Best Path to Finding a Top Coding Auditing Company

The ever-evolving pace of healthcare demands an increase in coding accuracy and ensures practices yielding positive results in providers receiving reimbursement for the services rendered. Some crucial components of achieving that objective are providing proper documentation, maintaining accuracy and compliance, and implementing transparent medical coding and billing practices for coding auditing companies. Compliance is significantly substantial as the measure of successful Practice and reducing the risk and billing fraud. According to Medical Economics, in 2016, Medicare's fee for service improper payment rate measuring payments withdrawing from Medicare coding and billing regulations was 11%, equivalent to $40.4 billion. The causes, as reported, of these improper payments are either billing errors or deliberate fraud. Hence, the Medicare Fraud Strike Force charged 301 professionals $900 million in medicare billing fraud.

Introducing several effective methods in Practice, such as regular monitoring and auditing coding, is crucial to bear fruit, while outsourcing coding auditing is also a preferable way for professionals searching for an error-free and result-driven coding auditing compliant with current standards set by healthcare regulatory bodies. However, finding the right coding auditing company may intimidate you as it isn't a random decision. Professionals must investigate certain essential factors before choosing the best coding auditing company. MedsIT Nexus medical coding and auditing services not only efficiently impact your coding quality but also ensure empowering your coding teams in the best possible ways.

Introducing several effective methods in Practice, such as regular monitoring and auditing coding, is crucial to bear fruit, while outsourcing coding auditing is also a preferable way for professionals searching for an error-free and result-driven coding auditing compliant with current standards set by healthcare regulatory bodies. However, finding the right coding auditing company may intimidate you as it isn't a random decision. Professionals must investigate certain essential factors before choosing the best coding auditing company. MedsIT Nexus medical coding and auditing services not only efficiently impact your coding quality but also ensure empowering your coding teams in the best possible ways.

In this article, we provide insights into the best path to finding a top coding auditing company as per the latest research and studies in the healthcare field.

What role do medical coding auditing companies play in healthcare?

Professionals must understand the significance of coding auditing in healthcare before researching the top coding auditing company. Medical coding in healthcare is a delicate and crucial process of converting care procedures or services into standardized codes for billing and documentation. In order to avoid revenue loss for the organization and all the members working inside, accuracy is the most important in preventing fraud and ensuring quality patient care and due reimbursement.
Coding auditing companies play a pivotal role in the healthcare domain by conducting regular audits to evaluate the accuracy and compliance of medical coding. Coding audit companies performing audits accurately helps providers detect various malpractices causing the decline in your organization's regular revenue. According to a study, 70% of medical codes revealed that the causes of losing an organization's revenue were common issues like improper documentation, unbundling, or under-coding. The audits help healthcare providers identify potential coding errors and inconsistencies and recommend areas for improvement. Subsequently, coding auditing companies enable providers to optimize revenue while maintaining compliance with changing healthcare regulations.

How can you decide on choosing the right Coding Auditing Company?

Experience and Expertise

The healthcare industry is highly complex, and coding requirements vary across specialties and medical settings. When selecting a coding auditing company, you must assess the company's expertise and experience in your field. Look for a company with a track record of working efficiently with care providers similar to your organization. Assessing the experience of a particular company will likely inform you that it is well-versed in the challenges of your specialty and overcoming those to help you achieve accurate coding and compliance.
Moreover, ensure searching for a company that is skilled and efficient in performing for both small and large organizations and whether the company is well-versed in performing on-site or remote audits for your Practice.

Certification and Credentials

Reputable coding auditing companies employ certified and credentialed professionals. Certified professional coders (CPCs) and Certified Coding Specialists (CCS) are well-recognized certifications in the industry. Verify the qualifications of the auditing team and ensure that they are up-to-date with the latest coding guidelines and regulations.
Furthermore, being a reputable company for coding auditing requires that these companies efficiently understand the coding systems, such as the CPT Code system from AMA, ICD codes from WHO, and HCPCS codes from CMS. They must also run their Practice as per the annual modifications and updates in these code sets.

Coding Auditing Types Efficiency

Search for a company well known for conducting several types of medical coding audits and their specialty in performing the best for your unique Practice. For example, they must understand the specific requirements of each Practice and organization in conducting audits, whether internal or external or pre-bill or post-bill auditing with their particular trends.

Tools and Technologies

The best coding auditing companies leverage advanced technology and efficient tools to streamline their auditing process. Search for a company that uses state-of-the-art software to perform audits efficiently and accurately. Technology can also help identify coding errors, trends, and novel opportunities for improvement to ensure your organization is well-prepared for coding challenges encountered in the Practice.

Customization with Flexibility

Healthcare organizations are not one-size-fits-all ever, and neither should your coding auditing solutions. A top coding auditing company must be willing to customize its services to meet the unprecedented needs of your organization. They must also be flexible in adapting to changes in healthcare regulations and coding guidelines.

Comprehensive Reporting

Effective communication works when it comes to coding auditing. Consider looking for a company that provides detailed reports with fruitful insights. The reports must highlight areas that need improvement and provide recommendations to enhance coding accuracy and compliance.
Medical coding auditing companies must adhere to the standards of compliance with payer's policy, including Medicaid and Medicare and private payers, and more importantly, ensure they stick to the rules and policies from the Office of Inspector General OIG for reviewing and monitoring the documentation and coding audits.

Cost-Effectiveness in the Services Provided

Although quality is crucial, cost-effectiveness is also a consideration for professionals handling intricate jobs. Obtain quotes from potential coding auditing companies and compare their pricing against the value they offer in services. Moreover, you must remember that the right coding auditing company can significantly improve your revenue cycle and compliance to make it a worthy investment.

Reputation and References

A reputable coding auditing company will have a strong reputation in the industry. Providers must seek customer reviews, testimonials, and references to gain insights into the company's performance. Furthermore, you can also check with professional organizations, such as the American Health Information Management Association (AHIMA), for recommendations.

Scrutinize Some of the Latest Trends and Findings

Before selecting a particular coding auditing partner, it is essential to stay up-to-date with some of the latest research and studies in the field that offer valuable information and insights for selection:
Remote Auditing - according to the research, there is a growing trend towards remote coding auditing, especially in the wake of the COVID-19 Pandemic. Organizations are increasingly seeking companies that can offer remote auditing services and provide flexibility and cost savings.
Data Analytics - the use of data analytics in coding auditing is on the rise. Advanced analytics tools can identify coding errors and trends more efficiently, improving accuracy and compliance in Practice.
Conversion to New ICD Systems - change is inevitable in healthcare, and acquiring new methods and procedure updates isn't only needed for care providers but also for medical coders and other staff working in the process. WHO maintains the ICD coding system, and the annual modification in the coding system also signals medical coders and auditors to do their jobs accordingly. For example, the new version of the ICD system IC-11 contains 55,000 unique codes for varying diseases and procedures. Medical coding auditing companies must ensure they likely handle their Practice by keeping a sharp notice of these updates while reviewing professionals' documentation and coding practice.
Compliance-Oriented Practice - recent studies emphasize the significance of compliance in coding auditing. Healthcare organizations are looking for auditing companies that are proficient in regulatory requirements and can assist them in avoiding costly compliance violations.
AI and Machine Learning - some coding auditing companies efficiently incorporate artificial intelligence and machine learning into their process. These technologies can assist widely in identifying coding anomalies and improving accuracy.

Connect With MedsIT Nexus and Learn How It Can Validate Your Coding Auditing Success

Connect with us and bring your Practice on the right track because the right coding auditing company will not only help you optimize revenue and ensure compliance but also provide comfort that your coding process is in capable hands. MedsIT Nexus Medical Coding and Auditing Services will amplify your organization's coding accuracy and improper payment recovery. Working for years in coding and auditing, our highly qualified coding auditors have helped clients in their entire medical coding auditing process to reveal inefficiencies and compliance. We are proficient in multiple expertise to audit your medical coding process and provide you with an efficient track to improve practice revenue and reduce the risk of compliance or potential fraud.