The Importance of Accuracy and Compliance in Billing and Coding

Billing & Reimbursement Medical Coding


Always Ensure Accurate and Compliant Billing and Coding

When managing a medical practice, you undoubtedly have several things to worry about at any given time. Medical billing and coding is difficult to keep up with, especially with evolving laws, regulations, and medical codes. These changes make it difficult to be compliant even for the most astute practices. Unfortunately, failure to have accurate and compliant medical billing and coding can result in several negative ramifications for your practice. Here are the top three reasons it is vital to be accurate and compliant in billing and coding all of the time, and some of our tips for achieving greater accuracy and compliance.

1. Financial Protection of Your Business

Inaccurate billing and coding can have serious financial consequences for your business. Often, it will result in your practice not receiving the full amount it is entitled to from the patient and/or insurance company. Sometimes this amount can be small on a per claim basis and may not seem like a big deal, however, we have seen this cost practices tens of thousands of dollars over a period of time. Inaccurate or noncompliant billing and coding can also leave your practice vulnerable to a lawsuit. By maintaining accurate billing and coding protocol, you can ensure your practice is achieving compliance and is financially protected, while reaping the benefits of boosted revenues.

In addition, inaccuracies can cause delay and/or denial of your claim and therefore payment altogether. And if your practice does not have a robust denial management strategy and protocol, claims such as this may be simply resubmitted erroneously or even written off entirely.

2. Protection for Your Patients

Medical coding is utilized to pinpoint and document exactly what diagnoses and treatments were performed during a patient’s time at your practice. This documentation remains a part of the patient’s medical record, so it is important for the protection of your patient that it is absolutely accurate. From lab results, to x-rays, to medications prescribed, the patient and designated patient’s family may at any time need access to this information. Inaccurate information can harm the patient and can harm the quality and accuracy of future care. It is irresponsible to put patient health at risk because of something like inaccurate coding. 

3. Forecasting for the Future

When your practice is compliant with all medical coding protocol, it is much easier to ensure that billing to patients and insurance is accurate. Accurate billing allows your practice to forecast for the future. Your medical practice will be able to analyze accurate data on revenue, costs, write offs, et al giving your practice the ability to make informant decisions about your business and prepare your practice for financial success in the future. Accurate billing will help with making important business decisions that may involve staffing, patient outreach, and adding service lines to your practice.

How to Achieve Stronger Accuracy and Compliance at Your Practice

Now that you know how important it is to have accurate and compliant billing and coding within your practice, you are probably wondering how to improve your current system. If your practice is struggling to reach compliance and fear you are not capturing the maxim reimbursement, the best possible solution is to hire a third party for revenue cycle management. Revenue cycle management improves the efficiency, accuracy, and reimbursements for medical practices. At Healthcare Information Services (HIS) our experts can take over the entire revenue cycle management process to take the burden off of our clients. Typically, HIS clients collect on average 10-15% more than their peers. Reliable revenue cycle management services improve practice efficiency and compliance, allowing your team to focus on providing superior medical care.

If your practice already has a billing team, then coding education may be the course of action for improving accuracy and compliance in billing and coding. By staying up to date on coding, your team can directly improve reimbursements and reap the benefits of compliant coding outlined above. HIS proudly offers a thorough coding education program to streamline your staff and boost revenue.

Contact HIS Today for Improving Your Practice’s Billing and Coding

To learn more about the importance of accuracy and compliance in billing and coding, contact the medical coding professionals at HIS today. We will want to learn more about your practice and the challenges you face, and then together we can come up with a plan for improving accuracy and compliance. We look forward to working with you!