Making Medical Sense

Is your medical practice or healthcare organization leaving money on the table? Unless you are unusually diligent about collecting from third-party payers, the answer is likely yes, says Carol Coots, owner of Medical Consulting From A to Z.

Drawing on 20 years of experience in medical billing and government auditing, Coots, based in Indianapolis, suggests that physicians should approach their practice with a serious eye toward properly coding the bills they send to insurers. When a bill isn’t properly coded, she explains, an insurer returns it unpaid. What’s more, inadequately trained coders often simply omit procedures that they don’t realize are billable.

Coots recommends that practices invest in certified billing coders who have a full understanding of the medical terminology and anatomy related to the procedures being billed.

In addition, Coots implements simpler solutions for her clients, such as purchasing updated coding books and enrolling coders in annual courses. She also looks for ways to reduce costs, such as improving patient flow and exploring alternative payment methods. Hiring and training the right people and putting proper processes in place are the keys to a healthy practice, she says.