Errors and Compliance in Coding - 1
Errors and Compliance in Coding
There are many errors associated with the medical billing and coding process. Not everyone is perfect and we all make mistakes sometimes. At the same time, someone who is improperly trained will make far more mistakes that may costs the company a lot of money.
Some typical billing and coding errors would be: * Double billing: This occurs when a coder puts a bill on the patients chart more than once, or files the claim with the insurance, but also bills the patient for the same procedure.
* Upcoding/Downcoding: Upcoding is when the coder uses a higher code for the services they actually received. Downcoding is the opposite; it is used when the patient is charged less for the services they received.
* Assumption coding: This is when the coder assumes something was performed, when it is not stated in the patients chart. Charging extra for services that were not used could potentially cause a law suit.
Ensuring all employees are properly trained, and allowing them to use software to double check their coding could significantly help improve the coding and billing process in an medical facility.
The Medicare National Correct Coding Initiative effects the billing and coding process in many ways. This organization was established to prevent improper coding and billing. The benefits of the CCI, is it performs audits that catch most of the improper coding. It detects codes that should not be coded together, which could cause the patient to be double billed, or improperly billed. The system stops the physician from billing the patient until the codes are properly
There are many errors associated with the medical billing and coding process. Not everyone is perfect and we all make mistakes sometimes. At the same time, someone who is improperly trained will make far more mistakes that may costs the company a lot of money.
Some typical billing and coding errors would be: * Double billing: This occurs when a coder puts a bill on the patients chart more than once, or files the claim with the insurance, but also bills the patient for the same procedure.
* Upcoding/Downcoding: Upcoding is when the coder uses a higher code for the services they actually received. Downcoding is the opposite; it is used when the patient is charged less for the services they received.
* Assumption coding: This is when the coder assumes something was performed, when it is not stated in the patients chart. Charging extra for services that were not used could potentially cause a law suit.
Ensuring all employees are properly trained, and allowing them to use software to double check their coding could significantly help improve the coding and billing process in an medical facility.
The Medicare National Correct Coding Initiative effects the billing and coding process in many ways. This organization was established to prevent improper coding and billing. The benefits of the CCI, is it performs audits that catch most of the improper coding. It detects codes that should not be coded together, which could cause the patient to be double billed, or improperly billed. The system stops the physician from billing the patient until the codes are properly