Errors In Coding Causing A Ripple Effect Research

Coders have to be mindful of how inaccurate coding on their behalf can affect others. Constant training in an organization is a great way to keep coders updated with coding practices and will allow open communication in how to deter errors within the department. Besides affecting patient health and insurance companies returning claims coders should take into consideration that inaccurate coding creates more work for multiple departments within their organization. If more man-hours are needed to correct mistakes facilities lose revenue to spend on resources to improve patient care.

More than 25% of the insurance claims submitted by a clinic are rejected because of mistakes made by the clinic’s billing clerks.

It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).

When assessing whether a no fault regime is better than a negligence rule in dealing with the causes and consequences of medical error, it would seem prudent to first understand the meaning of the term “medical error”. Liang defines medical error as ‘a mistake, inadvertent occurrence, or unintended event in health-care delivery which may, or may not, result in patient injury’ (2000, p.542). The consequence of these errors (or adverse events) that lead to patient injury, and the method by which we determine and administer compensation for such injuries, has been the source of heated debate amongst scholars in recent

You might think an occasional mistake in medical billing is not a big deal. And, in fact, you are right. Medicare and Medicaid, as well as private insurers, expect there to be a small number of mistakes. That is just human nature and data entry mistakes.

If the code is entered incorrectly the patient could get billed something more expensive. The insurance company is also likely to deny the claim that the medical assistant had sent. If the claim is denied, they should go back and review the information. If they find the error they should go through and fix the mistake, then resend it to the insurance company.

When the coding and billing is wrong it can greatly affect the budget. It not only includes the coding staff but also the physicians. There is a wide variety of factors that go into the payments an organization gets back. Sometimes physicians mean to order a test and they forget or they ordered it and did not send it off and these types of things affect billing. An organization may have to have an average budget because knowing up front what will be collected can change at any time.

The Institute of Medicine released a report in 1999 titled To Err is Human: Building a Safer Health Care System concerning the number of medical error related deaths. The report states that between 44,000 and 98,000 medical error related deaths occur each year in hospitals across the country (Kohn, L. T., Corrigan, J., & Donaldson, M. S., 2000) In response to this report, the Institute of Medicine released Crossing the Quality Chasm: Health: A New Health Care System for the 21st Century that outlines six aims for the future of the healthcare system: safe, effective, patient-centered, timely, efficient, equitable (Institute of Medicine, 2001). These aims set to establish the quality of healthcare across the country. Quality is defined by the Institute of Medicine as ““the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (2001).

Coding plays a big part to an even bigger picture. That’s why every doctor’s office takes coding very serious. The coding process has to run smoothly, for the doctor and the patient. If you do not get the coding correct it will take longer for the money to come full circle. Since the money being covered for the patient hasn’t even gone through they will have to pay more out of pocket and

Mistakes and errors caused by medical providers happen in the healthcare field, resulting in punitive actions against the provider. As cited by Geffken-Eddy (2011) studies by the Institute of Medicine have shown that punishment will only lead to more medical errors or providers not reporting their

Whenever there is an error or miss reporting allows for analysis and identification of potential errors, which can help in improving and sharing of information for safer patient care (Glynda Rees Doyle, 2016).

Medical errors cause not only physical and psychological strain on patients, but financial as well. In the article ‘Preventable Medical Errors: a $1 trillion problem ', Amy Chen states, “the Society of Actuaries estimates that the direct costs of medical errors totaled $19.5 billion in 2008.” However that figure did not include indirect costs such as lost income, lost household production, disability, and additional healthcare costs. “When these other costs are taken

Wrong site, wrong procedure, and wrong patient errors are avoidable safety issues. Nearly 1.9 trillion dollars are spent on medical errors each year in the United States (Catalano & Fickenscher, 2008). Between 1995 and 2007, 691 wrong-site surgeries have been reported to The Joint Commission's Sentinel Event data repository (AHC Media LLC, 2008). In 2003 in response to the outcry for better patient safety The Joint Commission

In today's modern world with plenty of technology, it is hard to believe that we cannot figure out how to reduce Medical errors. The issue of medical error is not new in health care organizations. It has been in spot light since 1990's, when government did research on sudden increase in number of death in the hospitals. According to Lester, H., & Tritter, J. (2001), "Medical error is an actual or potential serious lapse in the standard of care provided to a patient, or harm caused to a patient through the performance of a health service or health care professional." Medical errors

Reporting errors can strengthen the processes of care and also enhance the quality of care. To effectively avoid further errors that can cause harm to patients, improvements must be made on the incidents or events reported in reporting system. Reporting errors can help the organizations better understand what happened, identify the factors that cause the occurrence of errors or incidents, determine its frequency and predict whether it could happen again and find an intervention to prevent or to