The Merriam-Webster dictionary defines commodity as “something useful or valued.” In healthcare, coding is the most important yet silent commodity in the revenue cycle. With over 68,000 medical diagnosis codes available through ICD-10 and over 87,000 procedures codes for providers to comb through, coding specialists are essential to get paid.
Though electronic health records were supposed to assist with coding – the EMR does not have the experience working with payers who may have different policies on how to code a single procedure. Some may require a modifier – while some may not. Some may only pay when a procedure is paired with a certain diagnosis – while some may be flexible.
Providers should spend time with their patients. If a provider is searching for the right code that is time they are not spending with their patient. Wasted time. Any process improvement program would tell you wasted time/wasted resources is inefficient. Inefficiency can cause a debilitating effect on a medical practice.
Experienced coders or certified professional coders added into a revenue cycle allows a critical view on a patient encounter prior to being sent to payers. Coders who focus on certain specialties such as orthopaedics, podiatry, optometry, etc. can garner experience from the payers and maximize payment for the providers on the first pass of a claim. This importance of getting paid on the first pass of a claim is the money in the bank. The averages for working denied claims range from $25/claim to 20-30% of the value of the paid claim, either way you slice it, that is a lot of money not in the bank.
Paying an experienced coder will more than pay for itself by maximizing reimbursement and decreased denials. FinanSynergy will be bringing on an experienced coder for our Cash Flow Management service. The combination of a Financial Analyst and an experienced coder will bring depth to the data gathered from our clients. To tap into this Coding Commodity call Katie at FinanSynergy 515.635.5531 or email email@example.com to receive a FREE CONSULTATION on how FinanSynergy might help your practice maximize revenues and boost your cash flow.