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Correct coding – and knowledge of medical necessities rules in particular – is an after thought for many medical office staff, but it could mean the difference in thousands of dollars of revenue each year. For instance, by identifying and correcting just $100 in coding errors, a practice can increase payer reimbursements by as much as $26,000 annually.

Filing clean claims is additionally an important way to steer clear of an audit by the Office of the Inspector General (OIG) or the Centers for Medicare and Medicaid Services (CMS). If this has not been a concern for medical practices in the past, it stands to be soon. The Patient Protection and Affordable Care Act that became law earlier this year includes a mandatory compliance program for providers enrolled in Medicare or Medicaid programs.

“Taking the time to be knowledgeable about medical necessities and file claims cleanly the first time really pays off in the end,” said Mark Weber, a content development manager with the Medical Necessity and Compliance Division, at 3M Health Information Systems. Weber is the featured speaker in Nuesoft’s August podcast, “The Down and Dirty on Clean Claims.”

“If you have processes in place to help you code more carefully, you will spend less time looking up codes and doing reworks, resubmitting claims, and dealing with write-offs – not to mention a smaller A/R,” Weber said. “Time is money, and with estimates of up to $70 to rework a claim, it’s hard to justify not being more knowledgeable and thorough about coding.”

To hear more advice from Mark Weber, tune into the podcast.