Coding

Medical offices lose thousands of dollars every year due to coding errors!

Coding is a part of the provider's daily routine, yet most have little or no training in this area. Coding errors and omissions impact a practice's revenue and leave the practice and/or provider vulnerable.

Quality Physician Services, (QPS) employs professional coders who are certified through the American Academy of Professional Coders and the Board of Advanced Medical Coding, the nationally recognized authorities on medical coding. Their specific training requires proficiency with the codes, rules and regulations. Our Certified Professional Coders ("CPC's") and Advanced Coding Specialists ("ACS") bring an exceptionally strong level of expertise that is necessary to maximize client reimbursement and compliance while reducing errors and liability.

Outsourced Coding & Compliance
When we partner with clients in an outsourced arrangement, we mitigate compliance risks by performing daily pre-submission reviews. We compare the CPT and ICD9 codes, and make revisions to ensure maximum reimbursement and legal compliance. We also review mid-level provider services to ensure they are billed properly on behalf of the physician, relevant to the treatment provided. Each year, we conduct a review of client encounter forms and make changes as necessary. We also perform quarterly audits to ensure compliance using a sampling of charts including Medicare, Medicaid and private insurance claims. By comparing charges and related documentation, we are able to determine if they are under-coded (did not receive the maximum reimbursement) and over-coded (at risk for insurance fraud). In an outsourced arrangement, QPS will make the necessary adjustments and resubmit claims on our clients' behalf. We also schedule periodic coding classes and workshops to better educate physicians in this area.

Denials & Appeals Projects
Some clients choose to engage us on a project basis to correct their payment denials and submit appeals. This is a great way for a practice to preview a partnership with QPS, and reclaim lost revenues in the process. We will meet with you to determine the scope of the project and associated fees, then focus on getting those claims paid. During this process, we document changes made to denied claims and make recommendations to ensure prompt and complete payment in the future.

Coding Workshops
QPS also works with practices by conducting 4 or 8 hour coding workshops. We create custom manuals for our clients' particular type of practice, based on a review of the encounter form, procedures and required coding. We also examine LCD's (local coverage determinations), payor requirements and specialty practice needs prior to the workshop. At the workshop we not only educate participants regarding correct coding processes, new codes and coding strategies, but also provide hands-on classroom work with real practice claims. A practice can typically see an immediate increase in revenue that is many times more then their class investment.