In the healthcare industry there are many working parts behind the scenes that enable the industry to operate effectively. One of these critical parts is medical coding and it is a crucial aspect of the medical billing process. In addition to being used in the billing process, these codes also have numerous other applications within the healthcare industry. Medical coding and HCC coding, which is more detailed medical coding that is utilized by Medicare Advantage, are used in everything from ongoing medical research to reimbursements that insurance companies and Medicare issue. For these reasons, accurate and efficient medical coding is crucial to the success of the healthcare industry.
How Medical Codes are Used in the Reimbursement Process
Reimbursements are an important part of the medical billing process. Healthcare facilities earn a majority of their revenues through reimbursements that are distributed to them via insurance companies and Medicare Advantage. All healthcare facilities have coders who code all physician – patient encounters. These codes cover any diagnoses made, treatments given, and procedures performed. These codes are then sent to the appropriate insurance companies and Medicare administrators who in turn issue the healthcare facilities reimbursements based on the codes. Each medical code has an associated monetary value which is used to determine the amount of reimbursement money that a healthcare provider should receive.
If medical coding is inaccurate or incomplete, facilities may be over or underpaid. This can result in many headaches down the line, especially for patients dealing with insurance providers. Not only can this affect one’s quality of care, but it can also lead to denial of coverage. If the coding is not properly done and facilities are losing out on money, then their practices survival may be at stake. For these reasons, accurate medical coding is essential.
Accurate Coding Helps Medical Facilities Monitor Progress and Diseases
Compiling relevant medical data can be a great way for medical facilities to track the level of care being provided to their patients. In many cases, this data is gathered from medical codes as these codes detail exactly what patients are being diagnosed with and the treatments and/or medications that they are receiving. These codes are sort of a short cut for the facilities as they help them determine what they have done without having to go back through and review every individual’s chart.
This data can go far in improving the quality of healthcare offered by a facility. Tracking patient visits related to particular procedures can help physicians and the facilities focus on problem areas. These areas can then be addressed and fixed which will help the facility and its doctors provide better care to all of their patients. Medical codes are also used by healthcare professionals across the globe to track which diseases are becoming more prevalent and which are decreasing in the number of cases. Without the use of medical codes, this information would be very difficult to compile as the codes allow data to be tracked and analyzed in a very simple way.
Medical Codes Are Used in Research and Funding
Medical research is a very important aspect of healthcare. Medical studies and research have enabled the medical community to make great strides in the treatment of numerous serious conditions ranging from cancer to devastating childhood illnesses. Without the means to perform such research, many important medical advances would never have been made.
Medical codes are important in research because they allow researchers to easily track certain diseases and conditions. This tracking is useful to organizations when they are seeking critical funding for projects. By showing the numbers and real-world ramifications of certain conditions, researchers can present stronger cases to the funding organizations.
Accurate Coding is Everything
Accurate medical coding is vitally important to many different components of the healthcare industry. Many healthcare providers are not having their coding handled by qualified professionals and this is hurting these organizations financially and in the level of patient care that they are able to provide. HCC Coders offers medical facilities the professional resources necessary to ensure that all coding is performed as accurately and efficiently as possible. Contact us to find out more about how HCC Coders can help your medical practice today.