Exceptional Coders | Innovative Technology

Revenues hinge on proper medical coding. Without it, reimbursements will not come in, and the facility will not generate money. With the recently implemented ICD-10 standards here in the USA these codes will become under more scrutiny. Let's discuss the top 3 secrets to a successful medical coding reimbursement: 

1. Experienced Medical Coders

Previously, medical coders using ICD-9 spent an average of 12-15 minutes per chart with a turnaround period of about 69 days. With the implementation of ICD-10 it is now estimated that coders will spend an average of 33 minutes per chart with a turnaround period of about 139 days. Time lost means revenue lost. Without extensive preparation, inexperiened medical coders will directly impact the loss of revenue and increase in denied claims. Here at Aviacode we ensure all of our medical coders are not only ICD-10 Certified, but specialty specific subject matter experts for our clients coding. Our model has been followed not only by outsourced medical coding companies, but those medical practices that choose to keep their medical coding in house. Each and every one of Aviacode's Medical coders are AAPC or AHIMA certified with three or more years of experience and are required to pass specialty-specific exams. 

It should go without saying, the first secret to a successful claim reimbursement starts with having an experienced medical coder. Without the right coder, you will not have the maximum reimbursement potential you are seeking out. 

 With October 1st in our rearview mirror, we thought it would be a good time to stop, take a deep breathe, and look at your physicians clinical documentation. How does it look? Take a look at our infographic and decide which Dr. you relate with more: 

 For those familiar with the healthcare industry, right now you may be holding your breath as the much anticipated switch from ICD-9 to ICD-10 is only days away. Whether you work with physicians, in a third party billing company, insurance agency or see a future in the healthcare industry, this switch will inevitably effect the way your job is performed. This switch will even change the way one must prepare for a job in medical coding and the industry itself, from education and training, to benefits, work flexibility and market potential. Read on to find out why this is an exciting time to join the medical coding industry and how to land a job post ICD-10 implementation. 

Industry Changes & What This Means For You

The switch to ICD-10 means that, unless granted a crossover or extension, all states will be required to process all medical billing and documentation in the new code which increased the volume of codes by 520% or from 13,000 used in ICD-9 to 68,000 total for ICD-10. The bright side is, for those considering a career in medical coding, the switch has many healthcare providers and medical billing companies searching for well-trained and certified coders proficient in ICD-10. The US Bureau of Labor Statistics estimates a shortage of more than 50,000 qualified Health Information Management and Health Information Technology Workers by 2015. Meaning that while some degrees and programs leave you to fend for yourself in competitive, oversaturated job markets, while gaining certification in ICD-10 will leave you with many potential prospects in a secure and growing market. 

ICD-10 Training, Certification & Resources

Medical professionals undergo extensive training and preparation before they ever receive a license to practice medicine, however even these highly trained professionals make mistakes that can lead to costly and irreversible consequences. Failure to provide proper documentation is one of the problem areas among leading healthcare providers because of the continued changes within this industry related to medical coding and proper documenation of medical records. The following list sheds light on some of the issues that arise as a result of improper documentation.

1. Denials

Denied claims are a healthcare provider’s worst nightmare and can lead to costly issues due to wasted time and resources. There are several main reasons why an insurance provider will deny a medical claim, one of them being improper documentation, with non-capture of tests and procedures. This is an often a result when a physician or medical coder fails to input a code correctly or omits something entirely.  Although, a claim is still recoverable even after it has been denied, the time and money spent rebilling and appealing the claim will not.

There has been a wealth of information available on the ICD-10 initiative. Nevertheless, many physicians still strongly believe that this is strictly a ‘coding’ issue. Hence, it will not affect them in anyway as they go about their daily routine, nor will they have to submit to any type of training in advance of the October 1, 2015 go-live date.

Most physicians seem to comprehend that the ICD-9 to the ICD-10 changeover may result in a loss of revenue if they do not personally ensure that their coders are correctly trained to use the new code sets. On the other hand, the physicians who do not fully comprehend the extensive effects of the ICD-10 implementation will be faced with a momentous revenue loss if they themselves are not sufficiently prepared.

While the ICD-10 moves us ahead from our current number of 14,000 diagnosis codes to a future number of 68,000 diagnosis codes, the capability of the coder to properly assign the new codes and use the new coding system relies profoundly on the physician's clinical documentation to finish the process.

Are you articulate, computer savvy and interested in joining one of the leading industries in the nation? If so, medical coding may be a smart career choice for you. Although, it is not ideal for everyone, the benefits, job security and high demand, are all great reasons why medical coding may be the ultimate dream job for some. Read on for more details about why one should choose a career in medical coding.

1. Demand For Medical Coders

There is a growing need for medical coders and now is a good time to join this industry if you’re looking for a strong job market. With the impending switch from ICD-9 to ICD-10, we will soon see the demand for skilled medical coders with ICD-10 certification and training increase. The switch will take effect October 1^st, 2015 and at that point, unless the state has been issued and extension, it will be required that all medical coding be done in ICD-10. This change will leave many healthcare and insurance providers unequipped to continue providing service at same capacity. In preparation for this switch many medical coding companies and healthcare service providers are seeking out coders with ICD-10 certification.

This is post 10 of a 10 post series on the top 10 reasons you should consider outsourcing your coding.

According to the U.S Bureau of Labor Statistics (BLS), medical coders are considered health information technicians. Health Technicians hold at least a certificate in health information technology or medical coding. The BLS has also reported that medical coding companies like Aviacode or any healthcare provider prefer a medical coder to have a certification which makes them marketable and more valuable. 

Who cares if your medical coder is educated? Having a basic understanding of ICD-9 and ICD-10 will allow them to perform at the level they need in order to fulfill their role, right? 

At the center of the revenue cycle there is medical coding. Without it, nobody makes any money ever, period. With a medical coder, companies now have the ability to take their clinical documentation and insert the proper ICD-9 or ICD-10 codes that will allow for proper reimbursement from the payer. 

According to Payscale.com the average medical coder makes $37,884 annually. If you add on the costs associated with that the number can reach over $50,000 for a fully burdened medical coder on average. The cost to employ a medical coder, even fully burdened can pale in comparison to the opportunity cost of hiring a medical coder who is not highly educated and dedicated to their trade. 

This is post 9 of a 10 post series on the top 10 reasons you should consider outsourcing your coding.

The Golden Gate Bridge in San Francisco can hold 4,000 pounds per lineal foot. Meaning that if we cut out just one foot of the bridge out it could support two tons. Despite it being capable of holding massive amounts of weights, it can also move downwards by 10.8 ft. and move upward by 5.8 ft. So during winds or storms it can actually move to prevent damage or destruction.

These two essential qualities that have kept the bridge there for 82 years are provided by the specific suspension bridge structure that the engineers used. Two large cables run from each tower, with smaller wires jetting down, attaching themselves to the bridge itself. 

Speaking to some of our account executives recently I was able to hear stories of why clients leave certain medical coding companies and why they stick with others. The common thread between each story was the support the client would receive from the medical coding company. If the support was good, they would stick. If the support was bad, the relationship would inevitably deteriorate and turn sour. 

As our conversation continued I learned a few points that I thought noteworthy to share as people search for a medical coding company. Here are the top 3 points that are critical for selecting a medical coding company that will support you.

It’s a great day for Aviacode – and the healthcare industry specifically as we all transition to ICD-10!

Today we announced the closing of a $16 million growth investment from Frontier Capital. We plan to use the funds to further develop and market both our network of certified medical coders and our SaaS-based platform to meet the growing demand for solutions that facilitate medical coding and auditing for physician groups, facilities and surgical centers.

This is especially beneficial for these entities as the October 1 deadline for transitioning to ICD-10 quickly approaches. ICD-10 includes more than 140,000 codes—19 times the number of codes in the outdated ICD-9. The new coding system reflects the latest medical knowledge, allows for more specificity in describing conditions and procedures, and is also a step toward the transition to quality and value-based reimbursement models.

Australia began their ICD-10 coding standard in 1999. Canada has been using ICD-10 nationwide since 2006. These countries have already been through the process of implementation with all of its problems and headaches. With the idea that, “Those who do no learn from history are doomed to repeat it” here are 6 things we can learn from the Australian and Canadian ICD-10 Implementation:

Education

 Australia took the time to meet with analysts, coders, and healthcare professionals to create educational materials. They utilized their resources and took the time to educate their coders on ICD-10. This process began 18 months before it was implemented, which reduced lag times and lead to normal coding production after 12-16 weeks on average.