Fill This Hole in Med School Curricula to Manage Revenue More Effectively
What didn’t your organization’s doctors learn in med school that they wish they had?
Physicians know they have knowledge gaps—from data science and information technology skills to being able to talk about nutrition with patients. Medical schools are changing to help students master more of what they must know, turning to team-based. cross-disciplinary “flipped classrooms” and more hands-on learning.
But physician coding education, which no medical practice can afford to ignore, continues to go neglected.
Barbara Fontaine, an AAPC Coder of the Year, compares medical coding and billing to “a language in which all doctors should be proficient.” Unfortunately, even though students would like to learn it, medical schools don’t usually offer physician coding classes to expose future doctors to this language they’ll have to use to translate their expert knowledge and hard work into revenue.
The MDCodePro app is one way physicians can get the coding education med school never gave them. And because strong cash flow in medical practices depends, in large part, on strong coding, the app can also play a key role in profitable revenue cycle management.
How Training Physicians in Medical Coding and Billing Enhances the Revenue Cycle
Several recent developments in U.S. healthcare have made revenue cycle management an especially pressing challenge. But better medical coding education for doctors helps practices meet the challenge at every turn.
Here are just four examples:
- The Affordable Care Act – More Patients Mean More Codes to Correctly Submit
The Tax Cuts and Jobs Act effectively repealed the ACA’s individual mandate, but “Obamacare” still means the number of Americans without health insurance has dropped from 45 million to 27 million. Providers are seeing more patients, nearly half of whom (46.2%) are covered by Medicare and Medicaid combined. Given the government’s low reimbursement rates, you don’t want to forfeit any legitimately earned revenue, which means the coding in your submitted claims must be precise and optimized every time.
- Value-Based Payment – Raising the Stakes for Documentation and Coding
Under CMS’ Quality Payment Program (QPP), which implements MACRA (the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act), providers are paid on the basis of effective use of resources, clinical improvement, and improved patient outcomes. In the “pay-for-performance” model, only targeted diagnostic and procedural coding grounded in accurate, comprehensive documentation will demonstrate value and quality. Many auditors are already looking beyond transactional coding for evidence of how a practice’s coding reflects efforts to improve clinical documentation. Teaching physicians stronger documentation and coding skills now gives you an advantage.
- ICD-10 – Diagnostic Specificity Demands Appropriately Matched Procedure Codes
After three delays, the U.S. implemented ICD-10 in October 2015. The extensive set of 69,823 diagnostic codes and 71,924 procedure codes enables coding with extreme specificity, which leads to better patient care and better clinical data. Providers must make sure the procedural code aligns with the diagnostic code’s specificity. A mismatch can mean rejected claims and less reimbursement. Educating practitioners how their documentation can support the most specific code will guard against reduced revenue.
- EHRs – Costly Adoption Makes Coding Accuracy Matter More
Medicare’s Electronic Health Records incentive program, or “Meaningful Use,” is now part of the Merit-Based Incentive Payment System (MIPS). EHR adoption is often expensive, costing as much as $32,500 per physician in 2015. So it’s essential practices train practitioners to take full advantage of EHRs’ automated documentation, coding, and billing features, all of which can increase efficiency and revenue. But clinicians can’t substitute automation for their own coding know-how, and must learn how to avoid such frequent EHR mistakes as copy-paste errors that lead to rejected and denied claims.
Accurate, optimal coding isn’t the only factor in medical practice profitability. But, as you can see, it is an indispensable one.
Give Your Physicians a Practical, Profit-Enhancing Coding Education
At MDCodePro, we want to help medical practices operate more profitably by improving their documentation and coding in revenue-enhancing ways.
Our innovative, user-friendly app is one way we do it. Its short video lectures break down CMS’ complicated coding guidelines into an easy-to-understand, easy-to-implement approach for improving documentation. And its intuitive, step-by-step code generator lets you convert that documentation into the CPT® code that captures the maximum appropriate revenue for every patient visit. The MDCodePro app is the coding class physicians never had but urgently need to increase practice profitability.
We also continue physicians’ coding education with webinars. Please reach out to us at firstname.lastname@example.org to sign up for our next webinar.
Don’t let the coding education hole in med school curriculum keep your practice from developing a healthier revenue cycle and achieving greater profitability. Register for the webinar today.