Medical Coding Audits
Professional fee coding can be complicated for medical coders to capture accurately. There are several strategies to ensure your coding team maintains quality and accuracy standards, including coder assessments to evaluate the team’s skills and knowledge level.
Qualified HIM consultants, such as those at YES HIM Consulting, assist hospital management by analyzing coding audit data and recommending actionable solutions to pinpoint revenue-killers in the organization.
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.
Why is accuracy important in the medical coding and billing field? And how is accuracy determined? We asked Amy Davis, Director, Inpatient Coding and CDI Services, to weigh in on these important questions.
So, how can an organization leverage the analyzed data to sustain continuous quality improvement? A key principle to continuous coding quality improvement in healthcare is the approach of the quality/compliance audit programs.
One of the biggest revenue-killers for healthcare providers is DNFB accounts. DNFB (DNFB meaning “discharged, not final billed”) – defines unbilled accounts where the patient has been discharged from the healthcare facility, but the final bill from the encounter has not been submitted. The cost effects of outstanding DNFB accounts and claims denials are staggering, and can negatively impact the providers’ cash flow and potential net revenue. So, what are the best practices to reduce DNFB days and claims denials?
Bolstered with the right data, medical coder performance evaluations can be an empowering tool for your organization’s coding team. Performance reviews that have been fueled by research from coding compliance audits will only help coders improve and increase engagement with the organization.
Undercoding in healthcare is the action leaving out codes that reflect all the services and procedures performed. Not only does undercoding lead to lower revenue, but it also skews the healthcare provider’s claims data.
Several recent lawsuits have brought to light a list of risk adjustment schemes to increase reimbursements in violation of the False Claims Act. Here are some HCC coding 101 best practices to help your organization avoid scrutiny.
Reducing your risk of inaccurate HCC coding and compliance issues begins with an efficient HCC auditing partner. An external HCC auditing consultant, like YES HIM Consulting, can conduct regular coding audits to identify issues before they are flagged.