Our experience has shown that deploying certified coders on the front end of the billing process results in fewer denials by Medicare and Private Insurance Companies. The coding function is one of the most important aspects of the billing
process. Insurance companies do not pay for tension headaches and 15 minute office
visits for an established patient. Insurance companies pay for medical codes, diagnosis codes such as 307.81 and procedure codes such as 99213.
Many medical providers do not have coders in their front office staff
Instead, the provider will do the coding and pass it along to the biller. While providers are trained in ICD-9 and CPT coding, these codes are
frequently modified and the requirements to assign specific codes to encounters are
changed. Incorrectly assigning a diagnosis code or procedure code could result in
decreased revenue (under coding), denied claims because the diagnosis and procedure
do not match and over payment for services (over-coding) which in turn could lead to
problems for the medical provider if CMS or private insurance companies audit their
medical charts/records. The CMS is doing just that with their Recovery Audit
Contractor (RAC) Program. Thus, incorrect coding results in underpayment, no payment
or overpayment with possible legal action taken by the payers against the medical
The Solution? Coding support from Profast Billing Solutions
How much time do you spend coding your patient encounters daily? What if you could have someone else
do the coding for you? Having a certified coder on staff can not only be costly, as many certified coders can command
a higher salary than other staff. It can also be difficult as there can be a shortage of qualified coders in your area. "Remote coding", or out-sourcing,
is the perfect answer to this dilemna.
How does Coding Support work?
The process is simple. For each patient encounter on a particular DOS, your office provides the superbill/charge sheet, medical notes from the encounter, and any lab results from the encounter.
These are then faxed to us at our toll-free, secure internet based fax. The data is then forwarded to our highly trained team of certified coders who are all AHIMA or AAPC certified. These coders also
have extensive experience performing government audits to prepare and guide providers in Medicare compliance requirements. Typical turn-around time is 24 hours. We deliver your report to you
by email with all medical codes, diagnosis ICD-9 codes, procedure CPT codes, and HCPCS codes.