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Medical Billing and Coding: Avoiding Costly Coding Mistakes

medical billing and coding Now that you’ve completed your medical billing and coding class, you are ready to embark on a new and rewarding career. Medical billing & coding professionals are often the last point of contact a patient has with a doctor’s office or hospital. In fact, your accuracy and the quality of your work effect their last impression of the facility. Mistakes made by the medical billing and coding specialist can have grave repercussions. Many times mistakes are made during reimbursement that could have easily been avoided. Here are some of the top mistakes made by medical billing and coding specialists. Equipped with this information, you will have insight into what you should avoid as you step into your new career:

Keeping Accurate Charts

Physicians are required to notate all the services that they performed for both the patient’s medical record and for medical billing & coding purposes. One of the first things that those in the health care field are taught is that if it is not in the chart, it did not happen. With this in mind, it is imperative that charts are accurate. If a bill is reimbursed and then invoiced, only to be amended later, once the error is realized, patients can get extremely frustrated with the process. It can also affect reimbursement by insurance companies.

On occasion, a physician may take this to the extreme and write out a detailed explanation of what occurred during their time with the patient, but never actually write the specific name of the procedure. Medical billing & coding professionals need to be on the lookout for this and should be able to interpret the information for accurate reimbursement. If necessary, ask for help from a supervisor or the medical office manager when interpreting information.

Coding Issues

Medical billing & coding staff have so many codes to learn, so continuing education is essential if you want to maintain a consistent level of quality and accuracy in your work. Attend continuing education classes as required in your state, and study any changes from individual insurance companies as they come up.

Many coders do not realize that codes need to be taken to as many digits as available for accurate billing. In fact, ICD-9-CM codes can extend to the 4th or 5th digit for complete accuracy. Likewise, many procedural codes are bundled together. Some medical billing & coding beginners may try to separate these codes in an attempt to solve a billing issue but this process is not allowed, and actually illegal. Talk to your supervisor for suggestions on how to accurately handle individual questions as they arise.

Medical Billing and Coding: Working with the Front Desk Staff

In general, the front desk staff does a great job of collecting information from sick and often cranky patients. Your job, as part of the medical & billing team, is to cross reference their work. Accurate and updated insurance records as well as information on whether a co-pay has been collected are necessary for you to perform your job duties effectively. Front and back office staff need to communicate well in order to avoid frustrating the patient. If a patient receives a bill in the mail from a doctor’s office a month or more after services have been performed, they no longer remember whether they paid the $10 co-pay or not. This time lapse and ensuing confusion can lead to a patient’s dissatisfaction with the office or hospital as a whole. Operating as a cohesive team can enhance the overall experience for the patient, even from behind the scenes.

As you can see, in order to perform properly in your new medical billing and coding career, a certain amount of team work is necessary. Always promote a team effort and add value to the office you are employed with. Placing blame when mistakes occur will only divide the staff. Instead, as a professional medical billing and coding specialist, always take a proactive, solution seeking approach to mistakes.

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