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Medical Coding & Auditing

Medical Coding & Auditing

PBMS ensures our team of Professional Coders are well trained and customer oriented. We employ AAPC Certified Coders to maintain accuracy and ensure total compliance. Additionally, as new technology and training becomes available, we regularly invest in developing our team’s knowledge and skillset.

Why is professional coding important?  Having Certified Coders ensures the coding accuracy and specificity that translates to accurate reimbursement.  Many billing services do not offer this service and leave the coding to the provider or their staff.  Clinical documentation improvement to help physicians capture patient severity and complexity is what a coder can do for the practice.  The bottom line is that accurate coding and documentation results in better reimbursement.  It also allows the provider to have confidence that their billing and coding are submitted compliantly, appropriately and resulting in the most appropriate compensation for the services provided.  Medical coders are the essential connection between clinicians who care for their patients and the insurance companies that reimburse physicians under patient policies.  The essential job of a medical coder is to inform insurers about patient diagnoses and treatments in a format that allow them to calculate reimbursements for medical services. 

In the last few years, coding changes have taken place at warp speed, beginning with Workers’ Compensation insurance adopting CMS guidelines, to ICD-10-CM, and now the new Evaluation and Management coding guidelines for 2021.  In addition, every year brings multiple coding changes that relate to most specialties.  PBMS coders are working diligently every year to be sure we are up-to-date on these changes and pass that needed education on to our providers.