It is essential for a healthcare company to process appropriate medical coding before billing transactions, audit, or preparing budget reports. Medical coding is a process where all the healthcare reports, prescriptions, user data, payment details, and more are converted into alphanumeric codes. These universal information pieces allow healthcare companies to fetch patient information, vendor details, and other information within seconds.
Even though it can be done quickly by an in-house team in a healthcare institute, most companies like to outsource the medical coding services to a consulting firm.
Importance Of Medical Coding Auditor
An auditor's tasks involve reviewing a random selection of charts. This review helps identify trends in coding practices that result in higher costs of practice.
Medical Coding audits include:-
- An evaluation of the practice's fee schedule
- Modifier usage
- CPT/ICD coding
- EOB denial trends
- Productivity levels for Bell Curve analysis
Choosing the best medical coding audit consultant is complex, with many consultants available. If you end up with the wrong professional, your healthcare company will suffer from financial and legal issues. That's why we have discussed some of the primary skills you need to look for in a medical coding audit consultant before you finalize the decision.
Must -Have Of Medical Coding Audit Consultant
Medical coding audit consultants assist healthcare providers in improving and maintaining medical coding compliance. Their prominent role involves auditing and training medical providers and coders with updated coding practices.
Here is the checklist for reliable medical coding audit consultants:-
1) Professional Qualifications
A medical coding audit consultant should be highly experienced AHIMA and/or AAPC-certified coding experts. Professional qualifications ascertain that they can identify any potential issues related to billing documentation and coding accuracy.
2) Market reputation and experience
Medical coding is a complicated task. You cannot choose a random audit consultant. It is necessary to check their credibility. An experienced professional will know more about different coding techniques and changes that have been introduced in the laws.
Similarly, you also need to check the professional's market reputation. Check the hospitals and healthcare centers with which the professional has worked previously. You can also take help from reviews to understand whether your chosen professional will be suitable for your requirements or not.
3) Ability to handle large data sets
The medical coding services involve handling a lot of data sets, starting from patient billing information to vendor transactions and more. So, make sure that your chosen consultant can deal with these large sets of information without making mistakes or errors that can't be fixed.
Besides, make sure that they can work with proper concentration and focus, irrespective of the work pressure.
4) Can communicate properly
Effective communication is crucial in business. The coding auditor needs to coordinate with you and other staff members. So, you need a professional who can easily communicate.
In addition, you should also ensure that the chosen professional is a good listener so that they can understand what you want and act accordingly. Any communication gap will lead you to jeopardy, which is why you need to consider this particular skill in the coding consultant.
5) Have solid morals and ethics
You need to choose a medical coding audit consultant who knows what's expected from them. The person should have proper morals and ethics and not manipulate any data to finish the work early or earn more profit.
Working with an unethical professional will put your patient details' at stake and reduce the efficiency of your staff. That's why you should look for a professional who can show dedication and passion towards the work.
