We asked our expert coders:

“What is the #1 thing that can be done immediately to increase reimbursements?”

You may be surprised by the answer: 

Improve Documentation.

Your clinical documentation is the key to your reimbursements and the profitability of your practice. The simple answer to how you can make sure you are maximizing reimbursements for your practice is by improving your clinical documentation and detailing every surgical dictation… the end result can literally take your coding to the next level.

Detailed documentation is imperative.

You know what procedures you performed but remember, you can only get paid for what your notes say you performed. Documentation, such as the operative report and op notes are the only way a coder can translate the procedures performed into billable revenue via (CPT codes). Incomplete or vague documentation can lead to a major loss in billable revenue. By making sure you include the 4 following details in every dictation, Coders can determine the correct level codes are claimed so that you are reimbursed adequately.

Your time matters – Make sure to state the amount of time spent with the patient in the plan portion of the dictation. For example, “I’ve spent __ minutes face-to-face with the patient.” Having that time included could bump your visit code to the next level.

Classify treatment plans – State clearly if a fracture is seen and being treated either conservatively or surgically. This cuts down on addendum’s and corrected claims and helps get paid faster.

Detailed Dictations – State chief complaints, ROS, HPI, PFSH, and Physical exam clearly in dictation.  One extra detail could mean a higher level!

Erroneous diagnosis dictations cause delayed claims – Watch out for dictation mistakes on the diagnosis level.  For example, if a patient comes in for right ankle pain and the x-rays are dictated as left ankle x-rays which continues to the plan of care section, the coder will have to put the claim on hold and get an addendum made to clarify which ankle was actually examined.  Coding errors could delay the claim timely if not done promptly. 

How to improve accurate and timely coding

We believe Specialty providers deserve specialty coders.

At MEREM Healthcare Solutions, that is what we provide to Orthopedics and Sports Medicine practices. Every client deserves the expertise of experienced CPC coders. That is why we employ COSC coders for their specialized knowledge pertaining to complex orthopedic surgical cases.

CPC certification by the AAPC has become the gold standard with additional specialty certification available such as AAPC’s COSC (Certified Orthopedic Surgical Coder).

Get reimbursed faster by turning to an experienced team of certified professional coders to improve accurate and timely coding for your practice. Whether you scribe dictations or utilize an intuitive EMR, MEREM Healthcare Solutions tailors our coding strategy to fit the specific process used for your specialty physician documentation and will also assign and develop our coding staff around your specialty.

Charge Optimization

Working to implement the standard of including as much detail as possible is the first steps toward documenting iron-clad operative reports. Op notes are never written in stone, but the sooner they are finalized with as much information as possible, the sooner it can be coded and paid.

Improved documentation results in revenue improvement. Accurate coding results in faster reimbursement. With detailed documentation, coders don’t have to rely on addendums and delay processing claims. The turn around is quicker and more effective for the physician to be paid.

The coding team at MEREM Healthcare Solutions is trained to help your practice maximize billed charges. By reviewing every encounter note and operative report, our specialty coders will prevent under-coding and over-coding to ensure that every billable procedure performed is correctly reported. Additionally, our consulting team can help you increase charges by maximizing your clinic output and improving documentation quality.

The post Next Level Coding Begins with Improved Documentation appeared first on MEREM Health.

• When was the last time we reviewed our process or improved our technology?
• How accurate is our documentation?
• Can we improve

But it doesn’t have to be this way. Our team at MEREM Healthcare Solutions wants you to know how to be as prepared as possible in case your medical practice finds itself in the middle of a CMS audit this year. One of the best ways to avoid a CMS audit is to be prepared at all times, the best way to do so is by conducting internal audits within your medical practice.

When Was the Last Time You Reviewed Your Process?

Every medical practice has its own unique operations “process.” Is your process working for your medical practice as it should? Internal audits can be helpful in identifying areas of improvement such as your practice management software/technology and can highlight challenges within each step of your revenue cycle from documentation and coding, to billing and collections.

Technology is always changing to provide improved accuracy, especially when it comes to medical billing. If your medical practice is still using technology from years ago, then you may face a higher chance of errors in addition to your team being limited in their ability to work as effectively and efficiently as possible thorough streamlined pms processes.

Conducting an internal audit can allow you to see if the time has come to update your medical practice’s “process,” also known as “technology.”

An internal audit can also prevent revenue loss from occurring, as it can point to where issues are happening so that you can identify areas to focus on improving. For example, if your practice is facing a signifacant amount of claim denials due to coding mistakes, it might be better to consider outsourcing your medical billing and coding to a team of experts that have the experience,and ongoing training for coding within your specialty —like us!

If it has been a while since your last internal audit, you might want to conduct one sooner rather than later.

How Accurate Is Your Documentation?

When it comes to a patient health record, there is absolutely no room for error. Not only can it cause harm to the patient, it can also cause your medical practice harm and possible fines if caught while undergoing a CMS audit.

There should be no discrepancies whatsoever when comparing medical information, such as health records, which should be filled out properly throughout the entire process. Every detail is key.

MEREM Healthcare Solutions Is Here to Help!

A lot of concerns that we’ve discussed with potential clients particularly come from Pain Management physicians because they are a high risk for audits and they want to make sure everything is being coded and billed correctly and ethically to keep them off the grid from auditors.

As we explained earlier, one of the best ways to avoid a CMS audit is to be prepared at all times, which includes conducting your own audits within your medical practice. If you are noticing your medical practice is losing money or you do not have 100-percent faith in your team’s coding accuracy, it may be time for an internal audit! We can help you.

At MEREM Healthcare Solutions, you can feel confident that our knowledgeable and experienced team provides the coding accuracy your medical practice needs in order to keep insurance claims correct and get your medical practice paid for services provided.

Discover how our team at MEREM Healthcare Solutions in Birmingham, AL, can help your medical practice avoid and/or prepare for a CMS audit.

Merem Healthcare Solutions offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. We offer a wide range of solutions which include auditing, billing, coding, consulting, credentialing, payment posting, practice management, and pre-collections training. Check us out on our website or feel free to call us to see how. Our customized healthcare solutions can help you run your practice like a well-oiled machine – (205) 329-7519.

The post How Can Your Practice Avoid An Audit? appeared first on MEREM Health.

Below, our professional biller and coders have provided some information about the benefits of outsourcing your medical billing and coding.

Medical Coding and Billing Services – Why Outsource?

One reason to outsource your medical coding and billing is that it frees you and your staff up to care for your patients.

When your staff are rushed because you’re clinic is busy or running behind, it is easy to make mistakes. Your patients will be taken care of more effectively at your practice with billing and coding taken off of your staff’s plate. Outsourcing this time critical solution to our certified medical billers and coders will be able to dedicate their time fully to coding and following up on unpaid claims, resulting in more claims being processed in a timely manner with fewer errors.

Accountability for Coding Errors

The CMS modify codes on a quarterly and annual basis. Incorrect coding, or miscoding, is likely for any medical practice that does not implement ongoing CPT code training for their medical coders.  Medical coding errors may lead to major delays in payment reimbursements and payer audits, which hurts your practice. Failure to provide correct coding can cause these payments to be delayed, denied, or limited.

MEREM Healthcare Solutions has found that an alarming majority of claims are rejected or denied upon initial submission. The reimbursement for denied claims depends on a practice’s efforts for correcting and resubmitting claim denials. You can avoid this problem by outsourcing your medical coding to certified professionals who have already become familiar with the new coding system and pursue ongoing training for relevant CPT code changes that directly affect our practice specialties.

When practices utilize outsourced medical coding solutions,

1. fewer mistakes are made
2. better care is given to patients
3. and billing cycles run smoothly.

Certified Coders Do More Than Just Submit Claims

It’s not uncommon for people to have multiple insurance companies. A professional, certified coder will make sure that each claim is submitted properly. Our expert coders have the correct software and expertise necessary to submit claims to all of the responsible payers while staying compliant with CMS and payer guidelines.

If any of your claims are denied, our billers can also handle the appeal process. Outsourcing your medical coding will ensure your revenue cycle is always running as smoothly as possible. (Did you know in-house medical coding costs more? Outsource!)

Ready to Outsource Your Medical Coding?

MEREM Healthcare Solutions, located in Birmingham, Alabama offers medical coding, billing, and revenue cycle management services to clients across the nation.

We are familiar with all of the ICD-10 and ongoing CPT changes upheld by CMS and MEREM Health will provide you with superior service for a fraction of the cost of our competitors! Contact MEREM Health today or request a FREE revenue cycle audit to find out how your medical coding can be enhanced with our dedicated expert medical coding team.

The post Should You Outsource Medical Coding? Yes! appeared first on MEREM Health.