The Problems with Under-Coding and How to Avoid Them

Under-coding is a popular concept in optometry practices. Many times under coding can be considered fraud and lead to an audit.

Many problems arise due to under-coding; one is the unnecessary investigation of unreported medical cases. Under-coding is considered a severe crime as it’s highly illegal and unethical. If your office is experiencing under-coding, there are ways you can stop it.

Let’s explore how you can stop under-coding.

Train Your Staff

The best way to overcome under-coding at your office is by ensuring your staff is adequately trained. They’ll ensure every patient walking in has a proper file and officially gets recorded when they’ve received sufficient training. If you want your office to succeed while avoiding any audits due to under-coding, you must hire efficient staff who know how to work. As long as they’re well-equipped, you hopefully won’t encounter under-coding at your facility.

Uniform Coding Is a Must

Two types of patients walk into a optometry office: those who pay cash and those with insurance. Ideally, these patients should go into the registers if under-coding is avoided. The best way to ensure that happens is by providing a code. There will be no confusion when uniform codes are present for each type of patient. Also, there won’t be any discrepancy between patients with codes attached. Even if there is, you can easily sort it out through the billing. Also pay attention if you are billing routine eye exams to vision plans when you are supposed to bill it to medical because the patient has significant cataracts for example.

Double-Check Everything

When you have a high inflow of patients coming in, the wise thing to do is double-check everything. This includes their files, medical reports, history, etc. It’ll be easier to manage to code when you know everything about your patients and keep up with their cases now and then. You can stay on top of your coding game by ensuring there’s no case of over or under-coding whatsoever. However, you’ll have to be pretty vigilant to do that.

Hire a Professional Medical Billing Company

If you’re having trouble keeping up with your facility’s billing, you can always employ a professional medical billing service. They’re professionals who specifically deal with numerous healthcare facilities’ billing. That way, you won’t have to stress so much regarding billing, and you can also avoid the constant problem of under-coding. Yes, such companies charge a fee, but paying them is better than paying large sums of money as penalties if your facility is under investigation for under-coding.

Don’t Overuse Codes

If you want to avoid under-coding at your facility, it’s recommended you don’t use the same codes repeatedly. Using the same codes often leads to confusion regarding patients’ files, which might result in double-coding. If you don’t want that to happen, please keep using new codes each time you enter a patient’s information into your system. The newer your codes are each time you have a new patient, the fewer chances of under-coding. Hence, please focus on using codes appropriately.