What should HIM directors prioritize to ensure medical coding quality?

As an HIM director, you’re likely looking for ways to reduce inefficiencies to boost your organization’s bottom line and ensure PHI security. 

Your medical coding team has the power to help you with both of those endeavors. However, because they’re known for quietly working with their heads down, they’re often overlooked—a colossal mistake. 

Prioritizing your coding team and the quality of their coding is to your advantage as they can either positively or negatively impact your organization’s operations and finances. 

You may be asking yourself: What should I prioritize? How can I ensure my coding team positively impacts my organization? Here are a few ideas. 

Staying up-to-date on healthcare changes

Coding guidelines are complex and ever-changing. For example, there are annual updates to the health common procedure coding system (HCPCS), ICD-10, and CPT, all of which require education and, sometimes, retraining. For example, urgent care guidelines were updated recently, and emergency medicine E&M guidance is expected to change in 2023. 

Your staff must also be up-to-date on the fee schedules for all the commercial payors with which your organization is contracted. It’s not unusual that a health system has 40+ contracts whose rules and guidelines are also updated regularly. 

Ensuring the education of your coding team on any healthcare coding changes is imperative to your overall coding quality and avoiding the unwanted consequences of inaccurate coding, such as denied claims. Because denials delay reimbursements and cost time to research, defend, and fix, ensuring compliance with new reporting guidelines is essential.

Performing coding audits

Performing coding audits on a regular basis helps medical organizations, no matter the size, ensure quality and accuracy to maintain compliant billing and coding.

Audits can reveal unwanted issues such as outdated or incorrect coding, and even fraudulent activity. Being aware of these happenings can help organizations avoid denied claims and adverse external audit results, find lost revenue, and save time and money.

Regular audits bring errors to your coding team’s attention. Once they’re aware of these errors, they won’t continue to make the same mistakes, resulting in better coding quality and a more informed, educated team.

While a coding team sometimes interprets audits as a negative practice to see what they’re doing wrong, it’s not! Reiterate to your team that they are opportunities for growth and to create a positive domino effect stretching through the entire revenue cycle.

Many options, such as Fathom’s comprehensive, real-time coding audit, make the process as easy as it is informative.

Leveraging the right technology

The great resignation is affecting all areas of healthcare, including coding teams. According to the American Health Information Management Association (AHIMA), there’s a nationwide shortage of certified medical coders in hospitals, physician practices, and other healthcare facilities. 

If your team needs help, especially considering the current staffing shortages, leveraging technology to supplement your existing team or completely outsource coding is a great option.

The right technology solution should ensure quality and accuracy, lower your costs, and be easy to deploy. 

Utilize technology to automate the repetitive, simple tasks your coding team doesn’t have time to do. Taking those tasks off their plate allows them to focus on more in-depth jobs like denials management. This, in turn, boosts employee morale and retention and bolsters your denials management operations. At the same time, it saves your organization time and money while also ensuring coding quality.

For example, Fathom’s autonomous coding model automates 80-97% of encounters, allowing coders to focus on higher revenue risk activities and resulting in up to a 70% reduction in coding costs while increasing speed, accuracy, and security within weeks.

How will you prioritize coding quality?

The quality and accuracy of your organization’s medical coding create a ripple effect throughout your operations and the entire revenue cycle. 

Whether that’s a positive or negative impact is up to you.

Prioritizing regular audits, education on constantly evolving guidelines and requirements, and finding the right technology solution for your coding department is a great way to ensure it’s a positive one. 

Fathom’s solutions can help you with all three of these priorities. Want a free analysis of your coding operations to see what we can do for you? We’re ready to get started.

Request a free coding analysis