20 Sep WHY HOSPITALS NEED A CODING SERVICE
Most hospitals have medical coders on staff. Large hospitals that operate 24/7 have more options available to them, whether a dedicated group of medical coders or hiring a third-party medical coding company to help alleviate some of the stress of the large volume of patient records being handled. In fact, a recent survey said that 60% of hospitals hire third-party medical coding companies to handle their coding needs to free up their staff for other important tasks. This is a trend that is reversing from just a few years ago where most hospital coders were only in-house.
Hospital coding is broad-based and involves many different types of treatments. As we all know, radiation oncology is complex, and coders that are trained in this specialty are rare. The challenges that internal billing operations are faced with on a regular basis can lead to collection shortfalls and non-compliance issues. Given the complexity of today’s revenue cycle processes, it takes the specialized skill of someone who knows radiation oncology treatment to ensure your practice’s economic success and compliance with the many government regulations.
In today’s complex world of billing, correct coding has become key to getting paid. If you have not kept up with the CMS Advanced payment Model (APM) that will be implemented in 2022, you need to know that accurate coding is an absolute must for the APM. There are many factors that can affect your radiation oncology payments, including authorization issues, but having a gatekeeper position (a coder that sits in between your EMR and the central billing software) is not only a good way to stay compliant but the best way to ensure your claims get paid.
What to look for: When evaluating a third-party coding option, be sure that you look for a medical coding company that has a rigorous compliance program, and that employs certified coders with AAPC and/or AHIMA certifications. You also need to look for a coding service that demonstrates at least a 95% accuracy rate and has processes in place to keep that benchmark high (and demonstrate the results).
Conclusion: Declining reimbursement and the high cost of collecting on a claim are two reasons to have a coder (Gatekeeper) looking at your charges. You want to make sure your charges are correct “before” they leave your hospital. This will ensure you have the best chance of getting paid the first time you submit charges.
Declining reimbursement and the high cost of collecting on a claim are two reasons to have a coder (Gatekeeper) looking at your charges. You want to make sure your charges are correct “before” they leave your hospital. This will ensure you have the best chance of getting paid the first time you submit charges. Contact us today to learn how Radiation Business Solutions can elevate your coding services.