Service Benefit: Accurate Coding
Our accurate and timely medical coding services help you secure prompt payment for covered services while you focus on providing optimal care to your patients and staying competitive in the industry. We follow practices that completely support major healthcare insurances such as Aetna, United Healthcare, BCBS, Medicare, Medicaid, Humana, Tricare, Champva and Medicare products. Diagnosis codes, procedure codes and modifiers are assigned in accordance with the latest AMA and CMS guidelines. Our services adhere to the Health Insurance Portability and Accountability Act (HIPAA), NCCI edits (National Correct Coding Initiatives), NCD (National Coverage Determinations) and LCD (Local Coverage Determinations).
Our physician coding services are available for all types of physicians' offices, specialty treatment centers, doctors' offices, and medical practices. Our physician coding services offer coding in the following specialties:
Pathology: Surgical& Anatomic
PHYSICIAN CREDENTIALING SERVICE
Service Benefit: Qualified Physicians
At SR Medical Coding we provide physician credentialing that acquires information about a health care provider in order to ascertain their medical qualifications and credibility to practice medicine in their chosen line of specialty. It is mandated and obligatory for medical practitioners to undergo credentialing to enable them to work in medical centers and insurance companies. We provide physician credentialing service for physicians that involves scrutinizing essential documents, qualification history like education, licensure, training, ethical qualification and recognition in the healthcare community.
Service Benefits: Revenue Cycle/Medical Laws
Both the OIG and CMS recommend that all providers have their coding reviewed by an outside independent party with appropriate expertise in that clinical specialty, on a regular basis. The purpose of these reviews is to obtain an unbiased independent evaluation of the provider’s coding and to ensure its accuracy and compliance with current laws, rules, and regulations. Only an independent review can serve to identify errors and misconceptions regarding coding, as well as ensure that coding regulatory updates are being incorporated into the provider’s coding protocols. Feedback is essential for a program of “continuous quality improvement” to prevent errors from becoming “institutionalized.” Specialty coding skills vary from individual-to-individual and staff changes can occur at anytime, so the recommendation for independent reviews applies not only to whenever regulatory coding changes occur, but also when a provider experiences personnel changes in its coding staff.
Accuracy in coding does not solely mean the reduction of compliance exposure. An equally important result of an independent coding review is the identification of opportunities to optimize reimbursement. Coding errors and misconceptions can also result in lost charges and undervalued services. Without outside “peer reviews,” errors, along with whatever else the coder does-not-know becomes institutionalized and can be extremely costly in terms of lost charges and reimbursement over time. No payer will ever send payment for more than was billed because they identified an omitted code. Our audit reports address this by identifying missed charges and undervalued services.
The purpose of coding is to accurately report what happened during the provider-patient encounter. This is totally dependent upon the thoroughness and clarity of the doctors’ medical reports. The codes must reflect the contents of the doctors’ medical records. They are the legal source documents; nurses’ notes, technicians’ notes, and the rest of the chart are secondary to the physicians’ notes and reports. An integral component of our coding accuracy review is to identify any documentation deficiencies or discrepancies in the physicians’ reports that we observe. This feedback helps our clients improve the quality of their medical records, which we feel leads to improved patient care, and also gives the coders more complete and thorough documentation from which to code.
Our medical coding accuracy evaluations are designed to be part of a continuous quality improvement program. It gives our clients’ medical coders the feedback they need to more accurately code the patient-care services.
How can having SR Medical Coding perform periodic coding accuracy audits help your organization:
Helps with OIG regulations compliance
Keeps you from paying fines and/or going to jail
Identifies if you are leaving money on the table
Ensures you are up to date with coding rules and regulations
Improves the accuracy of your medical records
Enables you to better manage your staff
Serves as a teaching tool for your employees