3 Common Medical Coding Problems... And How To Solve Them!

Posted by Dave Cowley on Dec 22, 2017 9:08:30 AM

Medical coding is an extremely important part of any medical practice. Having the proper experience and know-how will lead to accurate reimbursements and a compliant office. However, without that knowledge medical coding can dam the cash flow and suffocate the financial situation of your practice. Here are 3 very common problems with medical coding.  

1. Clean Claims - Without a doubt things will happen and some of your claims will get submitted without having everything correct. This happens very frequently, and being able to submit a clean claim will help you get paid faster, more accurately and avoid any issues with compliance. 

In a recent article Crystal Miner discussed Claims Submission with our readers. The importance of having a defined process is critical to submitting a clean claim. I know you are thinking, "Obviously!" well, that is obvious, however, most people set a process in place and do not improve upon that process. If you are still getting a lot of claims denied, ask yourself a few questions. Why are they getting denied? Who is responsible for that part of the process? How can we remedy that and get cleaner claims submitted? Answering these questions and continuing to improve the process will no doubt allow you to overcome this common problem and achieve a higher rate of 1st pass submissions. 

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Topics: medical coding, Practice Administrator

Balance Medical Coding, Scheduling, Paperwork & The Patient Experience

Posted by Dave Cowley on Dec 15, 2017 11:22:32 AM

It is no mystery that today’s healthcare comes with mountains of paperwork.  As a consumer we see the front and back slopes of these mountains, but rarely the summit.  This piece of the equation falls on the providers and their administrative staff.  Consider this:  Where do you think all of those confusing details about your diagnosis, care, follow up, and ultimately your bill come from?  Someone has to document everything about your care...start to finish.  Just a piece of this process requires the physician to document their care, which is used for the medical coding to assign diagnosis and procedure codes for insurance reimbursement.  This piece alone requires time and a high level of expertise.  A recently published study in the Annals of Internal Medicine found that for every hour physicians were seeing patients, they were spending nearly two additional hours on paperwork.  It is difficult for me to imagine a physician pursuing the medical field and truly recognizing this administrative burden before it is too late.  Many physicians are trained once in the field for these pieces (if at all), including the sophisticated medical coding process.  This barrier to care is enormous and it bleeds over into the patient experience.  Have you ever needed care and then sat with a physician while they type into their laptop?  They are documenting everything...what’s wrong and what they are going to do about it...and that is just a start. 


The study confirmed what many physicians have already observed (such as James Sanders, MD in this 2005 editorial for Family Practice Management): the amount of paperwork that doctors have to do is out of control. Led by Christine Sinsky, MD, at the American Medical Association, the study followed 57 U.S. physicians in family medicine, internal medicine, cardiology and orthopedics for a total of 430 hours. In addition, 21 physicians completed after-hours diaries. The results? Physicians spent 27% of their time in their offices seeing patients and 49.2% of their time doing paperwork, which includes using the electronic health record (EHR) system. Even when the doctors were in the examination room with patients, they were spending only 52.9% of the time talking to or examining the patients and 37.0% on paperwork.  The doctors who completed the after-hours diaries indicated that they were spending one to two hours each night doing...paperwork (or the EHR).  I have seen it.  I watched a friend last week sit at his son’s wrestling tournament with a laptop doing this work.


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Topics: medical coding, Practice Administrator

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