One Diagnosis Code

One Diagnosis Code?

A situation that happens frequently in the medical billing industry is when a physician sees a patient, puts one diagnosis code on the form, yet multiple services were rendered.

As detailed as medical coding is, in many cases, one code won’t cover the range of services the physician may have performed for the patient and portions of the claim will get rejected. Meaning the physician will only receive a partial reimbursement and the claim will have to be recoded covering the additional services originally not coded and the entire process can snarl up the repayment process for the practice.

Most medical billing companies have a series of checks and balances in place to catch things like one diagnosis code, something a busy in house staff in a thriving practice may simply not have time to look over and catch.

Delayed claims mean delayed cash flow for a practice, A/R aging goes up and that looks bad for the accounting department, so proper coding and claims submission is a must.

Did you know recent statistic show nearly one third of in-practice handled medical billing is only partially paid or rejected? Furthermore, the average rejection rate and partial payment rate for a professional medical billing firm is less than 5% of claims, and some are even less!

By outsourcing your medical billing claims, these problems will be greatly reduced and your claims will be handled in a much more timely manner with fewer partial payments and rejections and a healthy A/R will make your accounting department smile.

View all Articles by: Melissa Clark, CCS-P