When you are providing a medical speciality you are under far more scrutiny to follow regulations and maintain compliance when doing your billing. Many Specialists do not work with a billing staff that is completely focused on their particular medical specialty meaning they are open to scrutiny over their billing and coding practices. Working with medical coding companies allows specialists to take full advantage of the proper coding without breaking away from regulations.
Fines and Lost Revenues
When you depend on your own staff to provide the billing and coding services required for your revenue you have to be certain they are fully versed and trained in your specialty. Unless you yourself are a coding expert you will never truly know if your staff are in fact capable of coding within regulations which can leave you open to fines and lost revenues. In many cases fines are applied to practices that were unaware they were even over billing or over stepping when it came to coding. It was due to a lack of understanding of the proper procedures and coding that lead them to breaking regulations. Medical coding companies adhere to regulations and are sticklers for compliance and will keep you honest so to speak.
Legal and Ethical Issues
It is difficult to fathom a billing and coding clerk’s knowledge of legal and ethical practices without doing a thorough testing of their skills. However, you may not have the knowledge to do so. Poorly kept medical records as well as not maintaining compliance can lead to issues you do not want to have to face. You need someone who is always aware of the latest state and federal guidelines or you have to be focused on staying abreast of changes in order to remain compliant yourself. This can be challenging and stressful when the onus is on you. It can be so much easier when working with medical coding companies who are in the business of compliance with third party paying code rules as well as state and federal billing guidelines.
Even if you hire a certified coder you have no way of knowing how on top of federal and state changes they remain. Medical coding companies maintain compliance using a number of strategies as well as programs that are constantly updated with changing rules and regulations from both federal and state governing bodies.