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Pain Point Series: Is Your Coding Accuracy a Cause for Concern?

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We continue our Pain Point series this week and are talking about Coding. Medical Coding is absolutely central to the Ambulatory Surgery Center (ASC) billing process. It is the grouping of medical codes and modifiers that tell the story of the work performed, and the materials used, in a given procedure and the story must be told very accurately. In fact, the AAPC describes it as, “the lifeblood of all successful practices and facilities” and we can’t disagree.

When ASCs and Physicians come to us with concerns about their coding process or coding provider, they often state poor accuracy, slow turnaround, or insufficient denial assistance as their primary reason for concern.

            Poor Accuracy: This is, not surprisingly, the number one coding concern we hear from ASCs and Physicians. The good news is, there’s a lot that can be done to help. First, specialty matters a great deal in coding. If you’re at an ASC, make sure you’re working with a Certified ASC Coder (CASCC). Individuals with this specialized credential are best positioned to code to the highest level of specificity in the ASC setting. Also, make sure to create the time and space for communication between physicians and coders. To clarify, this is not to discuss specific cases, but rather to discuss industry trends and documentation requirements. Finally, one of the best things you can do is audit often. You cannot fix a problem until you are aware of it, so perform frequent, small sample-sized audits to keep your finger on the pulse of your coding provider or department.

            Slow Turnaround: If we’ve said it once, we’ve said it 100 times. Time is money and cash flow is king. This is especially true in independently owned ASCs and Physician Practices. It’s imperative that your policies and procedures support timely and complete documentation from physicians. Furthermore, it is the responsibility of the billing office or provider to bill these charges quickly. It’s also helpful to keep a very detailed spreadsheet of what documentation components are missing and assign someone to follow up on each item daily. This will prevent you, and your billing office, from scrambling to obtain documentation at the end of the month or temp coding.

            Insufficient Denial Assistance: We often hear of coding providers not providing ample denial assistance on their coding. At in2itive, we take accuracy seriously and ensure our coding meets our strict, 95% accuracy standard. That said, our pricing includes any additional denial follow up assistance you may need. Be sure to check with any coding provider you’re considering working with to understand their denial percentage and any fees that will be assessed for denial assistance. Documenting payer-specific trends is also helpful in reducing denials at a facility.

Because providing a world-class service is our #1 priority, we’ve taken extensive measures to ensure our clients no longer experience any of these issues. in2itive codes all charts with 48 hours of receipt of documentation, no exceptions. We audit each of our clients’ coding twice per year to ensure we’re meeting our strict accuracy standards. And finally, we provide extensive denial assistance and work directly with insurance carriers to ensure your facility receives the highest possible reimbursement for each case. Fill out the form below to discuss our coding services or schedule a coding audit. We look forward to hearing from you!

Leave us a comment below or give us a call today at 855-208-5566!

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