Mystery Solved: The Case of the Chronic Under-Coder
Although our client, an independent, Michigan-based, Multispecialty Family Physicians Group managed their medical billing, collections, and revenue cycle management; the group sensed that maximum reimbursements were not achieved. They wanted ebix, Inc. to be their silent partner to review the medical records.
Here’s the story
The ebix, Inc. team got to work by implementing a squad of AHIMA-certified coders who had vast experience in the required specialties. A project manager was assigned for the management of the production and process. The quality of coding is essential since only a correct code can help secure maximum reimbursement. So ebix had weekly meetings for reviewing the quality of the coding and also ensure that all expectations and protocols are met. In short, the coding solutions were high quality, confidential and cost-effective.
The client first wanted a trial. So they sent us 20 scanned charts uploaded on our FTP. We followed the coding requirements specific to the locality of the provider and provided all linked ICD-10 and associated modifiers required for proper billing. The coded files were returned via spreadsheet.
The solution noted a lucrative impact
On returning the work, the client was not only impressed with ebixs’ accurate coding but also benefited from some issues we identified that could directly impact the provider’s revenue.
We discovered that the providers were under-coding in many cases that not only decreased reimbursement but could also lead to the payor initiating an audit. We could offer guidance when there was a lack of medical documentation in the chart, and also crosswalk codes depending on the billed insurances. Our AHIMA-certified coders are experts in federal as well as commercial coding and billing guidelines.
The client is extremely pleased with the ebix team’s medical coding services and competitive prices too. Outsourcing the coding has had a very positive impact not only on their business but also on that of the people they serve.