Medical Coding Simplified

Too little attention is paid to documentation, coding, and billing in many medical practices. For patients, documentation simply means that your doctor is providing an account of your visit in your medical record. However, documentation and coding can affect revenue, quality of care, and possibly expose clinicians to legal consequences. Too often doctors and other healthcare providers (PAs, NPs, etc.) cruise through their documentation and coding training, giving short shrift to the nuances of this key aspect of care delivery. In fact, many medical practices offer no formal training in the use of Current Procedural Terminology (CPT©) codes and Internal Classification of Diseases (ICD) codes. In these instances, despite such inadequate preparation, doctors simply begin seeing patients and documenting medical visits in the electronic health record (EHR). I’m sure that most clinicians would rather just see patients than bother with the billing component of care delivery, which incl...

Payment posting and denial management are two extremely critical steps of the revenue cycle management of any solo practitioner or a healthcare organization. Streamlining these processes improves the RCM cycle leading to lesser delays in the A/R’s, ultimately guiding the way to increasing revenues along with patient satisfaction. Payment posting and its factors: In this process, the payment records of patients are recorded in the billing management software. It also includes attention to be given to claim denials — for identifying the problematic areas and their reasons along with apt actions to be taken on resolving the issues. Insurance Payment Posting: All payers either send an EOB (explanation of benefits) or ERA (electronic remittance advice) towards the payment of a claim. The medical billing staff posts these payments immediately into the respective patient accounts, against that particular claim to reconcile them. The payment posting is handled according to clie...

Patients come to your office looking for answers to their pain or lack of function. It’s critical that a doctor doesn’t do what one of my clients admitted to recently…“X-raying the patient’s wallet.” Your patients both deserve and expect your best recommendations. If you provide products or services and are withholding your recommendation because you think the patient may not be able to afford that, it is simply inappropriate. Providers should prescribe what the patient needs, and the team members’ job is to help the patient pay for these items according to your financial policy. Stabilizing orthotics Once such profit center that mirrors a patient’s needs is stabilizing orthotics. The number of miles the average person walks in a lifetime, about 110,000 miles, is the equivalent of five trips around the Earth. And it’s estimated that more than 90% of patients overpronate. Some patients see this as a discretionary choice in their treatment plan and others will immediately grasp the...