Medical Coding: A Critical Role in Healthcare Today

Medical coding and billing are important for healthcare providers to get paid for the services they render. They are also crucial for tracking medical data and providing accurate information to patients. Any inaccuracies can lead to overcharging or undercharging, denial of insurance claims, and even fraud.


Medical coding translates medical procedures and diagnoses by healthcare providers into alphanumeric codes known as ICD or CPT. Medical coders need to accurately classifying clinical statements and assign the right codes create accurate patient records that facilitate efficient medical billing. In this sense, medical coding and billing go hand in hand; billing is made more efficient with correct medical coding.


A complex process


Coding is critical in every medical specialty, including ambulatory surgery centers (ASCs) and anesthesia and DME services. Each specialty needs to follow complicated and ever-changing guidelines that make medical coding and billing even more challenging. If your in-house team is finding it hard to stay up-to-date with the latest regulations, it may be time to outsource medical coding to third-party experts.


One of the biggest benefits of outsourcing is that it can save you money. You’re essentially hiring a company to handle all of the administrative tasks associated with billing and collections. This can free up a significant amount of time and money that you would otherwise have to spend on these tasks.

Additionally, outsourcing can help improve your practice’s cash flow. You’ll have access to a team of experts who can help you maximize reimbursement and collect payments quickly. This can increase the amount of money that comes in each month and boost your bottom line.

Outsourcing medical billing can also help improve the quality of care that you’re able to provide. You’ll have access to a team of experts who can help you streamline your billing process and improve the way that you interact with patients. This can lead to better patient satisfaction and improved care overall.

For a healthy practice


Accurate coding and billing practices build a financially healthy healthcare practice that is ready and able to deliver optimum care. Precise preparation and submission of billing claims enables prompt and proper reimbursement in the expected amount for the services provided to the patients. It is essential for ensuring correct and timely reimbursements from healthcare programs like Medicaid, Medicare, and private insurance providers. It also prevents delays and denials that may affect the financial viability of a practice.


Get help from specialists


Outsource your medical coding and billing to Plutus Health. With AAPC and remote processing automation, Plutus Health ensures compliant medical coding that encourages the most reimbursements based on governing guidelines and the services provided.


About the Author:

Thomas John leads a global team of 500 employees in 3 locations as the President & CEO of Plutus Health providing, RPA powered revenue cycle management services to healthcare organizations across 22 states. Plutus Health Inc. is a 15-year-old full-cycle RCM firm specializing in medical coding & billing, denial management, credentialing, prior authorizations, AR follow-up for both medical and behavioral health specialties. As the industry experts in revenue cycle management solutions, they’ve created a unique process that combines machine learning and robotic process automation to address the clients’ most frustrating problems.

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