Question

Discuss with class, Addressing Medical Coding and Billing Part II: A Strategy for Achieving Compliance. A Risk Management Approach for Reducing Coding and Billing Errors"

Answer 1

Medical practice of today's era demands every physician to see more patients, provide more complex quality of care and services and stick on to regulatory rules, providing little time for coding and billing. In order to maintain a susceptable financial condition of medical care it is essential to document all medical records appropriately and accurately, applying billing codes and accurate charges for insured personnel. The physicians usually oversea the billing and hence end up in missing the actual amount that should be paid for them. Whereas other physicians make sure each and every billing is done so that they get remuneration for their efforts. Hence it is essential to monitor and audit the medical billings and coding system. When medical bills are submitted with missing and incorrect information, it results in unpaid claims and loss of revenue to physicians.

The potential risks include loss of revenue,fraud investigation, financial sanction, disciplinary action and exclusion from participation in government programs.