As defined by the Healthcare Financial Management Association, revenue cycle refers to “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” It means, it take account of the complete patient’s account lifecycle, from initial appointment setup to insurance collection.
Current financial year challenges are like to diagnose and treat Coronavirus patients, also surge in telehealth services been observed. Remote staff, which had been common in other industries, became the norm for many healthcare workers who had not been doing remote work previously. This was for medical coders and medical billers as well. The main aim of the healthcare practices is to deliver the best treatment to patients, this is possible only if administrative functions of a provider system is working efficiently.
When provider’s coding is done in the right manner, claims get processes quickly with fast reimbursement. On the other hand, if deadlines are missed, submission are not in proper manner, and lack of training can result in claim denials and it will cost to healthcare provider thousands of dollars in lost or delayed collection.
Let’s see how providers can improve medical coding quality.
Streamline EMR Workflows
The volume of charts to code are always in large quantity and overwhelming that working denied claims take carry over. Working on denials is hectic and time consuming process that require research, sometimes rework and resubmission all these activities has tight deadlines.
It is important to educate medical coder about editing practice management system and rules and regulations to prevent duplicate errors. Medical Coding managers have to correct all inadequacies in coding workflow to get some time to edit and rework.
You should make your EMR workflow efficient enough with medical coding department with all required trainings. Providers receive reimbursement on time if their billing and coding staff work efficiently with defined task list and priority.
Keep eye on HCC and SDOH
As increase in value-based purchasing and at-risk payment models has heightened interest in improving the populations being managed. So, correct coding for risk factors HCC Coding and SDOH capture has become more precarious than ever. In 2021, reducing cost with quality care and avoiding potential loss of revenue for healthcare providers’ means leaving every stone untouched.
The CMS mandates the use of HCC coding to calculate the reimbursement under Medicare. HCC coders understand patient’s demographic factors, such as age, gender, date of birth, etc. and current health status to calculate a risk adjustment factor that regulate the patient’s expected healthcare spending for the financial year.
HCC coding will allow providers to receive satisfactory and fair compensation for treating patients with risk with value-based care treatment.
Managers must make sure all stakeholders knows the impact of correct HCC coding on revenue cycle management.
Coding Compliance Audit
Every provider should ensure coding practices are at par with the stated guidelines and procedures to prevent denials that needs additional information for reimbursement.
A coding compliance audit examines few charts per qualified healthcare providers to check the accurateness of the services documented and codes recorded.
Carrying out quality audits highlights areas of improvement that cause revenue leakage, identify gaps in knowledge and workflow correction and expedites claim collection with reduced denials.
Partner with Best Talent
Hiring best medical billing and coding company is one of the best way to improve your revenue cycle management medical coding.
Benefits of Outsourcing Medical Coding
- Medical Coding staff has all required certifications from accredited healthcare organizations, including AAPC and AHIMA
- All medical coders has the knowledge of required guidelines and know that their role in RCM is very significant towards quality assurance.
- All Coders are always observe changes in regulations in the healthcare environment and learn every day from colleagues
As a complete RCM partner, MedisysData understand that efficient, correct and complete medical coding us essential to maintain for increasing collection. To know more about our RCM medical coding services, please feel free to submit your enquiry to schedule a call with our Medical Coding experts.