Up-Coding, Under-Coding – Huh?

Up-Coding, Under-Coding, Right-Coding - Medical Billing Audits what does it all mean? All medical providers receive requests from Medicare or Medicaid entities to provide documentation to review the accuracy of the coding. These inquiries may result in paybacks or recoupment of funds and/or informational letters describing the nature of the findings. Large health care entities [...]

By |2020-04-28T12:42:09-05:00August 5th, 2018|Finance, Financial, Healthcare|Comments Off on Up-Coding, Under-Coding – Huh?

Prior Authorizations, Denials, Death?

Are you aware how much time your practice spends obtaining prior authorizations for a patient’s care? Are you aware of the clinical knowledge one must know or have documentation for in order to obtain a prior authorization? I have a client that told me he had a nurse consistently sitting on hold with a particular [...]

By |2020-04-28T12:42:09-05:00August 13th, 2017|Finance, Healthcare, Medical|Comments Off on Prior Authorizations, Denials, Death?

The Coding Commodity

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 [...]

By |2020-04-28T12:42:11-05:00January 22nd, 2017|Business, Healthcare, Medical|Comments Off on The Coding Commodity