Coding Know-How
I have found that most new doctors are not interested in coding and the claim form. Instead, they delegate coding and even diagnosis to their insurance assistant. They look for the bottom line, “Just get it paid!”
Today’s insurance world demands a partnership between the doctor and their staff to gain reimbursement and survive a peer review audit. You and your staff have to take a team approach to insurance reimbursement.
Staff cannot and should not choose the diagnosis for the patient; that is the doctor's responsibility. Choosing the correct diagnosis could be the make or break point in case reimbursement.
A prime example is with the diagnosis "lumbago." Lumbago is lower back pain. It is worthless as a diagnosis!
Why does the patient have lower back pain? That is the real diagnosis.
Early in your practice, your insurance staff can be one in the same with the front desk or therapy staff. Communication between the doctor and the staff is paramount. Choose a staff member who is organized and has a feel for insurance requirements.
Your staff is an investment in your practice. They should attend reputable, continuing education classes. Most importantly, the doctor should attend the classes with their staff. |
by Mario Fucinari, D.C., C.C.S.P