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RCM Tip of the Day: Simplify Coding

August 2015
Becker's Hospital CFO


Amy Sullivan, Vice President, Revenue Cycle Solutions, PatientKeeper: In order for providers to save time (while also improving billing accuracy), physicians need the ability to view and select the appropriate clinical codes knowing their selections will be mapped to the appropriate billing codes upon submission. It’s equally important for them to have point-of-care code edits, which leads to a reduction in coding errors. Having the ability to accurately specify codes in real time means fewer changes downstream for the administration staff, less time spent on research and follow-up of charges, and fewer instances of costly resubmissions and missing the claim-submission window.

Without up-front edits, coders are often left having to input many more changes. Sometimes a procedure is performed on a patient during an office visit; the reason for the procedure may be separate from the visit, but doctors would have a difficult time remembering to add the appropriate modifier. Coders would have to go back and ask them, and an investigation would ensue.  But if a code edit flags this for the physician, they know to bill for the procedure separately.

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