For patients paying with insurance, the way you code their visit is as important to you as it is to them. If you code something incorrectly, it could cost the patient money as well as your practice. Insurance carriers will only pay a contracted amount for each code, so it is important to make sure you are using the codes that benefit the business the most (and save you money). This is a win-win situation, because the more the insurance pays out to you, the less the patient pays out of pocket. This leaves them with a pleasant experience and can create either a return patient, or a referred one.
There are a number of approaches you can use to improve coding in your practice. For instance, if your claim denial rate is higher than 5%, you likely need to look a little closer at the denied claims. Essentially, learn from your mistakes, and monitor trends.
Once you have a better understanding of what is approved and what is denied, train your staff to that effect. If there is a way to code a procedure or visit just a little differently, have your staff default to that code which will be approved. Many continuing education organizations offer coding classes as well, which may help keep your coding staff up to date with the latest codes. Your administrative staff also has the benefit of being able to talk with the patient and make sure everyone has a clear understanding of the patient’s insurance plan and coverage. This way, there are no surprises for either of you.
Something as simple as the wrong insurance code can end up costing your practice a lot of money. If you are interested in changing the way your practice codes, or have other questions about the management of your practice, contact us, we’d love to connect.