a claim denial. But if a patient brings forth an appeal, it is necessary to make them aware that they might have to pay the due balance (if any).
In a nutshell:
Appropriate coding, billing and collections is imperative for medical businesses who strive to thrive. It requires robust training and coding education along with in-depth knowledge of the ever-changing billing guidelines. Thus, staying up-to-date with the medical billing and coding guidelines and assigning accurate codes will positively impact your practice. Increasing efficiency of the entire process and ensuring higher revenue.