MEDICAL CODING

Prior to exploring the ways in which PRS can support your business, it’s essential to grasp the meaning of medical coding. Understanding this concept is pivotal in comprehending why outsourcing to providers like us is beneficial. Specifically, medical billing involves converting crucial medical information into simplified codes for recording medical data and ensuring precise medical billing. These codes are typically derived from various medical record sources, such as transcription of physician’s notes, laboratory results, and radiology reports. 

Moving forward, it's important to understand the role of medical coders. These professionals are responsible for ensuring the accurate application of codes throughout the medical billing process. Their work typically involves extracting intricate information from documentation, accurately assigning codes, and creating claims for reimbursement from insurance providers. Their primary responsibility involves reviewing clinical documentation and assigning standardized codes utilizing classification systems like  CPT, MIPS, ICD 10 CM & HCPCS Level II Coding.

At PRS, we possess comprehensive knowledge of the intricate and technical process involved in Medical Coding. Due to the constantly evolving norms and legislative guidelines, Medical Coding stands as one of the most complex and crucial elements within medical facilities, including hospitals, clinics, individual physicians, surgeons, and diagnostic laboratories. At PRS, we ensure the precise determination of medical codes through meticulous analysis of a patient's medical data. Our coding specialists operate with the utmost accountability, significantly elevating your business's financial performance. Over time, it has become increasingly evident that managing Medical Coding requires expertise in navigating the multitude of current medical codes, alongside continual amendments and updates. Monitoring these changes poses a significant administrative burden, necessitating professional handling. A specialized medical coder not only ensures increased profits amounting to thousands of dollars but also safeguards against legal implications stemming from incorrect coding. 

Our team comprises coders and auditors  we hold certifications from AAPC and AHIMA and boast extensive industry experience. Staying updated with the most recent code guidelines and industry norms is a priority, ensuring our auditors remain vigilant and well-informed about the continuously evolving coding trends. Through our dedicated efforts, we aim to eradicate persistent denials and establish a smooth revenue stream, resulting in a substantial surge in profits.  Our coders and auditors maintain a commitment of excellence by adhering HIPAA regulations and intend to protect private and sensitive information of Hospitals, Insurance companies and Healthcare providers they deal with.

At PRS, precision is our priority. We've implemented technology-based systems within our operations to thoroughly analyze the provided medical data. Competent coders conduct a comprehensive examination of medical documentation, aiming to prevent financial setbacks caused by denials, reimbursement issues, late payments, rejections, and inaccuracies. Utilizing electronic methods, our expert team can proactively detect discrepancies in the documentation, effectively mitigating revenue losses resulting from Medical Coding errors. Leveraging software, technology, and standardized processes ensures transparency, security, and high data integrity in the complex realm of Medical Coding. Whether it's a clinic or a large hospital, enlisting a Medical Coding expert alleviates a significant burden, allowing you to focus solely on your medical care business. As we manage the coding intricacies, you can direct your full attention to your healthcare services. Our team places particular emphasis on optimizing Revenue Cycle Management (RCM) for your medical facility, conducting comprehensive research to address every shortfall. 

 Our expert medical coders possess advanced skills and adhere strictly to the official HIPAA-mandated code sets, catering to a wide array of requirements. The standards we cover include:

• ICD-10-CM (International Classification of Diseases, 10th Edition, Clinical Modification)
• CPT® (Current Procedural Terminology)
• ICD-10-PCS (International Classification of Diseases, 10th Edition, Procedural Coding System)
• HCPCS Level II (Healthcare Common Procedure Coding System, Level II)
• CDT® (Code on Dental Procedures and Nomenclature)
• MS-DRG (Medical Severity Diagnosis Related Groups)
• APC (Ambulatory Payment Categories)
• NDC (National Drug Codes)
• ASC (Ambulatory Surgical Centers)

Advantages of choosing PRS

1) Specialized auditors and coders with high competence in every Medical Coding norm, standard, and legislative guideline. 

2) Customized Medical Coding solutions tailored to your specific medical-care business requirements. 

3) Efficient utilization of technology and automation to uphold a high level of accuracy, tracking, and data integrity. 

4) Focused analysis on Revenue Cycle Management (RCM), addressing the causes of revenue losses and providing solutions. 

5) Anticipating documentation errors and their effects to prevent denials, payment delays, and legal issues.