The onus is on coders to be prepared to deal with the challenges that impact reimbursement and to provide insight beyond that required for basic coding.
Coders need to understand billing expectations, how the billing process works and how the revenue cycle is affected. Many are learning on the job through payer websites, coding guidelines and queries to the American Hospital Association (AHA) Coding Clinic.
The three abilities every coder should possess to do the job are:
- Respond to denials based on payer regulations and documentation that supports the services being denied.
- Make adjustments in the coding and address issues to mitigate or overturn
a denial. - Review patterns and identify issues to determine how to move from denial management to prevention.
See related article: Know your denials challenges before developing prevention strategies
