Addressing Current Challenges to Mitigate Costly Risks

It sounds like a recipe for coding disaster: On one hand, rebounding service volumes following pandemic-related declines; on the other hand, staffing shortages and clinicians and ancillary team members who lack knowledge of coding rules and guidelines. This is today’s unfortunate reality for radiology providers and departments.

We’re confident that the extensive line-up of MedLearn Publishing radiology resources can empower team members to rise above these challenges and mitigate the risks of audits, lost revenue and denied claims. But we wanted to find out what top radiology coding, billing and compliance experts think about our radiology resources, which includes several books, educational webcasts and a monthly newsletter.

Summary of Industry Expert Reviews…

What’s driving the need: Many radiology providers and departments don’t have the staff to keep up with the recent growth in service volumes. Adding to this quandary, clinicians and ancillary team members typically use order-entry systems that automatically assign codes for services rendered — but, unbeknownst to the team member, these code assignments may be incorrect.

Example of the clinical vs. coding disconnect: A two-view chest X-ray is performed by a tech and read by a radiologist. However, the service is billed for a one-view X-ray, because the order-entry system generated the wrong code. This ultimately results in underpayment and lost revenue for the provider. Now, imagine the financial impact if this mistake is repeated over a high volume of patients.

Why our resources are uniquely effective in helping to reduce these risks: MedLearn Publishing employs a unique formula for delivering how-to information, including an intuitive chapter-by-chapter flow for each service line (much easier to navigate than official publications); concise and easily digestible language (vs. bureaucratic jargon); and sample reports that use commonly encountered situations to show team members how to “connect the dots” between clinical practice and correct coding.

The ROI of investing in high-quality resources: Return on investment can be measured in a number of ways. Most importantly, medical coding is highly complex, and this is not the place to skimp on how-to resources. Confusing instructions or the inability to quickly find answers can lead to erroneous coding or billing. And a single recurring mistake can have huge compliance and revenue implications.

Recognizing downstream impacts: Coding and billing mistakes don’t just cost an organization in terms of missed or denied payments. Think about all the staff hours consumed by addressing issues on the back end, whether it’s reviewing and appealing claim denials or querying providers to fill documentation gaps. Getting it right the first time would allow this time and effort to be put to better use.

Why official AMA and CMS resources are not enough: In the fast-paced worlds of coding and billing — especially with staffing shortages and turnover — team members simply don’t have time to get bogged down in massive manuals trying (sometimes futilely) to find essential information. By contrast, MedLearn Publishing provides resources that are not only accurate and reliable, but extremely easy and fast to navigate.

Importance of having access to the most current resources: Every year brings changes to codes, coding guidelines, and billing requirements. The changes may be minor in a given year; however, missing just one change due to outdated information can be quite costly. Also, coding evolves at a much slower rate than medical advances (typically there’s a three- to four-year lag). MedLearn does a great job of proactively alerting customers to the latest coding guidelines, NCCI edits and other changes.

Click here for detailed information about the full line-up of MedLearn Publishing radiology resources.