How Does Medical Coding Affect The Revenue Cycle

How Does Medical Coding Affect the Revenue Cycle?

The quote translates that revenue is vanity, definitely an achievement, but it’s not a complete picture of the company’s success. If the cash is not pouring into your business, there are high chances the cycle could be disrupted and the overall pipeline would be broken or distressed. A Medical Billing Company in New Jersey can fix this pipeline and ensure a proper flow of better cash and streamlined operations. 


To let your revenue cycle stream in a unified direction and your business uptake momentum, you need to balance out a lot of intricacies in your healthcare. One of the prominent players is “Medical Coding”, which can downturn your profits and ROI.


The healthcare services are a two-way road – translation of healthcare services into billable codes and preparation and submission of claims to insurance companies for reimbursement. 


Any bumps on these roads or any wrong medical code could hamper the overall process and impact the revenue cycle. 


Let’s decode each detail and dive into understanding the entire process.

What is Revenue Cycle Management in Healthcare?

Revenue cycle management refers to systematics, structure and coordinated processes managing the financial aspects of patient care in healthcare organisations. It includes every component, from patient interaction with the healthcare system scheduling to the final payment and reimbursement.


Revenue cycle management includes multiple processes and coding and claim submission is a crucial aspect that can make feast or famine. Either turn profits or redirect to denial, if not adhered to as per laws. A Medical Billing Solution can undertake the entire process, take care of intricacies and ensure that reimbursement is easy without any hindrances.

Role of Medical Billing Solution

Medical coding is converting healthcare diagnoses, procedures and other services into universal medical alphanumeric codes. There is each code for a patient’s diagnosis procedures performed to treat diagnoses. Whether it’s Regence or Premera, commercial insurance companies, or regulatory payers like Medicare and Medicaid, insurance companies adhere to these standard codes to settle claims and follow up.

Medical Billing services in New Jersey is skilled and knowledgeable with all these processes of patient billing practices, compliance with regulations, claim denials and much more. As a healthcare service provider, you don’t need to memorise codes, comply with guidelines or even evolve with a dynamic environment, all you need is the approach of professionals. 


Equifax found in an audit that hospital bills above $10,000 have a tentative error amount of $1300. This causes doctors to lose around $125 billion each year, all due to poor billing practices. 


Being a practitioner, you can’t afford to lose hard-earned cash in vain. Streamlined medical billing is not just a win for doctors but also for patients. Try outsourcing with Medical Billing Services New Jersey.

As per Becker's Hospital Review, 80% of US medical billing contains errors.

Don’t let errors in medical billing and coding termite your profits; choose a Medical Billing Solution for streamlined and better operations. 

What are the top challenges in Medical Coding, and How to optimise it?

Responding to evolving and dynamic medical coding challenges is common. Hospitals and healthcare staff do not comply with efficient processes and the latest codings, which subsequently costs their organisation. Administrative waste is a major contributor to rising costs and impacts 30 percent of healthcare spending. Beyond the rising rates of healthcare, wasted time in the workforce can deteriorate cash flow longer than necessary.


You can also read: How Revenue Cycle Management Can Help Medical Billing Business? 


Healthcare organisations must emphasise this factor and outsource this functioning to skilled and knowledgeable Medical Billing services in New Jersey to improve their bottom line. 

Improper Coding

Often in a hurry to accomplish the task, medical coders either neglect some codes or add too much information. Fitting the code in the right puzzle is crucial for the reimbursement process. The Centers for Medicare and Medicaid Services predefine hierarchical coding categories. The framework or structure is designed to improve health outcomes and reduce plan costs. Undercoding or overcoding can lead to potential penalties and fines. To avoid this pitfall, seek clarification from the provider or get help from supervisors and auditors. 


These are a few to mention. Some more include – misinterpretation of modifier guidelines, insufficient documentation, ignoring coding guidelines and more. 


It’s not just hospitals that gain benefits. Everyone is in the loop, be it healthcare providers, insurance providers, patients, researchers, or healthcare organisations. 


Medical coding is complex. One mistake can take you to rejection of reimbursement. Claim denials are prevalent and cause financial strain. Don’t dent your revenue cycle; get help from Akshar MediSolutions.


Call us or learn more about our process; we are just a call away. +1 833 248 7463

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