Lean Thinking With Focus on Medical Billing and Coding Services

Lean thinking is about mindset or the way of thinking of organizations to achieve a totally waste free operation that focuses on customer value. It involves cross functional orientation within organizations to improve efficiencies and achieve waste free operations. However, it is easier told than practiced!

It needs a house of lean tools laid on stronger organizational commitment to improve their level of service to the customers. It is more so challenging on the services industry when compared with the manufacturing since the process maturity levels on the services industry are still evolving. However setting aside the challenges, one would still find surprising similarities between services and manufacturing, that both involves complex interlinked processes managed by personnel to accomplish their tasks to yield end value to customers. Hence it necessitates a need to cognitively approach the success stories on the manufacturing side and apply those best practices with more rigor.

In the context of Medical Billing & Coding Service

To maximize value and reduce waste in the context of medical billing and coding services, the first step is to create a unit with lean thinking. It needs lots of communication from the strategic management team to the line personnel on the objectives of lean. This shall create a sense of belonging and brings down uncertainty around job losses. It needs to carry a strong and meaningful message that services differentiators can be accomplished only with personnel.

At a next level on the process side, the starting point need to be defining the critical to quality parameters for their customers that includes but not limited to,

* Expected financial accuracies and processing accuracies * Turnaround time requirements * Rework percentages

It is important that organizations assess themselves on their standings with respects to these parameters so that they will be able to define road maps. This includes doing a value stream mapping of their processes that will list the steps involved in accomplishing the end value desired by the customer.Being a federally regulated process, it becomes mandatory that organization assess their process efficiencies to identify and isolate value added processes from non value added processes. Imbalances here shall definitely create friction within the system. It needs classification of processes into,

* Core repeatable processes * Core non repeatable processes * Support and repeatable processes * Support and non repeatable processes

Define Implementation approach to a successful lean program

It begins with defining a program charter to roll out and institutionalize a lean program. It involves programs to 1. Improve Quality, Eliminate wastes through Training Integrated Quality Assurance Framework.

It involves rolling out a training integrated quality framework. This includes combination of statistical tools and methods that results in identifying and isolating defects / wastes from the process. Statistical tools are extensively adopted to perform

1. Pareto analysis - to identify the vital few 2. Define Corrective and Preventive Actions (CAPA) 3. 5 Why Analysis and 4. Time Trend Analysis

This QA framework helps in accomplishing the process within its control limits. However organizations need to appreciate those statistical tools assists only in identifying and isolating the outliers. But to improve quality, there needs to be very active participation from the training function since variations within billing and coding processes are very high.

2. Improve Quality, Eliminate wastes through Technology

Define claims scrubbing mechanisms on top of claims data so that common and more frequent errors can be automatically detected. This shall increase the velocity of the process and also reduce rework. For instance a claim for male insured with a diagnosis code related to gynecology is obviously incorrect and this can be caught upfront in the system instead of allowing it to traversing through different processes within the overall system and finally getting rejected for payment. This saves lot of payment rejection upfront. Hence a good lean program shall leverage the expertise from IT and operations team to define solution. Hence it becomes imperative that the medical billing and coding team to understand the way adjudication systems on the insurance companies work so they can build upfront claim scrubbers and pre edits.

3. Optimize Process overheads

It involves operations unit to do a comprehensive time trend analysis on operations data. This shall include incoming volume data, capacity utilization levels, throughput, TAT compliance etc. With proper incentive and remuneration program, organizations need to do plan for running the process with optimal utilization levels that shall remove over allocation of personnel to the processes. This approach reduces process overheads. Organizations need to understand overproduction is equally bad as under production.

Conclusion

Lean thinking is not new. However the dynamics of Health Care Industry keeps continuously changing and it places a need on the organizations to keep striving for innovations so they perform exceedingly well on customer satisfaction index. Innovations cease to exist if organizations fail to ask one fundamental question on an ongoing basis - Why am I doing it this way and am I doing it right?

Lean thinking facilitates organization to ask these fundamental questions, as it did before!

Medical Billing Coding Certification Is Necessary to Reduce Bogus Charges and Improve Reimbursement   Medical Billing - Front End Strategies   Bare Essentials of Medical Insurance   Medical Insurance Quotes - Things That Can Affect Your Premiums   

A Medical Billing and Coding Salary Comparison

Many people just starting to consider an administrative career in the healthcare industry are attracted by the fact that medical billing and coding is one of the fastest growing sectors over the past ten years. But once their research gets under way, it soon becomes obvious that aiming to earn a medical billing and coding salary isn't as straightforward as it seems.

The thing is, medical billing and coding, although closely linked, are in fact entirely separate disciplines. And once this fact becomes apparent, the inevitable question arises as to whether a medical billing salary is on a par with a medical coding salary, or whether one pays better than the other.

Comparison of a Medical Billing and Coding Salary

Firstly, we need to be clear as to what are the differences between the two areas. After all, if you are more comfortable dealing with numbers than people, then maybe you should aim to qualify as a medical coder.

Whereas, if you would rather pull your fingernails out than spend your working life manipulating numerical data, then you would be more comfortable with the duties of a medical biller.

Duties and Responsibilities

A medical biller is more akin to being a practice manager than a practice accountant. Whilst the task of compiling and submitting the required invoices to medical insurance companies or direct to patients, your job will involve patient liaison to a large degree.

From making appointments, greeting patients and their families to dealing with doctors, physicians and healthcare specialists, the job of a medical biller requires a far higher degree of people skills than maybe a medical coder does.

Certainly, a working knowledge of medical codes is essential for compiling patient records and accounts, but a specialist medical coder will be far more focused on data and numerical work than in dealing with doctors and patients.

So what is the implication for a difference in a medical billing and coding salary?

Initially, new employees in their first job after gaining their qualifications, be that in billing or coding, can expect to earn roughly the same amount. An hourly rate of between $10 - $14 is usual and is only influenced by whether the position is with a large or small organization and whether that organization is situated within a major city or rural town.

Once an amount of experience has been gained, the two disciplines begin to pull away from each other slightly. Certified medical coders with commensurate experience enjoy more satisfying salary levels than their unregistered and inexperienced counterparts. An average medical coder could reasonably hope to earn anywhere between $35000 - $45000 per annum.

A similarly qualified and experienced medical biller may find that their earning capacity is slightly lower at around $32000 - $43000 pa. However, those with specialization and experience encompass both areas are best placed to reach a salary level of up to $50000 pa or even higher. The inevitable conclusion to be drawn is that is you wish to earn a good medical billing and coding salary, then your best course of action is to qualify for both disciplines.

So before you make your choice whether to pursue a career as a medical biller or coder, you need to ask yourself whether you will be more comfortable dealing with people, number or both!

Medical Billing Coding Certification Is Necessary to Reduce Bogus Charges and Improve Reimbursement   Medical Billing - Front End Strategies   Bare Essentials of Medical Insurance   Medical Insurance Quotes - Things That Can Affect Your Premiums   How To Keep Up With So Many Changes in Medical Billing   Maximize Your Medisoft! (Unknown and Underused Functions of Medisoft)