Medical coding and billing productivity is going to decline after Oct. 1.
That means it will take longer to prepare medical claims and receive reimbursements. How much time is guesswork. But the factors working against productivity are fairly easy to see:
- Medical coders will spend more time working with the unfamiliar ICD-10 code set.
- Medical coders will spend more time on queries because physicians are unfamiliar with specificity requirements.
- Healthcare payers will reject more medical claims because of an initial increase in errors.
- Healthcare payers will take longer to reimburse claims because of internal problems.
How much this will happen is more guesswork. But hopefully knowledge on how to avoid these problems will spread quickly thanks to the yet-to-be named ICD-10 Ombudsman.
But there are steps that medical practices can take to preserve medical coder productivity even in the short time we have before Oct. 1:
- Practice ICD-10 coding on real medical records. Although could have the effect of decreasing productivity before Oct. 1.
- Schedule more coding training. Investing the time and money now will ease the pain of an ICD-10 learning curve.
- Hire coding help to keep medical claim processing moving.
- Focus specific medical coders on specialties to take advantage of their productivity.
- Clean up the discharged not final billed (DNFB) so medical coders can focus on ICD-10 codes.
- Carefully planned automation can boost efficiency and productivity.
But why bother unless you know what is your productivity now. The only way you're going to know that is if you start tracking key metrics now to make sure you have some sort of metrics now in order to set a baseline. You have to start measuring something such as charts coded in a day and coding accuracy.Start tracking metrics such as:
- Time to correctly code a medical claim
- Time it takes to get a medical claim from patient encounter to transmission to healthcare payer
- How long it takes for healthcare payers to answer coding questions
- How long medical claims are in accounts receivable
- Denial rates and how much money is denied
- Difference between reimbursements and contracted rates
Productivity does not have to be fatal to your medical practice. It's not too late to prepare.