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What work does a medical coding service company do, and why is it important?

Updated: Feb 8


Medical coding is one of the most critical parts of the healthcare industry, and a medical coding service company plays a vital role in handling all parts of the coding process for its client.

 

If you are a part of the healthcare industry, then coding is something that you will definitely know about. For others, here is a simple explanation of what that is.

 

Whenever practices want to submit their final bills to the payers (insurance providers), they need to convert pages of statements into codes. These codes are compiled together and sent to the insurance company.

 

A medical coding services company does this for various reasons.

1. Codes help easily know the diagnoses, treatments, and services provided. There are different codes for every single service provided by medical experts.

2. Sometimes, documentation may be confusing. Doctors may mention different treatments differently. Codes avoid this confusion.

3. Codes make it easy for payers to scan the bills and offer reimbursements.

 

Why is medical coding challenging?

Many healthcare practices choose to outsource medical billing and coding because the processes are very challenging and cannot be attempted with wavered focus. The following are reasons why coding is challenging and why it may be a better option to let experienced medical coding services companies take over the process.

 

1. There are thousands of CPT and ICD codes that the coders must be aware of to successfully convert physician notes and documents into codes.

2. Periodically, CPT and ICD codes keep getting upgraded, and coders have to be reskilled and retrained to understand the changes.

3. A medical coding services company needs to invest extensively in coding tools and new technology. Since these third-party service providers have multiple clients, their investments make sense. A private healthcare practice cannot afford to make huge investments in back-end coding when it can use that budget to improve its front-end services.

4. One of the most common reasons why claims are denied is the inaccurate or incomplete use of codes. The practice needs to spend more money appealing denials. Coding needs to be precise and perfect for it to add value to the practice.

 

The pros of hiring a medical coding services company instead of trying to code in-house

 

A medical coding services company offers coding services to all healthcare organizations, starting from small practices to multinational hospitals. Most healthcare brands find it easier to outsource billing and coding to third-party service providers because, honestly, handling billing and coding in-house is resource-consuming.

 

Burnout is a term that’s very common in the healthcare industry. Physicians, medical advisors, front desk administrators, and backend support staff are all working excessive hours, trying to provide the best service to patients. Asking an already tired team to take over another difficult process like coding may not be the smartest thing to do.

 

A third-party medical coding services company comes with the bandwidth to handle fluctuating coding needs, can reduce the burden on the practice, and ensure the coding process contributes to revenue generation.

 

Conclusion

A medical coding services company can become a very valuable partner to any healthcare organization by taking over medical coding and ensuring claims are submitted, and reimbursements are received smoothly and quickly. Precise coding also helps reduce the existing AR cycle, which can improve the financial stability of the organization.


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