Medical Coding Support Service from Payment Automation Network, Inc. www.PaymentAutomation.net

1. Medical Coding Support
By Payment Automation Network, Inc.
Remote Medical Coding Services
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.
The Problem: Insurance Companies hate to What is Medical Coding?
pay what they owe
Every time a patient receives profes-
The coding function is one of the most important sional health care in a physician’s
aspects of the billing process. Insurance companies office, hospital outpatient facility or
do not pay for tension headaches and 15 minute ambulatory surgical center (ASC),
office visits for an established patient. Insurance the provider must code and create a
companies pay for medical codes, diagnosis codes claim to be paid.
such as 307.81 and procedure codes such as 99213.
Many medical providers do not have coders in
How it works their front office staff
Instead, the provider will do the coding and pass it
Your staff will prepare a data packet along to the medical billing staff. While medical
for each patient seen on a specific providers are trained in ICD-9 and CPT coding,
Date of Service (DOS). The data these codes are frequently modified and the
packets is faxed or scanned to our requirements to assign specific codes to encounters
office. Our coders will access the are changed. Incorrectly assigning a diagnosis code
packet and review the documents to or procedure code could result in decreased revenue
assign proper ICD-9-CM, CPT and (under coding), denied claims because the diagnosis
HCPCS codes. and procedure do not match and over payment for
services (over-coding) which in turn could lead to While the medical coder and medical
Upon completing the coding for all problems for the medical provider if CMS or private biller may be the same person, the
the data packets for the DOS the insurance companies audit their medical medical coder is responsible for ac-
coder will create a Daily Coding Re- charts/records. The CMS is doing just that with their curately coding the claims. To do so,
port (an Excel spreadsheet with the Recovery Audit Contractor (RAC) Program. Thus, he/she checks a variety of sources
patients name, DOS, and codes incorrect coding results in underpayment, no within the patient’s medical record,
(E&M, CPT, DX and HCPCS)). This payment or overpayment with possible legal action such as transcription of the doctor’s
report will be returned to the biller to taken by the payers against the medical provider. notes, ordered laboratory tests, re-
allow the codes to be inserted into the quested imaging studies and other
patients claim. sources, to verify the work that was
The Solution: Coding support from Payment
Automation Network, Inc.
done. A thorough knowledge of anat-
omy and medical terminology is es-
How much time do you spend coding your patient sential. It is also important that the
encounters daily? What if you could have someone medical coder is familiar with differ-
else do the coding for you? Having a certified coder ent types of insurance plans, regula-
on staff can not only be costly, as many certified tions and, of course, CPT®, HCPCS
Level II, and ICD-9-CM codes and
coders can command a higher salary than other
staff. It can also be difficult as there can be a guidelines. This enables the coder to
shortage of qualified coders in your area. "Remote assign correct codes and service lev-
coding", or out-sourcing, is the perfect answer to els for the procedures performed and
Payment Automation Network Inc. supplies used to treat the patient dur-
this dilemma.
Call (800) 813-3740 x 1 ing an encounter as well as properly
PaymentAutomation.net identify the physician’s diagnoses.
MEDICAL CODING SUPPORT - Toll Free 800-813-3740