The financial stability of a healthcare provider is dependent on accurate medical billing that relies on accurate medical coding. Inaccurate medical coding practices have drastic consequences that range from medical claim rejections, denials to wrong treatment and legal complications. Most of the coding errors are due to upcoding, undercoding, and unbundling that can be averted with due diligence on part of professionals in medical coding jobs. The responsibility of giving the correct codes to procedures performed by the physicians is on the medical coders and to ensure that the coders perform their best, the job should be given to reliable medical coding companies that have experienced coders who with their expertise can avert many consequences of coding errors, some of which are mentioned here.
Financial burden on the providers: Although the health care providers may receive temporary benefits in the form of increased revenues due to upcoding or unbundling errors, the results of discovering the truth, later on, are far more expensive than the revenues. There are always chances of such medical claims being denied if the coding errors are identified at the time claim processing. In other instances, the faulty codes if discovered at later stages may be deemed to be fraud and health care providers have to pay a hefty penalty if they are found guilty. No health care provider can take these kinds of financial burden frivolously and to avoid such errors, it is pivotal that good medical coders are at the helm.
Financial burden on the patients: In recent times, financial responsibility is increasingly falling on the patients and upcoding and unbundling coding errors are major contributors to this. When a patient’s insurance doesn’t cover the expenses that are a resultant of the codes, the patient has to pay the amount from his/her personal finances. This creates disappointment among patients regarding the providers’ services and may incite to think about changing the healthcare provider.
Burden of audits: More than the financial burden, the challenging aspect for healthcare providers is, dealing with the negative attention they draw because of these errors and the ensuing coding audits and investigations that even spoil their reputation. Healthcare providers can avoid damage to their reputation and credibility among patients, insurance providers, and the healthcare provider fraternity, by hiring top-notch medical coding companies.
Assigning the medical coding jobs to a coding company of repute is the best thing a health care provider can do to avoid coding errors and improve accuracy. Healthcare providers must take necessary care to avert any kind of accidental errors or intentional fraud in coding to maintain their name and financial status.