Question

A medical billing company is finding that a higher percentage of its claims are being returned. Insurance companies are rejecting the bills because of medical coding errors. Managers believe the software and database used for the procedures involved in coding bills are not the problem. They are convinced that the problem occurs during data entry, and they want to implement changes that will ensure the right codes are entered. Which of the following should managers do to resolve the issue?a. change how the process flows so that only software is checking the medical codes.b. review what those who are performing the coding are doing and implement a quality check procedure.c. change the software to try a new procedure.d. change the database that stores all of the data.

Answer 1

review what those who are performing the coding are doing and implement a quality check procedure

Step-by-step explanation:

The point here is that there are medical coding errors and the problem is not the software or the database, but are convinced the problem lies in the data entry. In order to implement a change, it is only appropriate to first review the performance of the coders, or simply check to see if what they are doing are correct, and if it seems it is correct at that point due to the fact that they are being reviewed, it is right to implement a quality check procedure to check for the quality of all data entered, it is only after this is done and it has been seen that the fault isn't from the data entry that one may begin to check the software or database.