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Why Proper Reimbursement Depends on Coding Accuracy

As a homecare agency, you want focus on client care and not coding. Unfortunately, reimbursement is directly tied to correct, complete, and specific coding.

“Quality care is far more important than entering alphanumeric characters,” you might think. True, but only coding accuracy gets the reimbursement you are entitled to receive to provide quality care. And only by ensuring a healthy bottom line can you thrive in the industry and deliver care that improves quality of life.

4 Ways Coding Affects Bottom LineCoding Accuracy

There are many ways coding impacts financial health; some direct, some indirect. Here are important things to know coding and finances:

  1. A single coding error can result in denial by CMS. Even when you correct and successfully resubmit, payment can be significantly delayed. This means cash flow suffers even when revenues don’t.
  2. Incomplete, non- specific, or non-optimized coding means leaving money on the table. While not obvious like delays and denials, and it be undetected for years. Meaning, a non-specific or non-optimized code may “pass,” but often diminishes reimbursement. Only coders trained specifically for home health can maximize reimbursement through accurate coding.
  3. Bad coding can lose patients. If coding errors lead to payment denials and greater patient out-of-pocket expense, it could lose that client even if the error is eventually corrected. And, negative word of mouth can lose future referrals.
  4. Low productivity costs money. If submissions are slow or two less experienced coders do what a single efficient one can, the bottom line suffers.

4 Ways to Improve Coding

We could simply list ways coding impacts bottom line, but we want to focus on solutions. Here are four ways you can win with coding:

  1. Improve documentation. Coders can only code as well as the documentation they receive. Make sure clinicians are trained to document complete, accurate information and a system is in place that allows coders easily access clinicians for clarification.
  2. Hire better coders. If your coders are not certified, not trained specifically for HH, don’t have experience or good work habits, coding (and your bottom line) will suffer.
  3. Retrain existing coders. Coding clinics and further education help coders improve drastically. Investing in continuing education allows for coders to always be up to date.
  4. Outsource ICD coding. One of the easiest and often cost-effective ways to improve coding is to outsource. This decreases the cost of additional employees in-house and normally reimbursements jump 29% to 48%. Plus, clinical staff focuses on patient care when coding is no longer a responsibility.

Conclusion

Proper reimbursement is tied to coding. Poor coding causes delays, denials, and higher costs to do business. Never leave money on the table. Make sure you receive what you deserve to successfully care for patients.

To learn more about the importance of proper coding or to discuss benefits of outsourcing, contact Kenyon HomeCare Consulting today at 206-721-5091. Our Coding Plus Program and other services can help you improve your revenues and cash flow.

Category: ICD Coding

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