Medical Coding

How Does Incorrect Medical Coding Impact Your Practice? And Tips To Avoid It


Healthcare providers should also focus on aligning business development strategies that can make significant improvements in the healthcare revenue cycle management system. The best solution for this purpose is to outsource medical billing services to experienced medical billing companies.

Have you ever noticed that why do most medical practitioners deal with revenue loss despite the fact that the demand for quality healthcare services is increasing immensely?

It’s only because you’re not paying attention to your business’ administration and financial operations. If such a case, then you might also neglect errors and mistakes that are occurring in the healthcare revenue cycle management system i.e. information silos, ignoring prior-authorization, or medical coding errors.

These mistakes can lead to your medical billing procedures always ending up in the form of claim denials and rejections.  Most importantly, if you overlook the factor of accurate medical coding then it may also cause you to face federal penalties, payer’s fines, and legal imprisonment.

Impact of Incorrect Medical Coding

Are the consequences of incorrect medical billing and coding dropping your bottom line consistently? Then you should immediately consult with professional medical billers or outsource medical billing services to experienced medical billing companies.

Because it is the right solution to overcome such flaws in your revenue cycle management and maximize revenue. The fact is a lot of medical practitioners don’t know the extent of the potential damage that can happen due to administrative mistakes.

Therefore, they need better and insightful personnel that can audit their medical billing system. So they can prevent your practice from claim denials with medical billing and coding errors.

Before you end up struggling with the problems of high claim denials you should start eliminating your mistakes. Even this is the right time to understand the significance of the medical billing and coding system.

Why is Medical Coding Important?

Medical coding is the procedure of translating your medical services and diagnostics services into standard medical codes. It is the only way to inform insurance companies and other payers what have you done and why are you charging your patients.

Medical coders should represent every service during the patient’s visit through correspondent CPT and HCPCS codes. So that insurance companies, Medicare and Medicaid accept your medical claims with accurate codes.

If you are unable to code right then you also can’t claim your reimbursements from the respective payers. According to a recent study, miscoding a procedure can create a difference between $15 and $15,000. So ultimately, it would build an enormous cache of delayed reimbursements and you’ll have mounds of paperwork, stress, and uncollected revenue.

Moreover, incorrect medical coding and billing can also make you come under intense scrutiny for medical fraud and abuse. Hence, if clearing houses or insurance companies would recognize any abusive billing practice then they would seriously penalize your practice.

What are abusive billing Practices?

Abusive medical billing activities happen when medical billers and coders put false information in medical claims. More often, medical coders use such tactics to increase illegal monetary gains either intentionally or indeliberately. Such abusive billing practices are evidence of intentional misrepresentation over a long time period and across a huge volume of patients.

Especially, if medical practitioners are submitting inaccurate medical claims to the government insurance payers for (Medicare or Medicaid) then you would also violate the Tc and Cs of Federal Civil False Claims Act (FCA). Because this law doesn’t consider such activities as mistakes even they are done unintentionally.

Such civil penalties would lead you to recover your amount up to three times the amount of damages that are borne by the Government. As a result, these government agencies can put the penalty up to  $22,927 per false claim filed. Also, some government healthcare benefit program and the penalties could also lead you to face imprisonment.

Ultimately, it would negatively impact your practice’s reputation and bottom line.

How to Avoid such Medical Coding Errors?

For this purpose, you need an advanced practice management system. So you can closely monitor your revenue cycle management. Moreover, you also need a dedicated workforce and in-depth knowledge about the ICD-10 coding system. So you can never miss out on any useful feature that can help you spot mistakes, rectify them, and submit clean claims successfully.

Why do you need to outsource medical billing services to experienced medical billing companies?

You may have heard that smart work is better than hard work. Yes! It’s certainly true in this case. Because nobody goes to a medical school to learn about paperwork and financial management. So instead of investing your time in learning about the nuances of revenue cycle management, medical billing, and coding.

Practitioners should partner with those companies that have already well-experienced and certified staff for medical billing and coding. Moreover, it requires a huge amount of capital investment to initiate, maintain, and operate an in-house billing department.

Hence, in order to make a thrifty decision_ practitioners should prefer to outsource medical billing services to experienced billing companies.

Medicare MSI is a fully developed medical billing company in the United States. It’s been helping hundreds of thousands of medical practitioners to improve their practice’s revenue. Request a free demo of reliable and efficient medical billing services.


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