CODING AUDITS & ITS BENEFITS IN HEALTHCARE SERVICES

A Coding Audit is the most important part of the Revenue Cycle Process simultaneously with the medical coding. It is an internal or external review of coding practices that are conducted by checking patient medical records. It is essential in maintaining accuracy and precision. Coding Audit once a year is particularly important in identifying the areas of lost revenue and taking quick action on it. A slight error in the coding will lead to a drastic impact on the total revenue cycle process which will cause delays in claims payments and will slash the reimbursement process.

BENEFITS OF MEDICAL CODING

Medical coding is very important nowadays to all healthcare services industry. It plays an important role in the backend and has lots of benefits to healthcare. We will be discussing some of the benefits below –

1. Improved Data Quality – A good, accurate, and reliable data is a keystone in the healthcare industry. The right compliance auditing program, taking daily feedbacks, and consistency in follow-ups improve and increases the quality of the data. This makes it easier and for healthcare organizations to get quick approval of funds or grants.
2. Enhances Patient Safety – A real-time auditing with timely detection of errors and providing instant feedback to medical personnel can enhance patient safety. Any changes in the clinical policy and practice can be conducted with confidence, as the auditing will spot the area of such changes.
3. Lesser Rejections and Denials – A periodic coding audit helps in reducing the number of rejections and denials as it will be more accurately coded claims. Maintaining the habit of frequent coding audits helps in identifying issues and to take the necessary measures to correct them so that more cases can be paid on time with the full settlement.
4. Fend off Fines and Investigation – A good coding audit is especially important to prevent fines and investigation. If the coding problem persists for a long and if payers find lots of irregularities and a scrambled pattern, certain practices might be flagged off for investigation. This kind of investigation looks for potential fraud in the practice and in some scenarios, fines are also levied which is very costly and stressful. A good and regular coding audit practice improves the pattern and make sure that the process is not being flagged or fined.
5. Increase in Reimbursement – With proper and professional coding audits results in more claims being paid. Any rejections in claims and denials slow down the smooth operation and incur extra costs. Regular coding helps in reducing overpayments and underpayments.
6. Superior Operational Efficiency – Manual medical coding is a big challenge for healthcare providers. High-level risk and accuracy is the main concern when it comes to manual coding. Many healthcare providers have made a progress towards automated auditing services to make them more efficient, accurate and to reduce the time taken by manual coding. Automated coding can easily track various errors and helps in finding the root cause of such errors. Hence it helps the service providers to rectify and to avoid it.
7. Unrelated Quotes – One of the important benefits of maintaining a good coding audits is to avoid the usage of unrelated quotes that are not related to the diagnosis or procedure. This kind of unrelated quote raises a red flag and results in an investigation. In bad scenarios, your healthcare service company may be marked as a fraud.

Thank you for reading the article. I hope it was well informed. In case you want any information regarding the medical billing process, kindly contact us. Team SYANTHY will be happy to help you and make your work easier. It will be our immense pleasure if you give your valuable feedback in the comment section. Please share this article with your loved ones and professional circle if you like it.