How To Keep Up With Changes In Coding Guidelines And Reimbursement Policies?
Being on top of the industrial changes and updates is essential to survive in any industry. When it comes to healthcare, if professionals are not updated with the latest happenings, guidelines, regulations, and technological changes, they will be at a loss. Since the COVID19 pandemic, the healthcare industry has undergone major changes and updates. As an indispensable part of the healthcare sector, medical coding and billing professionals cannot not risk being updated with the constant changes and updates happening in the healthcare world.
From frequent changes to coding rules, payer policies, and regulations, keeping a track of updates may seem like a daunting task. With the right approach, professionals can stay informed and adjust the processes accordingly to maintain accuracy and financial health of the practice and the healthcare facility. A few small strategies can help in achieving long-term goals effectively.
Regular Reviews of Official Resources
The first step in staying informed about the changes to coding guidelines and reimbursement policies is to keep an eye on the official sources. Here is how to begin:
Streamlined communication facilitated through EHR systems between different healthcare providers. From a patient seeing a specialist or visiting the emergency room, health information is easy to access, leading to better-coordinated care.
Coding Guidelines from CMS (Centers for Medicare & Medicaid Services)
CMS is the primary authority for Medicare coding and reimbursement policies. Their official website is regularly updated with review updates on Medicare codes and new regulations. CMS also releases bulletins and memos that help stay on top of changes.
Coding Guidelines from CMS (Centers for Medicare & Medicaid Services)
AMA and AAPC offer guidance, resources, and updates relating to coding standards. The AMA regularly publishes updates made on the Current Procedural Terminology (CPT) codes. AAPC also offers webinar, training programs, and certifications that keeps coders updated on current changes.
Local Payer Websites
Insurance companies and other payers frequently update their policies. Be sure to check their websites and provider portals as these sites often feature updated reimbursement rates, billing rules, and claims submission procedures.
Subscribing to Newsletters and Alerts
Subscribing to newsletters or setting up email alerts is an easy way to be informed about the latest changes. Many organizations send out regular updates on coding and reimbursement news, so looking out for these is a smart idea.
Coding and Billing Newsletters
Many professional organizations like AAPC, the American Health Information Management Association (AHIMA), and the Medical Group Management Association (MGMA), have email subscription services that include news on coding, reimbursement, and regulatory changes. These newsletters are usually tailored as per the practice type, making sure that information is relevant and needed.
Utilizing Technology and Software
Using and implementing the right technology makes the tracking updates process easier and quicker. Billing software, coding tools, and practice management platforms usually integrate real-time updates. This ensures that providers are working with the most current guidelines.
Automated Updates in Software
Many coding software programs include automated updates. These updates ensure that you are using the latest codes and reimbursement guidelines, reducing the risk of errors and eventually streamlining the workflow.
Online Databases and Coding Tools
There are many online databases and tools providing updated coding guidelines. These platforms often include search features, allowing coders to quickly search for the latest rules for specific codes or services
Participate in Ongoing Education
Being current with the coding and reimbursement policies requires constantly keeping up with the education. Maintaining accuracy, and adhering with the compliance, billing and coding professionals regularly engage in continued training and development.
Attending Webinars and Conferences
Attending industry-focused webinars and conferences is an excellent way to get insights into the latest industry trends and best practices. Led by industry experts, these events provide valuable and important information regarding ways to navigate new coding challenges and reimbursement requirements.
Complete Certification Programs
Earning and renewal of certifications like the Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), allows professionals to have the knowledge required to stay on top of the changes. These certifications require continuing education, an excellent way to be engaged and informed.
Establishing an Internal Review Process
Having a solid internal review process catches errors and outdated information. Doing a few simple things can go a long way. .
Conducting Routine Audits and Code Reviews
Performing regular audits assesses whether your organization is updated with the coding guidelines and reimbursement policies. Internal coding reviews help identify any discrepancies, differences and areas where improvement is needed. This ensures that coding errors do not slip through the cracks.
Cross-training The Staff
Make sure your team is cross-trained on coding guidelines as well as reimbursement policies. This creates a more versatile workforce, lowering the risk of mistakes when an update or a change is added to either the coding or payment policies.
Collaborating With The Payers As Well As Other Professionals
Having a good relationship and maintaining it with the payers and industry experts can provide you with important, valuable information that is otherwise hard to find in official documentation. Networking with other professionals in the field keeps you updated on changes that are usually not widely communicated.
Engage with Payer Representatives
Regular communication with payer representatives helps clarify questions and ambiguities surrounding reimbursement policies. These representatives provide insights into changes before they are officially released or help interpret new guidelines.
Networking with Industry Peers
Collaborating with peers in the healthcare industry- be it through online forums, social media groups, or local professionals organizations, they offer additional resources for staying informed. These networks provide peer support and guidance when navigating complex coding and reimbursement challenges.
Take Help From Professional Medical Billing Services
It is not unusual to outsource tasks to experts who are aware about the nuances of the field. Along with managing the practice and taking care of patients, handling loads of paperwork can be overwhelming. Outsourcing medical billing to professionals alleviates the burden significantly. Being up-to-date with the latest coding and reimbursement regulations, these services make sure the practice is compliant with the most current standards.
Being current with coding guidelines and reimbursement policies is important for any healthcare provider who wants to maintain compliance and avoid costly mistakes. Regular reviewing of the official resources, subscribing to the newsletters, utilizing the best technology, participating in constant education, establishing an internal review process, and collaboration with payers and peers- these are ways to make sure the practice is efficient and financially healthy.
Keeping up with the constant changes of coding and reimbursement can be challenging to do. With the right tools, strategies and services providers, one can stay ahead of the curve and will continue offering high-quality care without the stress of outdated billing processes.
Taking care of the entire billing cycle, Instapay Healthcare Services is an expert in medical billing and coding solutions. Known to stay updated on coding policies and reimbursement requirements, Instapay Healthcare Services gives practices the access to specialized expertise, advanced technology and continuous training. This ultimately improves the quality of your revenue cycle management.
Reach out to us today and know how your practice can remain on the path of growth and success with Instapay Healthcare Services’ help!
