Iziphene ezimbini zokuCoding Coding Ufanele uziphephe
Ukugqithisa i-overcoding kunye ne-undercoding ngamaphutha adibaniso amabini anokuba nemiphumo emibi kwi-ofisi yezobugcisa. Ikhowudi yezokwelapha ayikho nje ngokufumana ukubuyiswa kweenkonzo ezibonelelwe. Amabango okukhangela ngokuchanekileyo avumela ukuba umntu ohlawula i-inshorensi awazi ukugula okanye ukulimala kwesigulane kunye nendlela yokonyango.
Kukho nezinye iindlela zokwenza i-coding yezokwelapha:
Ukubhala okanye ukubika umgangatho wokunyamekela isigulane.
Ukubonelela ngolwazi olunxibelelwano oluchanekileyo ngokusebenzisa inkqubo yohlulo lwesizwe eqondwa kubo bonke abahlawuli kunye nababoneleli.
Ukunika ingxelo esetyenzisiweyo kwizifundo ezahlukeneyo zophando ezifana nezifo, iziyobisi, iinkqubo okanye iindlela zonyango lwempilo.
Ukwenza izigqibo ezibalulekileyo zokuphatha ezifana nokuthengisa, abasebenzi, uhlahlo lwabiwo-mali kunye nokuthengwa
Ukuqhawula i-Overcoding Kukhohlisa
Iikhowudi ze-CPT kunye ne-HCPCS yindlela yokubhala ikhowudi ngenjongo yokunika iikhowudi zokunika ingxelo ngendlela ekhokelela ekuhlawuleni. Ukuqhawula i-overcoding kuyinto fra fra .
Ukugqithiswa kwee-overcoding kukhokelela kwiinkampani ze-inshorensi ezenza iimbuyekezo eziphezulu kakhulu kunokuba kuhlawulwa ukuhlawulelwa. Nangona kunjalo, izigwebo zokubanjwa zigqithise ngaphezu kweenzuzo zokufumana i-paycheck ephezulu.
Kukho iindlela ezimbini ezibonisa ukuba ababoneleli baqhotyoshelweyo, bahlaziya kwaye bahlaziya.
- Ukukhutshwa komthetho : Ukuchaswa kwezinga leenkonzo okanye inkqubo eyenziweyo ukwenzela ukuhlawula ngaphezulu okanye ukufumana isantya sokubuyisela ngaphezulu kuthethwa nge-coding. Ukukhishwa kweekhowudi kuyenzeka xa inkonzo eyenziweyo ingagqitywa yi-Medicare, kodwa iindleko zeenkonzo zenzelwe inkonzo kwindawo ekhoyo.
- Ukukhutshwa kweminye : Ezinye iinkonzo zithathwa njengento ebandakanyekayo. Ukuqhawula ukuhlawulela i-billing kwiinkqubo ngokwahlukileyo ezihlawulwa ngokuqhelekileyo njengentlawulo enye. Umzekelo, umniki-mboleko wonikezelo lwezilwanyana ezimbini zokungcebeleka, ngaphandle kokuhlawula i-one-quarryal screening mammogram.
Khumbula ukuba i-overcoding iyinkohliso, kwaye iziphumo zingakhokelela kwizigwebo zomthetho nezemali.
Kufuneka lilondolozwe ekuchaseni ukwenza impazamo, ngokuhlaziywa kunye nemfundo eqhubekayo.
Ukungena phantsi kweMali eLahlekileyo
Iikhowudi ze-CPT kunye ne-HCPCS ukukhutshwa phantsi kweekhowudi xa iikhowudi ezihlawulwayo zingabonakali ububanzi obupheleleyo bomsebenzi owenziwa ngugqirha okanye isibonelelo. Ukungena phantsi kwe-undercoding kungaholela ekulahlekelweni kwengeniso.
Abanye banikezeli ngenjongo yokukhusela ngokwabo ukuba bangaphantsi kweenkampani ze-inshorensi ezinokuphika okanye ukuphicotha amabango. Le ngcamango ingabangela ezininzi iingxaki ngesinye sezizathu: akunjalo. Iinkampani zomshuwalense azikhanyeli kuba iikhowudi zibuyisela phezulu kunezinye iikhowudi. Iinkampani zomshuwalense zifuna iikhowudi ezihambelana namaxwebhu kwisigulana somguli.
Indlela yokuphepha ukuphika kukuqinisekisa amaxwebhu afanelekileyo. Uxwebhu alubandakanyi kuphela iimpawu, ukuxilongwa, unyameko, unyango, kunye namayeza kodwa neengxaki kunye nobungozi bolwazi lwezempilo kunye nezokhuseleko. Ingxelo yesigulane kufuneka ibe neenkcukacha ezipheleleyo kwaye igqibe.
Ukuthintela ukucwangcisa i-overcoding kunye ne-undercoding, i-ofisi yezobugcisa kufuneka ihlale isesikhathini sokutshintshwa kwenguqu yekhowudi. Kufuneka uqiniseke ukuba ulandela izikhokelo eziqhelekileyo zokuqulunqa nokuqinisekisa ukuba abasebenzi bakho bafumana imfundo eqhubekayo. Ukugcina iirekhodi ezigciniweyo zesigulane ngumsebenzi wabanikezeli kunye nabasebenzi bokuxhasa.