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Medical billing process has fixed set of rules and standards to be followed by the medical billing and coding experts in order to generate a code for the services availed by the patient and this code is the base of the claim filing process for Medicare, Medicaid and other programs as well. This code makes it easy for the government and the insurance companies to decipher the services availed by the patient and they need not take the paints of going through each and every procedure’s papers. Hence it is the duty of the medical billing and coding expert to see to it that he generates the appropriate code for appropriate services so that the medical institutions and even the patients are reimbursed appropriate amount.
Do Not Indulge in Upcoding:
Upcoding can be defined as wrong use of the medical billing and coding standards to generate a code by which the medical institution can obtain more money than actually required to be reimbursed. Upcoding has become a rampant practice undertaken by unethical medical billers which also cause lots of hassles in the reimbursement procedure. They try to enhance the medical criticality of the patient and also the level of services given to the patient in order to claim more money which is a false practice and should be avoided in any circumstances.
A classical example of upcoding can be given by a medical biller enhancing the ailments to severe bronchitis and sinus and also the treatment given to patient is enhanced wrongly to overbill the insurance companies and get more money.
Even Medical Billing Business from Home is a Business:
The duty of medical billing and coding experts is one of great responsibility and requires high dedication and sincerity. One should make it a habit to maintain clear medical records and should follow government’s health compliance programs and self policing programs. Also one should be very careful while using the modifier 25 and 59 and try to minimize the risk to their own medical billing and coding practice by avoiding an Audit. An audit can hurt the reputation of your practice.