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How To Improve Your Billing And Coding Quickly

Maintaining a staff of top-tier clinicians who deliver second-to-none care to your clients is your first priority as a homecare organization owner or manager. But billing and coding are nearly as important. For, unless you are adequately reimbursed for the services you provide, your ability to deliver that unbeatable care will soon evaporate.

When your home health agency is experiencing delays, denials, and persistent problems with coding and claim submissions, every day these problems continue is a drain on your resources. How, then, can you improve your coding and billing as quickly as possible?

8 Key Strategies to Rapidly Improve Your Billing and Coding Processesbilling and coding

By fixing your coding and billing issues, both eliminating costly mistakes and maximizing your reimbursements on each claim, your agency will find immediate relief from financial strains and stressors.

Here are 9 keys to boosting reimbursements and improving cash flow rapidly by refining your billing and coding processes:

1. Use only certified coders with extensive home health & hospice specific experience.

Your coding program can only be as strong as your coders. So diligently searching for and carefully selecting superior homecare and/or hospice coders should be a top priority. There are many coding details that differ depending on if the claims are for homecare, hospital or physician practices. So your priority must be to find and hire coders with homecare training and experience if at all possible.

2. Don’t bog managers down with coding — practice division of labor.

Let your coders code and your leaders manage. Performing the duties managers are trained for is going to always be more efficient, When managers are distracted by non-managerial duties, the whole organization suffers.

3. Focus on providing coders with ideal documentation support.

Documentation is to a medical coder what ammo is to a machine gun, and you cannot expect to win the war if your front line soldiers are under-supplied. Documentation must be complete and sufficiently specific so coders can fill in all appropriate alphanumeric slots correctly. And remember, all clinical documentation must match that of other providers.

4. Avoid recertification denials by specifying measurable goals and detailing progress toward those goals.

CMS now demands more detailed data than previously required on recerts. Clinicians must “justify” the need for continued in-home care and services down to the tiniest details.

5. Invest in continued education for both coders and clinicians.

No matter how perfect your coders now code and your clinicians now document, there is always room for improvement. Because of constant tweaks and changes,staff will eventually fall behind without continuing education.

6. Immediately implement all ICD-10 updates.

Every year CMS provides ICD-10 coding updates, changing dozens of codes and delivering new information. You cannot afford to delay in becoming aware of and implementing these updates.

7. Gauge your progress with monthly and annual reports.

Only by knowing where you are can you measure your progress toward where you are going. Keep detailed statistics on your coding and documentation performance. Knowing specific areas of needed improvement for struggling clinicians and/or coders is critical.

8. Be prepared to reach out to your MAC for help.

Every homecare agency has its own Medicare Administrative Contractor (MAC) who processes claims for CMS. Click here to find your region, and to see which MAC processes claims for your state. Each MAC provides resources to answer billing and reimbursement questions. Find relevant phone numbers for your home health/hospice MAC here.

The Outsourcing Option

Although we have looked at 8 keys to improving your in-house billing and coding, the fastest and easiest way for many is to outsource. In most cases, outsourcing is the most financially feasible option overall. Outsourcing boosts reimbursements significantly and saves you the cost of employing coders in-house. Additional, most outsourcing partners offer help with optimizing documentation and provide monthly progress reports.

But, be sure to select your outsourcing partner as carefully as you would an in-house coder, for all outsourcing agencies are not created equal.


By working to improve your coding and billing in-house or by outsourcing these tasks to a top outsourcing partner, you can rapidly improve your reimbursements and cash flow. Kenyon’s program can

Learn how the Kenyon HomeCare Consulting program Coding Plus can boost your reimbursements by 29% to 48%! Call 206-721-5091 or schedule an appointment online for a free 30 minute consultation.

Category: ICD Coding

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