Medical Billing and Coding- Working with Patients to Understand ICD– 10

Medical Billing and Coding- Working with Patients to Understand ICD– 10

The move in medical billing and coding from ICD- 9 to ICD-10 occurred on October 1, 2015. Prior to that date, those professionals who were going to have to deal with the transition from using 14,000 codes with ICD-9 to close to 70,000 with ICD-10, were busy preparing to make the change as seamless as possible. Those people included medical practitioners and other healthcare works, medical billing and coding professionals, and insurers,

Although many anticipated that the move to the more exacting and complex system would produce major problems for caregivers, medical billers and coders, and insurance providers, the problems, thus far, have been minimal. That’s good news for everyone. However, one constituency that may need to be brought up to speed would be patients. They may find their paperwork, including their bills, benefits, and deductibles, a bit confusing.

Possible Confusion, Questions, and Concerns

Medical bills can be confusing enough, and although the new codes have been designed to be more specific, they can cause problems for consumers in understanding their bills. This may generate more questions that usual from patients, which means your billing office will need to be ready to address additional inquiries.

Anticipating patient confusion, questions, and concerns may help to reduce future queries. Thus, taking a few proactive steps will go a long way to creating a positive connection between physician and patient.

Simple Solutions

Addressing the changeover from ICD- 9 to ICD- 10 directly will help to alleviate patient confusion. One simple solution is for healthcare providers to have some basic literature on hand about ICD- 10. A handout explaining how ICD- 10 works and that it is geared towards improving patient care and outcomes is essential.

Plus, physicians and other healthcare providers should inform patients as to the steps they have taken towards successfully implementing the new system. Acknowledging that there may be some challenges associated with compliance that may affect billing and encouraging patient questions are also important. If there are billing problems or questions, this will set the stage for a positive dialogue.

Patient Problems with Billing

Patients who have ongoing medical problems that were reimbursed under ICD- 9 may have questions regarding coding and bills now being addressed by ICD- 10. Their bills will likely be more detailed, as procedures and other aspects of treatment will be outlined in a more specific manner.

The other major reason as to why a patient may have questions about their bill will revolve around any miscoding that may result in an initial rejection of their claim by an insurer. This may be related to poor or inaccurate recordkeeping by the healthcare practice or by mistakes made by those involved in medical coding and billing.

It’s important for patients to know that the medical provider and billing professionals are addressing any such problems in a timely manner. It would be helpful if the billing office were able to explain why the problem has occurred.

Be Available to Patients

Finally, it’s very important that medical coding and billing workers are readily available to answer patient questions. If a practice does have an increase in queries, it may want to consider bringing on additional help to handle the rise in volume. Of course, it’s essential that those addressing queries be knowledgeable of ICD- 10, and that they possess the ability to communicate that information. In terms of addressing patient understanding of and issues related to ICD- 10, clear and timely communication will serve everyone well.

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