7 strategies to improve coding productivity and efficiency in your medical practice
An aging population and pent-up demand for healthcare services post-pandemic have resulted in an ever-increasing volume of medical claims. The problem? There aren’t enough medical coders to review and submit them to payers.
Particularly in small medical practices, revenue cycle staff who code medical claims may also handle non-coding tasks such as answering phones, performing billing functions (e.g., running claim edits for payer-specific information or adding National Drug Codes), conducting internal audits, querying physicians for clinical documentation improvement, and appealing denials.
Unfortunately, if you can’t figure out how to improve coding efficiency for existing staff, your medical practice may become vulnerable to delayed payments and cashflow bottlenecks that can stunt financial growth.
Here are seven strategies to promote efficient medical coding in revenue cycle management:
1. Delegate, delegate, delegate. Consider eliminating redundant and unnecessary tasks that someone other than certified medical coders can perform. Answering phones is an obvious one. However, with a little digging into revenue cycle management workflows, you may be able to uncover others as well.
2. Provide medical coding resources. It may be an added cost, but it’s one that’s well worth it because it gives medical coders the tools they need to be efficient and accurate. These resources include official coding manuals (updated annually), online coding tools, reference books, access to payer/carrier websites, industry trade newsletters and publications, medical dictionaries, apps, and more. Budgeting for these resources isn’t optional. In today’s compliance-driven environment, medical coding resources are a cost of doing business. Be sure to leverage as many cost-effective resources as possible (e.g., webinars where multiple medical coders can listen in simultaneously for one price or free newsletters) when examining how to improve coding performance.
3. Embrace automation for coding productivity and efficiency. While automation and artificial intelligence (AI) will never fully replace medical coders, in today’s demanding workplace environment, these tools can greatly augment non-clinical staff abilities. Robotic process automation (RPA), for example, can perform many manual, repetitive tasks in revenue cycle management such as checking payer portals for claim payment status, responding to payer requests for additional information, verifying patient insurance, and more. Similarly, AI performs complex and cognitive functions based on an ability to learn from data. Medical practices may gain efficiencies by leveraging AI to analyze medical records and suggest medical codes or create original, fact-based appeals to health insurers. Exploring ways to automate the revenue cycle through computer-assisted coding, RPA, or natural language processing can greatly enhance medical coder efficiency.
4. Improve clinical documentation. When thinking about how to improve coding efficiency, remember this: Your medical coding is only as good as the documentation on which it’s based. When clinical documentation is unclear, inconsistent, or vague, medical coders must query physicians—a task that adds considerable time to the process. Consider implementing a formal clinical documentation improvement workflow that streamlines efficiencies. Also provide ongoing physician education regarding the importance of documenting diagnostic specificity; the presence of complications, comorbidities, and social determinants of health that affect medical decision-making, and other important details necessary for medical coding and revenue integrity. If you’re wondering how to improve coding performance, this is one of the most effective—and oftentimes overlooked—strategies.
5. Minimize personal distractions. Given the shift toward remote work, some medical coders may not even work directly in the medical practice. When this is the case, managers must reiterate the importance of removing phones, radios, TVs, or other distractions in the workspace. A comprehensive telecommuting agreement can spell out specific expectations to promote efficient medical coding.
6. Encourage certification. Medical coding certification from a reputable organization like the American Academy of Professional Coders promotes coding accuracy and efficiency as well as revenue integrity. Certification and ongoing continuing education also equips medical coders with the ability to handle complex coding challenges effectively. Certified medical coders are an incredible asset to your medical practice.
7. Consider an outsource partnership. If, after trying one or more of these revenue cycle strategies, you continue to struggle, it may be time to consider partnering with an outsource medical coding vendor that can help you weather the ups and downs of fluctuating claim volumes. Partnering with an outsource vendor may provide significant cashflow relief at a fraction of the cost associated with hiring full- or part-time staff.
Conclusion
Without proactive strategies that include technology and workflow changes, medical practices may continue to struggle to achieve optimal revenue cycle management. Learn how edgeMED can help and be sure to check the Healthy Snacks blog for more expert insights, best practices and industry trends.
