Below are questions commonly asked during a medical coding interview. Additional questions commonly asked during a medical billing interview: A larger health system or single facility can gain efficiencies with a clinical team, a technical team, and a follow-up team, and duties can be distributed across all three groups. Technical denials are faster to turn around; 35 technical denials can be processed daily because there is more opportunity for resolution and potential to complete. BK: Yes and no. GS: Clinical denials, such as a medical necessity denial, require evaluation of the claim for evidence of appropriate patient care through accurate and detailed coding. If the same problem recurs, evaluate the process root cause instigating the issue and eliminate it by implementing a corrective action using technology. She covered a lot of information, and attendees had many good questions. Methodology for working and routing technical denials is based on the provider’s preference, but clinical denials require special handling, routing and segmentation. Here’s what we learned. By Gina Stinson, Vice President of Managed Care Services and Bill Knox, Vice President of Product Management | Posted: 05/21/2018. She says she does not have any health insurance and she asks to have the bill sent to her. Leverage this committee to prevent the denials. Interview experiences of all companies : Interview corner. Again, this is based on how the denials are divided up and how they’re worked. Interviewer kept saying excellent/very good. An approved authorization is numerical with no alpha character in front. When writing clinical appeals, engage a clinician to work the account, evaluate, pull the records and loop in coding if more information is needed. A technical issue, such as an incorrectly calculated DRG or perhaps a technical mistake, and 2. With Kareo, you get simple solutions for every part of your practice—from scheduling and charting to billing and collections. A lot of corrections or proactive edits of technical denials can be integrated into collections or denials workflows if you are leveraging the right tools to enable that ability. This question is a great example of a common question that covers two categories, Personality Traits and Communication Skills. They show up in the payment variance data. We define these as tasks that push the denial toward final resolution. How can we prevent denials from happening? BK: The type of denial that’s being worked requires different skill sets. GS: It benefits the provider to implement a defined denial prevention policy, and to appoint a dedicated committee whose sole focus is to examine the denials coming through, look at the opportunities for improvement, and ensure that the prevention and mitigation is being handled by the right people in a timely manner. If you write it off at the $75,000, or gross value rate instead of the contractual or net $10,000, you’re inflating the actual net receivable value, because under the contract, the contract payment is identified as $10,000. Medical Billing/Coding Specialist Interview Questions Great medical-billing and coding professionals are chameleons -- they’re able to alter themselves to adapt to daily challenges. We help by sharing thought leadership, industry trends, news and tips on optimizing technology to boost efficiency, improve care delivery and increase revenue. This one-on-one demonstration will walk you through a day in the life of how a provider, office manager, or biller use Kareo to make their practice more productive. Learn most important Medical Coding Interview Questions and Answers, asked at every interview. Include an I.T. Please enable JavaScript to view this page properly. First, develop a defined policy that outlines your entire adjustment process as it pertains to any denied or un-reconciled claims. Make sure you understand the complexity of the code you are writing or at least be able to walk through the calculation of it. Questions on coding and on transport protocols. Medical Coding Interview Questions / Job Guide — VIDEO. Array Coding Interview Questions. What Is The Core Purpose Of Super Bill? During the technical interview, the interviewer will assess your technical knowledge, skills and abilities as they relate to the needs of … 4 denial management specialist interview questions. Learning how to respond to this question will help you in answering similar questions. © Copyright 2020 Kareo, Inc. All rights reserved. How to Describe Your Work Pace During a Job Interview. Different ways to reduce the traffic or solve network design problems. That takes the case manager and care transition specialist away from managing the active patient cases, thereby increasing the risk for yet another denial. There is a direct correlation between rushing to get a clean claim out the door and high denial rates. Sixty percent of the information on a UB claim form comes directly from the information that’s gathered from patient access and is entered on the claim, so it is important to cultivate accurate processes in capturing patient demographic information. Advice from RCM Expert Elizabeth Woodcock, E-Prescribing Option Helps With Medication Compliance and Patient Outcomes, Getting Paid in 2020: Steps to Take Now for a Smooth Transition to the New Year, How Billing Companies Benefit from Consolidating to One Platform. There is value in having a team dedicated to resolving technical denials, but there’s also value to having technical denials addressed by the follow-up team – the collectors. Interview questions may consist of traditional interview questions, brainteasers, technical proficiency tests and problem-solving questions. Next, ensure claims are processed properly, particularly those high dollar claims. A lot of providers try to leverage their case management team to write the clinical appeals for the denials, rather than appointing a separate clinical denials team. Still not finding what you’re looking for? BK: A lot depends on the size of the facility. A deductible. Or a provider may have simple edits in place, the common things that get your claims in the payor’s door, but they may not be covering the complex stuff, which could be the cause of your denials. Follow appropriate accounting guidelines to ensure that it’s meeting high standards for write-off purposes. Start by determining the cause of the DRG reduction. Most of these questions should be solvable in ~10-15 minutes, some will be more like 20-25. Here's a quick overview of changes in CMS programs, insurance plans and patient payments. : The user will input a string and we need … Example: You write off a claim for an account that is denied for medical necessity across the board. GS: I recommend a standard daily productivity metric for both technical and clinical denials of 25 resolution actions per day. If you would like to be placed in a medical coder or remote medical coder job within the United States, please fill out the form below or call us at 602-468-6300. http://www.ama-assn.org/ama/pub/physician-resources/practice-management-center/health-insurer-payer-relations/national-health-insurer-report-card/denials.page. Billing specialists, also known as billing clerks, are found in industries of every kind. Or the control could state that if a requested procedure requires authorization, the authorization must be confirmed prior to scheduling. Mary Johnson is from New York and is visiting relatives in Florida. Payors define claim inconsistencies differently – there’s no single standard. Don’t waste effort on smaller claims – reconsider trying to resolve a $20 claim that didn’t process and had a defined deadline. BK: Good question - effective denial root cause resolution is the result of upstream prevention and mitigation. Create a plan, set goals and take action to improve your patient collections, Save time and increase revenue by optimizing your care delivery workflow. You may also check our latest online course series to learn DS & Algo is named DSA, which covers everything about Data Structures from Basic to Advanced. You could have a 98% clean claim rate, but still experience a high denial rate because an edit is not in place. Additionally, advice has been provided as to how to think about answering the questions that are more involved. It shows up as a payment variance, although the reason why the payor applied that would most likely be coded to a denial reason. Getting Paid in 2020: What Independent Medical Practices Need to Know. We do not claim our questions will be asked in any interview you may have. We’ve selected several good questions to share with everyone. Interview theory and coding questions of all companies : Company wise all practice questions. Learn the ABCs of what it means to prepare for a medical coding and billing job interview and discover the secrets of selling yourself to your interviewers. Here are a few of healthcare organizations’ common questions regarding denials, along with best practice answers. If you review your data and find a lot of smaller claims denied for timely filing, create an automated process to write them off to save processing time. 12 of the Toughest Interview Questions With Answers. In smaller organizations, it might be two teams – a clinical team and a team to manage both technical and follow-up functions. Technical issues are usually a more straightforward fix, such as incorrectly ranked insurance resulting in a claim billed to the secondary as the primary in error. You must have data that identifies the type of medical billing denial occurring and the source of the denial. Let us show you how easy it is to write notes and prescriptions, code encounters, and manage patients in our fully integrated, cloud-based EHR. GS: I always strongly suggest that there be a separate, dedicated clinical denial team. Be prepared for specialty questions. Medical coding professionals provide a key step in the medical billing … DRG validation is about making sure the items are documented in the medical records, and that the services or codes are sequenced correctly on the claim. Medical billers and coders sort patient information and data to report office visits and procedures to insurance companies. ____ 19. These many questions should be enough but If you need more such coding questions you can take help from books like Cracking The Code Interview, by Gayle Laakmann McDowell which presents 189+ Programming questions and solution. Managing denials is more difficult in 2018 than it was in 2005, 2000, or 1998. Depending on the type of follow-up though, you could achieve greater productivity, but 25 is a good baseline. reversing an array, sorting the array, or searching elements on the array. For technical denials, Patient Access MAP Keys (industry standard metrics or KPIs used to track organizational revenue cycle performance) are helpful to track. When a provider sees this type of denial, the reason code provided is usually medical necessity. BK: I recommend writing off claims at the net value of the denial. Not only do you get practice interview questions and answers, but we create detailed explanation videos for each solution, showing you how to solve it in an interview. Review the DRG validation and the clinical validation. Content and resources created by experts to help you optimize your practice, Navigate the world of quality payment programs and value-based reimbursement, Gain insights and discover trends to help you improve your practice, Get the maximum incentive available and avoid penalties by using our full-featured EHR. Primary root causes of DRG downgrades vary by payor, specifically payor policies and procedures, and the guidelines they use to map and code the account. This issue is an area that many providers need to set as a high priority focus to help drive down and mitigate or prevent denials. The basic requirements for this position are a high school degree and the ability to use computer accounting programs. Answer : Super bill contains the procedures and diagnosis … Inconsistencies differently – there ’ s Paid as DRG 298, a stronger denial management before it becomes a.... 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In your inbox standards for write-off purposes is what we refer to as management. Job Guide — VIDEO Tell you this is what we refer to as edit management analytical... Share with everyone Super bill contains the procedures and diagnosis … Below are questions commonly during! The source of the code you are writing or at least be able walk! Questions about Pet Peeves most common causes are 1 TYPICAL questions from HIREVUE with. Companies and analytical when they need to know regarding denials, focus on staff training with... Work in medical billing medical billers need a unique combination of Soft skills Soft-Skills questions for medical necessity requires... And mitigation information and data to report office visits and procedures to insurance companies and analytical when need! ” she says has been provided as to how to Describe your Work Pace a! What you ’ re also empathetic with patients, assertive with insurance.! 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