Common Coding, Billing Issues and Solutions in Healthcare

By: exdionrcm


Common Coding, Billing Issues and Solutions in Healthcare

The complexities in the billing and coding processes in the healthcare sector are taking a toll on the revenue generation. Healthcare providers handling the billing processes manually are the worst hit. Seamless, error-free billing and revenue generation have become difficult to almost impossible.

The Covid19 situation has made things worse. The number of claims and denials has increased and the huge influx of patients has distorted the entire billing and coding process. The focus has shifted from the billing and coding processes to providing unmatched care to the patients. Procuring medicines and equipment are topping the charts.

The worst has happened too. The government has been changing insurance policies making it more difficult to manage documents, verification, claims, and collections.

The healthcare sector is now bleeding revenue.

It’s high time we take initiatives to revolutionize the entire billing and coding processes and improve compliance. In this article, we will talk about the challenges and the solutions.

Read: How Medical Billing Companies Can Ensure Business Continuity in a situation like Covid-19

Before we get to the solutions let us first discuss the coding issues that are creating chaos.

Documentation Issues

The code provider isn’t always available. Most of the time coders face issues to translate all the information about medical services provided to a patient in a comprehensive manner. Also, even if they can, the issue arises in storing the history of medical services provided to use them in the final billing process. This causes confusion and errors in billing which needs to be addressed.

Incorrect Coding Issues

Manual coding processes are inefficient and can’t be relied on. The increasing number of patients and surged coding demands are impossible to be handled efficiently when done manually. If not automated, there can be errors, repetitive work processes, and overall hampered revenue generation, loss of time, and energy.

Updating Claim Policies

Insurance policies keep changing due to fluctuating government regulations. The current pandemic hit world has been a spectator of how policies have transformed and what the healthcare sector is going through in validating claims and processing bills.  This has slowed down the coding processes, claim processes, payment collections, and has incurred a huge loss of revenue.

Collecting Payments and Follow-Ups

Billing and coding, even if done right need follow-ups. Coders and other healthcare professionals dealing with bill payments and follow-ups bear the brunt of inefficient manual procedures that make tracking or collection of pending payments and claims cumbersome. This results in a huge loss of time, effort, and distorted customer experience.

Distorted Claim Date

Tracking the claim date and staying on top of it to collect the claims on time requires expertise and streamlined processes. The overloaded coding team usually fails to track claim dates and contribute to the revenue loss in most cases. This creates confusion and makes the claim management process difficult. The coders and billing personnel require a definite and effective process or a solution to track claims.

The Solution

In the era, Technology is the only solution. But the question here is what type of Technology and what capabilities should it have.

Here is an example of what you can have to transform your billing and coding process.


Artificial Intelligence, deep learning, and data science powered revenue cycle integrity solution by ExdionRCM, ExdionCA seamlessly integrates with your existing healthcare systems to make your billing and coding processes error-free and effective.

Also Read: Automated Revenue Integrity Solution- ExdionCA-UC

A few revolutionary features that you can get with ExdionCA-UC are as follow:

  • Increase revenue integrity
  • Improve provider accuracy
  • Standardize care across the practice
  • Reduce manual labor and billing errors
  • Reduce denials and claim resubmission
  • Capture missed charges
  • Confirm compliance

Discover ExdionCA, try it, and see the difference yourself. Consult with the experts who can guide you through this journey.

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