How can healthcare providers ensure revenue integrity? Start by learning from the past. More providers are recognizing the value of reviewing historical coding errors—not just to correct them, but to prevent them. By partnering with experienced medical coding outsourcing teams, they’re gaining access to targeted physician education and real-time feedback that reduces denials and costly mistakes. We sat down with Adi Lakshmi, MBA, CPC, CPC-I, CIC, CRC, CPMA, CCS, Associate Vice President of Coding at Global Healthcare Resource, to uncover her top five strategies for educating physicians and driving improved outcomes.
1. Personalize provider education: It's crucial for outsource partners to analyze every medical record that comes through to identify common threads. Lakshmi says it’s important to pinpoint specific provider coding deficiencies and develop education accordingly. It’s also critical to conduct ongoing presentations regarding documentation improvement, medical coding best practices, and common coding errors. Coding outsource vendors should also offer specialty-specific training to ensure providers understand the nuances of coding for their specific field.
2. Monitor, measure progress. There needs to be a separate auditing process for focused reviews to ensure providers understand the education they receive and put it into action. “We audit, educate, and re-review,” says Lakshmi.
3. Take a holistic approach. Review official coding guidelines as well as payer-specific guidelines when coding, auditing, and developing provider education. “A comprehensive approach ensures providers have all the information they need for compliance," explains Lakshmi. She adds it’s also important to keep providers informed of ICD-10-CM/PCS, CPT, HCPCS, and payer-specific changes as well as important updates related to fraud and abuse, risk adjustment, and value-based care models.
4. Focus on documentation integrity. “The goal with education is not to increase reimbursement but rather ensure the revenue is accurate based on services rendered,” says Lakshmi. “We have different checkpoints to ensure precise documentation that captures all of the right components, including any comorbid conditions that support medical necessity.” She says it’s important to implement templates that guide providers in capturing necessary documentation for coding and encourage coder-provider communication to promote data and revenue integrity.
5. Develop coding tip sheets and resources for provider education. Reputable coding outsource partners give providers the tools they need to be successful, says Lakshmi. This includes easy-to-follow reference guides with key coding updates and common mistakes as well as access to a resource library with recorded training sessions, coding presentations, and FAQs. "As partners who work closely with denials, medical coding outsource companies are well-positioned—and, in my opinion, obligated—to create preventive action plans for providers that ultimately reduce the administrative burden in healthcare,” she adds.
Asking the right questions
As healthcare organizations explore coding outsource partnerships, Lakshmi says it’s important to ask these questions.
• Does the outsource medical coding vendor provide physician education?
• What level of provider education is included? What is the comprehensiveness? Is the education personalized in any way?
• What does the outsource medical coding vendor do to ensure the education is helpful and promotes revenue integrity?
Addressing ongoing provider education challenges
The biggest provider education challenge outsource medical coding companies may encounter in the months ahead? “Communication,” says Lakshmi. “Keeping lines of communication open to resolve queries and add addendums in a timely manner is always a challenge. That’s why Global leverages frequent touchpoints and communicates weekly using a data-driven approach.”
Looking ahead: Physician education and coding outsource vendors
Providers need—and deserve—the most up-to-date information and education so they can do what’s right for patients, payers, and the organizations that employ them. By providing targeted education, outsource medical coding companies help address the trend of rising healthcare costs and enable clients to get paid quickly and accurately. Learn how Global Healthcare Resource can take your provider education to the next level.