Your Rehab Is Losing Profits Due To Incorrect Coding

By Lidia Micckey


Profits are often being lost in drug and alcohol treatment centers. There are many different reasons why this is happening. Many treatment centers find that they cannot turn a good profit in order to keep their doors open. Many complain that the insurance companies are not paying out on claims like they used to. It seems as though the medical industry has had somewhat of a shakeup in 2016. We are off to a new year and many rehabs are not happy about it.

It is estimated that 1 out of every 3 treatment centers will see their center being audited by an insurance company this year. It is mainly due to the fact that new regulations are put into effect. ICD-10 coding is a system in which took over ICD-9. The codes are longer and often more complex than what you are seeing right now. Try to remember that it is not easy to have a treatment center today. Most owners say that they are not seeing a good return on their investment. It is now becoming less of a money maker.

It is important to have our own internal audits when it comes to medical billing. Ask your billers or outsourced company more about your utilization management. What have you learned this year about your business that you did not know last year? When it comes to turning a profit, rehabs want to know how to get to the next level. Straightening out your medical billing is the first step to your success.

You need to update your software if you are going to do in house billing. I say this because the new codes in ICD-10 are often longer than they were in ICD-9. If you are like me, you don't want to waste money. It is important to buy software that is HIPAA compliant and obey all the rules of the law. Once you figure out your billing, you will find that it's more profitable to run a treatment center today. The problem with most business owners is that they are uninformed about billing. They think that anyone can do billing. The truth of the matter is that this is not true.

There are literally thousands of medical billers in the world today. Most want to believe that they are qualified enough to do the job. However, most are seeing their claims coming back from the insurance companies time and time again. It is rare to see a medical biller doing well these days. Most are struggling to submit claims correctly. A lot of billers today are frustrated because they keep on seeing their profits dwindling down. What can a person do to get better results? For starters, work with only ICD-10 certified coders. Try to get an employee that knows a lot about anatomy and physiology.




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