Many physician practices, from allergists to dentists, dermatologists, and urologists – regardless of specialty – put billing and coding specialists on their payroll.
Certified coders can fill a significant role in ensuring that the company’s systems operate as they should, saving both money and time.
Here are a few of the reasons why it’s smart to hire a certified coding specialist:
What is Medical Coding?
Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. That’s according to the standard authority on the topic and certifying agency, the AAPC.
When you hire a certified medical coding specialist you should be getting someone that knows the ins and outs of the process. The job is to take medical record documentation, such as transcription of physician’s notes, laboratory and radiologic results, and match them to the appropriate codes.
The right medical codes communicate the following:
- Patient's diagnosis
- Medical necessity for treatments, services, or supplies the patient received
- Treatments, services, and supplies provided to the patient
- Any unusual circumstances or medical condition that affected those treatments and services
Once that’s done, they submit those codes, with an claim for payment.
Your medical coding and billing clerk is who translates the work a physician does into the money in his/her practice bank account.
What to look for in a Certified Coding Specialist
If you are an employer, it’s obvious that you want your employees to know how to code documents and make them do what’s expected of them.
So the first thing you need to look for is that CERTIFICATION from the AAPC mentioned above.
A certified coding and billing specialist will have taken the appropriate courses and passed the exams become certified, obviously. But what exactly does that mean?
During your time in medical school and even since you’ve been in private practice you’ve probably observed different skill levels among your peers. Maybe you can even tell the difference between a doctor that’s been treating patients for decades and one a bit more newly minted.
Or you can simply compare your own skills to your peers – aren’t YOU better at the job, in spite of equal “certification”?
It’s the same for Coding and Billing! Some people are just better at their job than others. Whether it’s because of work ethic, intelligence or that striving to stay up to date – not all employees are the same.
Only this particular employee will be 100% responsible for collecting your money!
Finding Experienced Medical Coders
The problem even with certified medical coders is that not all of them have the requisite experience for the job.
In addition to being technically qualified in the field of coding, your employees should also have sufficient experience to perform the tasks necessary for the job.
Most coders begin their careers working entry-level positions. They often have limited experience, and then only in a specific discipline.
They may get a few incorrect codes, or they might try to input data the wrong way. It’s not uncommon for workers to double check their data. If the numbers change, there’s a good chance that they made a mistake.
The fact that coding is such a specialized job means that your workers have to know what they’re doing in order to do it effectively. That means that some workers won’t necessarily know how to do it right the first time.
That leads to DENIALS, and that is money out of your pocket.
Even a Hiring a Certified Coding Specialist Might not be Enough
The desire to have certified coders on staff is what brought you to this article
And at the very least you SHOULD hire someone certified to do your billing and coding because of how important that role is.
But what you simply can’t afford is someone inexperienced, or someone that thinks the job is just to look up the billing codes and type them into the computer.
Working with a professional company, like Integra, that offers outsourced medical coding and billing, is the best way to ensure that your work is rewarded with the highest possible income.
Because outsourcing to a company like Integra Medical Billing & Practice Management has huge advantages:
First: We ARE certified by the AAPC
That’s important because you know that we’ve done the work and passed the tests. That’s the only real objective measurement for based knowledge.
And “we” in this case means our internal staff. We have an office and direct employees that do the work under direct supervision. There’s no network of workers overseas that look up codes and type them in blindly.
Second: We Read the Notes
One of the secrets to maximizing YOUR income is by your coder/biller staff to read your notes. And not just read them but understand how to interpret them to make sure the RIGHT medical code is used to bill for the procedure.
That diligence is something you cannot get from most outsourced medical billing and coding companies. And certainly not with the experienced eyes ours do.
Third: Our Income Depends on YOUR Income
You want someone that’s paid well and motivated by a quest for perfection – AND one that works on a percentage basis.
According to nurse.org they typical medical coder makes about $44,000/year. That may SEEM like a deal when you’re looking at your employee expenses but they can cost you 10x that much in Denials, Missed Opportunities in coding and just not chasing AR like you need them to.
We work all day every day to increase how much that adds up to for us – which translates into more for you!
