24 May 2019

7 Medical Coding Mistakes You Must Avoid

The Medical Coding industry was worth more than 12 billion USD in 2018 and is expected to reach double, i.e., over 24 billion by 2025 by achieving a CAGR of over 10 percent from 2019 to 2025. These stats and growth numbers are enough to lure any job seeker into trying medical coding as a profession and having a share of the incredible growth that is bound to happen.

If the lucrative industry has also tempted you and you wish to make a career in it, then you must learn about 7 medical coding mistakes you must avoid becoming a successful coder who delivers perfection all the time.

  1. Upcoding

If patients are billed for services not performed or the procedure performed was simpler than what was done, it is categorized as upcoding. As upcoding leads to an inflated bill, it is wise to avoid it to get more money because it’s illegal and can land you in jail.

  1. Undercoding

Skipping codes or showing less than the procedures done is known as undercoding. It is the opposite of upcoding and is also illegal. Many people do it to avoid audits or reduce the bill of the patient.

  1. Mismatching the Codes

To ensure correct medical coding, it is essential that the diagnostics and treatment codes match flawlessly. If the diagnosis doesn’t prove the need for a medical procedure, the claims can be denied.

  1. Wrongfully Reporting Injection Codes

Some coders report multiple units of code for one session that involved administering of various injections. This is an incorrect approach. Only one code needs to be reported in such cases.

  1. Not Presenting Documentation

When reporting unlisted codes, you must ensure that there is proper documentation because if there is a lack of documentation, it can lead to rejection of claims too.

  1. Being Too Comfortable

You must have heard of the term “know it all.” Some coders think that they know it all within a few years of being on the job. The result, they end up assuming the right codes rather than checking them. This leads to blundering mistakes and wrong coding.

  1. Not Focusing on Demographic Data

The demographic data of patients is essential for every medical coding report. If the data is not there or there is a mistake in data like age, date of birth, address or sex are incorrect, it can also lead to a lot of problems.

The Aim

After reading all these points, you must know that the aim of medical coding should be to ensure that the claims are processed seamlessly and all the people’s whose money is due to get it. The lower the rejections, the higher would be the coding success.

Get the Right Codes Every Time

Now, if you think that medical coding is too tedious, you can outsource it to us, the team of Win Healthcare. We have a skilled team of coders who remember and avoid all the abovementioned mistakes. We also have a quality check system in place that ensures coding errors, if any are eliminated before the delivery to the client. Sounds interesting? Call us for more!


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09 Jan 2018

Ask 5 Questions Before Hiring a Medical Data Management Firm

Outsourcing medical data management is not a big deal now. Every other insurance company, lawyer or even a medical facility does that to ensure that data is correctly organized, and categorized so that it makes sense. If you are also considering hiring an outsourcing partner, you should ask an outsourcing firm a few questions to judge its capabilities. Here they are:

Have You Got Any Experience?

Though hiring a new company would seem like an attractive option because of the fact that it would be considerably cheaper than an experienced one, your focus should be on hiring a company that has got some experience of medical data management and doesn’t need you to guide them at every step. Hiring a company with experience will also ensure that you get the precise results you want in a timely manner.

Are You HIPAA Compliant?

Even if the answer is yes, you should dig deeper and ensure that they know of all the HIPAA regulations and follow them to the letter. You can also hire an expert to judge whether the company is totally HIPAA compliant or not. It’s the issue of not only the law but your patients’ medical data privacy as well. Never take it lightly. You can also access their security shields and their ways of destroying data to judge their adherence to HIPAA.

Who are Your Backups?

In many medical data management companies, several teams are formed to ensure that if one person is unable to handle a task, the other can take over. Make sure that the company you are hiring is not a one-man show and there are several people with medical knowledge and skills to complete your project even if the person you were assigned falls sick or takes personal leaves. You work must never suffer.

Can You Provide Any Samples/References?

It is a good idea to hire a medical data management company that can offer you sample reports. It should be able to show you how a weekly, monthly or even daily report would look like so that you can be sure the data is assorted wisely. You can also ask for references of previous clients who attest to the fact that a job will be done in the way you want.

Can You Meet All My Requirements?

Finally, you should ask a medical data management company about whether it can meet all your requirements or not. You may have added instructions like highlight specific data or create a bi-weekly report which might be different from the way it’s usually done at the firm. So, ask them whether they will be able to follow your instructions precisely or not.

If you don’t want to do all this research and just hire a reliable medical data management company, then you can trust Win Healthcare. We offer top of the line services and ensure that all projects are delivered in a timely and cost-effective manner without failing even once.  

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