Clinical Documentation Improvement
Physician queries serve as a bridge for healthcare providers and medical coders to communicate effectively. To make sure medical records are correctly coded, it’s important to understand physician query guidelines and utilize these query best practices.
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Healthcare organizations need to put the focus back on medical coding compliance and offer their teams effective strategies to get coding inaccuracies and inefficient claims management under control. Here are several coding compliance strategies to try this quarter for your organization’s clinical documentation improvement and bottom line.
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There are myriad benefits to performing regular medical coding compliance audits. In order to have a successful audit process, coders must feel like their voices are heard. We’ve compiled these strategies to help empower the coding team during the next audit.
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ED claims denials are a common occurrence in medical facility coding and billing when the payers (or insurance providers) deny a claim for reimbursement. This article dives into the most common causes for these denials, how to prevent them with denial management services, and related topics, such as ANSI codes and the definitions of appeal versus rebill.
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Given that severe malnutrition MCCs increase the dollar amount in Medicare reimbursements, overcoding is a potential risk for all healthcare organizations. Review our recent case study findings where we present compliance, standardization, and improvement opportunities to one client hospital.
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Medical necessity denials can’t be ignored, as they can lead to significant revenue loss and compliance issues. These best practices for clinical documentation improvement, education, and standardization will help providers overcome their medical necessity denials.
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To successfully navigate the future – and be prepared for anything – healthcare organizations need to craft a strategic plan. A strategic plan is beneficial for everyone: It allows the company owner to identify potentially fruitful goals, and it helps the employees foster that growth.
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Every year, the Centers for Medicare & Medicaid Services (CMS), and the American Medical Association (AMA) release updated coding and reporting guidelines that make additions, deletions, and revisions to the ICD-10 and HCPCS code sets, and CPT codes, respectively. During Public Health Emergencies (PHE), such as the COVID-19 pandemic, CMS and AMA will release updates more frequently. By offering ongoing medical coding training to cover these annual updates, your coding team upholds an accuracy standard and stays compliant with these revised guidelines. YES Education offers a robust catalog of medical coding updates that refreshes as the code set revisions are released, including annual updates for ICD-10-CM/PCS and CPT.
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How do you shape the future of an accurate Inpatient, Outpatient, or Profee coder? With several best practices that have been thoroughly tested by a team of real-world coding and auditing experts who have 20+ years’ experience in HIM.
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The risks of inaccurate professional fee coding could be detrimental to your organization’s revenue and overall success. Follow these steps to eliminate those risks and save your bottom line.
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