Paying adequate attention to and investing in a professional service coding program is crucial for employed network sustainability. An effective program directly supports patient care revenue generation, provider productivity determinations, and corporate compliance assurance. While technical services coding and billing are also important facets of the network revenue cycle – especially in provider-based billing scenarios, many networks experience greater inadequacies in the professional services elements as these differ significantly from other hospital billing practices.
Programs that offer one-time or episodic general provider education tend to be relatively ineffective as the information often does not “stick” with the providers – especially if the session(s) are perceived to lack direct applicability to an individual provider’s circumstances. It is also difficult to provide a “one size fits all” educational session – even by specialty – as circumstances vary so significantly within and across specialties.
Effective programs tend to combine regularly performed audits with timely individual educational feedback about each audited patient encounter – while reviewing the encounter documentation and providing direct insight. This approach tends to make the interaction more “real” and to produce more enduring results.
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