Mystery Solved: The Case of the Chronic Under-Coder

As a chronic under-coder, you may be experiencing difficulty accurately documenting medical diagnoses and procedures in your billing. This can lead to denials, rejections, and payment delays. Reviewing documentation and establishing open communication with healthcare providers can help streamline the coding process. Consider taking courses, attending workshops, and seeking mentorship to improve your coding skills. It is also essential to maintain up-to-date coding books, understand coding guidelines, and stay current on any changes in the industry.

Additionally, utilizing technology such as coding software and online resources can help reduce errors and improve efficiency. Chronic under-coders can improve their coding skills and optimize their medical billing processes with dedication and effort. Our client is a Family Physicians Group from Michigan that handles medical billing and revenue management. However, they feel like they could get more reimbursement than they currently do. They wanted ebix, Inc. to be their silent partner in reviewing the medical records.

The ebix, Inc. team got to work by implementing a squad of AHIMA-certified coders with vast experience in the required specialties. A project manager was assigned to manage the production and process. Coding quality is essential since only a correct code can help secure maximum reimbursement. The ebix team had weekly meetings to review the coding rate and ensure all expectations and protocols were met. In short, the coding solutions were high quality, confidential, and cost-effective.

At first, the client 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.

Our client was highly impressed with the exceptional accuracy of the coding rendered by ebix. They were happy that we were able to help them with their problems. We even found some issues they didn’t know they had and fixed them, making them even more satisfied with our services.

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. In case of inadequate insurance billing and insufficient medical documentation in the chart, we shall provide guidance and crosswalk codes to rectify the situation. Our AHIMA-certified coders are experts in federal and commercial coding and billing guidelines.

Outsourcing coding has had a very positive impact on their business and the people they serve.