Medical Coding has a significant impact on the revenue cycle performance of Oncology Medical Billing. Therefore, it is necessary to take the time to analyze your coding department is indeed mandatory. It can help you recover funds lost due to discharges that weren’t entirely billed or reduce denials due to coding issues. You may enhance Oncology coding quality by identifying important clinical documentation errors using medical coding analytics by facility or provider.
Your revenue cycle is a continuous operation. Many of the coding-related problems you find during the initial round of analysis and corrections may be solved at a high level. To ensure that the discovered faults are not repeating, you must continuously examine your Oncology coding and make structural corrections.
We hope that the suggestions we provide below will have a beneficial impact on your Urology revenue cycle performance. These tips basis on our experience developing high-quality coding programs.
Pay close attention to HCCs and SDOH
Valid Coding for Risk Factors More than ever, HCC coding and SDOH (Social Determinants of Healthcare) collection are essential.
The CMS approved using Hierarchical Condition Categories (HCC) coding to calculate the Oncology Medical Billing reimbursement under Medicare.
HCC codes analyze a patient’s data, including age, gender, and current health condition, to determine risk adjustment variables. Additionally, it determines the patient’s anticipated annual healthcare costs. HCC coding enables providers to deliver value-based care while receiving fair reimbursement for treating patients with a higher risk.
Using the MEAT (Monitoring, Evaluating, Assessing, and Treatment) criteria, doctors must record the patient’s status with 100 % accuracy. This made it easier for coders to assign the appropriate codes.
Social Determinants of Health
The same is true for accurate coding for social determinants of health (SDOH), which enhances patient care and satisfaction while lowering readmission rates and supporting a robust revenue cycle. One can evaluate the five SDOH categories listed below;
- Socioeconomic conditions.
- Educational background and quality.
- Access to high-quality healthcare.
- Neighborhood where they live.
- Social strata and community context.
Medical coders must mark the SDOH with “Z” codes. The “Z” codes help identify drug usage, personal medical history, family medical history, and diseases. The coders with ICD-10-CM must get familiar with documented SDOH and code them. The current practice of ignoring “Z” Codes is essential to the success of the Medica Coding function but will not last in the long run. Correct coding is the essence of good Oncology Medical Billing that ultimately boosts the revenue cycle.
Study Claim Denial Reports with A Focus on EMR Workflows
It takes time to work on claim denials since they require revision, investigation, and resubmission. Analyzing your claim denial reports can help you identify repeated cases of Oncology Medical Billing errors committed by coders.
Optimizing Your Coding Process by Setting Up Systemic Checks
Recognize how your revenue cycle system works and, if feasible, develop systemic validations to assist you in spotting frequent errors. You may stop these errors and expedite cash flow by using system-driven validations.
Oncology Medical Billing and Coding (Remedial) Training
Review Oncology coding denials with your coding team on a regular basis, ideally every two weeks. Determine the reason for the top 5–10 coding-related denials by looking at them. Frequently, it can result from improper clinical documentation in the setting or a lack of understanding of the proper codes for a particular procedure. A brainstorming session will help you solve many of the coding problems you’re currently having by training the coders on the appropriate codes Fashion write for us guest post
Coding Team’s Workload
The Medical Billing companies are suffering from a chronic shortage of skilled medical coders. The Medical Coding team has excessively high-performance expectations as a result of the lack of professional resources. Burnout among coders is a problem that many organizations neglect.
Conduct Coding Compliance Audits: At Least Once A Year
Coders assist healthcare companies’ quality compliance processes by interpreting documentation using standard codes and coding guidelines.
Coding compliance audits may improve revenue cycle processes, lower the frequency of claim disputes and denials, and guarantee compliance with locally and nationally healthcare reforms. The cornerstone of a successful Oncology Medical Billing revenue cycle is accurate coding.
The number of denials requiring more information for payment can be reduced by ensuring that Oncology medical coding practices comply with the established rules and standards.
For each Oncology certified medical coder, a coding compliance audit evaluates a statistically valid sample of charts to check the codes entered and the caliber of clinical documentation. In order to obtain the knowledge they lack internally, many Oncology facilities are turning to outside parties for ongoing Coding Quality Audits and annual coding compliance audits.
Outsource the Coding to A Group of Certified Medical Coders
Today, it is common practice to outsource Oncology Medical Billing and coding processes, including ongoing coding and quality assurance programs. It might be challenging to find experienced and qualified coders in the current revenue cycle labor shortage. It might be extremely harder to locate coding expertise with an Oncology specialty.
Additionally, outsourcing your coding may assist you in speeding up innovation in the revenue cycle because the partner you work with might make numerous improvements to your coding workflow to raise the quality of the final version. The playbooks they have available for various specializations and Revenue Cycle Management services can raise the standard of coding as a whole.
Medical Billing for Oncology patients and Revenue Cycle Management
Oncology patients typically struggle with their physical and financial well-being. This combination compels physicians to spend more time with each patient while also taking the risk of payment issues brought on by under- or over-coding.
Outsourcing Revenue Cycle Management tasks like compliance audit and Oncology Medical Billing to a billing partner who understands the distinction between a consultation and a new patient visit. Additionally, it ensures the correct use of codes for extended services, clinical trial insurance, and codes for particular operations like transplants. It might increase payments and decrease claim denials.
How does NEO MD Works?
Medical Billing is undergoing fast changes as a result of the No Surprises Act and current state legislation. Switching to third-part Revenue Cycle Management companies has never been more advantageous.
NEO MD provides unmatched Oncology Medical Billing and coding services in all 50 US states. Our billing services are tailored to the demands of the physician specifically and complaint to the mandatory Coding rules for a quick and efficient claims processing procedure. We have more than 15 years of expertise in Oncology Coding, and our unique approaches have sparked several-trembling Revenue Cycle Management. Furthermore, our Revenue Cycle Management services are frequently updated with relevant CMS rules.
Additionally, NEO MD offers the Best Medical Billing Services in terms of quality and value to assist efficient cash flow and revenue. We provide affordable billing services with No Hidden Fees.
What Makes NEO MD the Best Medical Billing Company?
NEOMD stood best among competitors due to the following cores;
- Refunds adjustment and Payment posting to improve the cash flow.
- Out of Network Negotiations.
- Improve RCM system efficiency with a robust credentialing team.
- Our experts work hard to reduce your front-end denials by 20%.
- We have consistently increased the collection rate for our clients because of the faster processing of accounts receivable and on-time follow-up.
- Increase in the accuracy of fees and collection.
- Offer internal audits to uncover loopholes
- Provide fortnightly financial and practice overviews.
- Offer Services that are easily scalable at all times.
- Provide Oncology Medical Billing and collection services that are of high quality and error-free.
- processing of accounts receivable and on-time follow-up.
- Use the latest technology and tools.