Naturally, your practice’s medical coders are already going to be highly skilled professionals that can aid you with your overall billing process, but there are a few skills in particular that are absolutely paramount for long-term financial stability.

So, throughout this article, we’ll be covering some of the most important skills for a coding specialist to be proficient in, from coding a medical procedure to preventing claim denials from insurance providers.

Ultimately, all of the options on our list are vital in terms of optimizing revenue and enhancing your level of patient care, so let’s get started and understand what really separates a medical coder from the pack.

1. Proficiency In Medical Terminology

Put simply, having a firm grasp of some of the more complicated jargon associated with the medical industry is essentially like being able to speak the language of healthcare. Generally speaking, being fluent in this language means you can properly translate complex details into medical codes that are then used by an insurance company or your medical billers.

Whether it’s diagnoses or more general medical procedures, there’s little margin for error here. Let’s explore some of the benefits of understanding how to code a range of different medical terminology:

– Reduce Errors: Accurate coding means you’ll have far fewer mistakes on your insurance claims which leads to a much smoother reimbursement process.

– Improve Communication: Clear codes help your healthcare professionals understand any given patient’s medical records with ease.

Let’s look at an example to wrap this section up. For instance, let’s say one of your professional coders has coded something like a “coronary artery bypass graft” as a “coronary artery bridge graft” instead.

Though these are functionally very similar procedures, such a seemingly minor difference can actually have huge ramifications for your practice and cause delays in reimbursement. Subsequently, this takes a toll on your practice’s cash flow, so having a clear understanding of medical terminology helps to prevent this kind of thing.

2. In-depth Knowledge of The Various Coding Systems

It can help to think of coding systems almost like they’re roadmaps for medical information – let’s focus on some of the main ones:

– ICD-10 (diagnoses): Describes the current condition of your patients.

– CPT (procedures): Covers more on medical treatments and services that your practice provides.

– HCPCS (supplies/services): Typically focuses on things like equipment, medications, and even healthcare supplies that are used on a daily basis.

Similarly to understanding medical terminology, knowing how these systems work inside out comes with huge advantages for your practice, things such as:

– Smooth Billing: Get paid faster because your insurance claims aren’t being denied due to incorrect coding.

– Optimized Reimbursement: Accurate codes generally lead to fairer reimbursement rates for your practice.

Still, coding systems aren’t exactly static in California or throughout the rest of the country. Changes happen on a fairly frequent basis, so staying updated at all times is vital if you’re trying to minimize the number of claim denials your practice is receiving (which should generally be a top priority to ensure a good cash flow.

Whether it’s new codes being introduced or old ones getting revised, it can generally help to have a professional third-party company such as PMN by your side to handle both medical billing and coding. With PMN, you’ll gain instant access to a medical biller/coding team with over 20 years of experience aiding small medical practices – not only ensuring accurate claim submission but also liberating your team to focus on patient-centric tasks.

If you’d like to hear more about PMNs physician services, don’t hesitate to contact them at (949) 215-5055 or schedule an in-person appointment at their office in Laguna Hills, Orange County, California.

3. Ensuring Accuracy

This goes for your medical billers, too, but meticulous attention in all areas is generally one of the most coveted medical coder skills. If your coders are able to properly scrutinize things like patient records and diagnoses prior to submitting your claims, you’re ultimately able to prevent coding errors that can otherwise snowball into billing discrepancies and regulatory violations pretty easily.

Naturally, it doesn’t stop at the regulatory violations either, as accidentally upcoding or costing your patients more money than they’re already paying massively dents your patient trust and overall reputation.

4. Regulatory Knowledge and Compliance

As touched on earlier, compliance with all the relevant regulatory bodies in the country is vital when it comes to maintaining financial stability. Conversely, any errors in this field can result in suspensions or other negative implications for your revenue cycle management, so this is definitely something you want to stay on top of.

Organizations such as HIPAA and Medicare are some of the main bodies to adhere to, and they’re mainly responsible for safeguarding things like patient medical records and other kinds of data security – both of which accurate coding helps maintain.

FAQs

Can Outsourcing Coding Services Help Your Practice Ensure Accuracy?

Yes, generally speaking, it’s a far safer bet to delegate your coding services to a specialized professional rather than handling it in-house – especially with the threat of suspensions and fines looming over your practice. Aside from this, companies like PMN are typically less expensive than training all of your existing staff members to a high standard.

How Does Accurate Coding Contribute To a Positive Practice Reputation?

Ultimately, having a good record when it comes to coding demonstrates your overall commitment to precise and ethical practices throughout your facility. It shouldn’t come as a surprise that patients appreciate receiving accurate bills, so error-free coding can be generally helpful when you’re trying to foster trust and satisfaction among your patients.