Medical Coding
The Steps We Take To Ensure Your Practice Survives
Here’s a general outline of the process:
1. Patient Registration and Encounter Creation: Begin by registering the patient and creating a record of the encounter, including the details of the visit, treatments provided, and diagnoses.
2. Documentation Review: Review the medical documentation from the visit, including physician notes, lab results, and any other relevant records.
3. Code Selection: Assign appropriate medical codes to accurately represent the diagnoses (ICD-10 codes) and procedures/services (CPT codes) performed during the visit.
4. Code Entry: Enter the assigned codes into the billing software or system, ensuring accuracy and completeness.
5. Modifier Application: Apply any necessary modifiers to the codes to provide additional information or context, such as indicating multiple procedures or unusual circumstances.
6. Claim Creation: Compile the coded information into a claim form, which includes patient details, insurance information, and the coded diagnoses and procedures.
The Tedious but Necessary
- Claim Submission: Transmit the claim electronically or via paper to the patient’s insurance company or payer.
- Claim Adjudication: The insurance company reviews the claim, verifying the accuracy of the codes, coverage, and other details.
- Payment Posting: Once the claim is approved, record the payment received from the insurance company, which may include adjustments, co-pays, and deductibles.
- Denial Management: Address and rectify any denied claims by reviewing the denial reason, making necessary corrections, and resubmitting if required.
- Patient Billing: If there is a patient responsibility portion, generate an invoice for the patient detailing the remaining balance after insurance payments.
- Follow-Up: Monitor the progress of outstanding claims and follow up with insurance companies to ensure proper reimbursement.
- Appeals: If a claim is unfairly denied, submit appeals with additional documentation and explanation to challenge the denial.
- Financial Reconciliation: Regularly reconcile payments received with expected amounts, identifying discrepancies and addressing any inconsistencies.
- Reporting and Analysis: Generate financial and operational reports to assess practice performance, identify trends, and make informed business decisions.
The Impact That Coding Will Have On Your Practice
- We solve the deficency in the industry for you
- Providing value to all practices with experienced coders
- Less errors in billing and higher rates of payout
Don't Prolong The Process, Reach out!
Why Consult With Us?
