In the modern age of the healthcare industry, quick and accurate ICD and HCC coding are critical requirements for healthcare providers in order to keep their operations up and running. Healthcare providers receive reimbursements for the Medicare Advantage patients that they treat based on the HCC coding that they submit. The coding process enables providers to receive reimbursements proportional to the health expenditure risks associated with each individual patient, which helps to ensure that all patients, including high-risk ones, receive the proper care and coverage.
As more patients have become covered by an expanding Medicare and reimbursement rates have been lowered, successful HCC coding has never been more important for healthcare providers. Unfortunately, many healthcare providers do not receive large portions of their deserved reimbursements because of errors that are made in their HCC coding processes. In order to help your facility maximize your reimbursement rates, we have compiled a list of four tips describing how your practice can improve your coding practices.
Ensure That You Meet Coding Deadlines
HCC codes describing each patient’s medical conditions must be re-captured and documented every 12 months. If a facility misses a deadline, the result can be a funding gap of six months which can bring serious financial issues for the healthcare provider. In order to speed up this process and avoid suffering from this gap in funding, your practice can take the following measures. First, you can hire an outside service like HCC Coders to provide you with prospective risk adjustment services. These services entail working ahead on annual visit forms to pre-code all known patient conditions into the system which saves time later on down the road. Our professional coders regularly perform prospective risk adjustments in order to help clients make sure that their HCC codes are submitted on time. In addition to prospective risk adjustments, your facility should establish a high quality patient outreach program. These programs are designed to remind Medicare patients to schedule and attend their annual visits. Making sure patients attend their appointments on a regular basis will help your coders finish all of their work before coding deadlines.
Provide Your Coders with Detailed ICD-10 Training
Starting in October of 2015, all healthcare providers and medical facilities will be required to switch from the old ICD-9 code set to the new ICD-10 set. These codes are used to develop HCC categories and are a critical component of medical billing. The ICD-10 code set has thousands more codes than the current ICD-9 set and the whole numbering system has been significantly updated and redesigned. This switch will definitely be a major problem for coders who are unprepared. If your facility has your own coders, then make sure they have received thorough training on the new code set. You can avoid these issues and the costs of training your staff by utilizing the skills of our professional coders who have already been trained on the new ICD-10 code set.
Improve Your Quality Control
As we have discussed, the more accurate your coding is, the better your reimbursement rates will be. HCC Coders offers retrospective risk adjustment services to ensure all relevant codes have been captured. If we find that new codes can be used, we annotate these codes in order to maximize your reimbursement rates. We also offer software that contains an auditing feature that allows you to review your coders’ work for quality control purposes. In order to earn the most reimbursements possible, it is crucial that your quality control processes are spotting all errors and omissions.
Increase the Speed of Your Medical Record Retrieval
Another factor that can affect your ability to earn the maximum possible amount of reimbursements is the speed and efficiency of your medical record retrieval process. Coders cannot do their jobs without having the records in hand so if your facility is slow to input medical records or send them to your coders, then you are likely losing out on reimbursement money. We can provide your facility with the software needed to help speed up these processes or can provide you with some of the best record retrieval services in the industry. These services are designed to ensure that our customers earn all of the reimbursements that they are entitled to.
Get The Help You Need Today
HCC coders specialize in various different services related to the coding process. Working with ICD and HCC codes is very complex work that is critical to the health of medical practices across the country. Contact HCC Coders today to learn how we can optimize your coding efforts and bring in the most reimbursements possible for your facility.