Importance of Medical Coding for Insurance

With health and diseases becoming a major issue these days around the world, it has become A LOT more important to have more and more coders involved in the medical field for insurance. But what is medical coding? A medical coder, clinical coding officer, or diagnostic coder are professionals involved in the health care sector who analyze clinical documents and using proper classification systems, assign standard codes to them. They provide medical coding guidelines and suggestions to help regulate the ways doctors, nurses, and other medical staff provide care for their patients. There are three main types of medical coding:

1) ICD (International Classification of Diseases): These are codes used for describing the cause of illness, injury, or death.

2) CPT (Current Procedural Terminology): These deal with anesthesia, surgery, pathology, radiology, measurement procedures, and new technological changes in the medical field.

3) HCPCS Healthcare Common Procedure Coding System): These include outpatient hospital care, medical aid, and Medicare.

Let us look at some points as to why coding is necessary for the medical field.

DATA SYSTEMS
When the coding is paired with the data systems of the hospitals, a powerful tool is made. By doing so, a large number of data from various hospitals, clinics, and other sources are stored, accessed, and used from one large online data system. This implementation helps in the transfer of any patient’s data from any hospital to another for any medical purpose. This information helps doctors to be more connected and make wiser decisions, especially in cases involving the life and death situation of the patient.

PATIENT CARE

Coding is very much required for reimbursements, which include submitting medical claims with insurance companies and bills between insurers and patients. The transfer of information for bill related purposes requires medical records, patient’s medical needs, lab results, pathology records (if any), and any other related documents. Appropriate payment is possible only when the required diagnostic codes are put in place, which also means to verify in case the medical claim is denied by the insurance company.

REGULATIONS

Medical billing and coding fall under the rules and guidelines of many countries and states. Coders in this field are also responsible for protecting the privacy of the patients and their families. They are supposed to take safeguards to preserve the confidential details concerning the patient and his/her medical background in a safe place. Electronic medical records fall under the International Classification of Diseases (ICD-10) codes issued by the World Health Organization (WHO).

Medical coding analysts are in the front line in healthcare data analytics. They work in many types of healthcare setups and not necessarily in hospitals and clinics. Their valuable service is very functional for research and development in the medical field.

Mastering Home Staging Design

Home staging design is not as difficult as it sounds. You see, the big difference between interior design and home staging is essentially the goal of each activity.

When a home owner embarks on interior design, they want the house to reflect their own personality and desires. But when a person engages in home staging, they avoid reflecting any aspect of their personality so that the home has a broad and universal appeal.

During home staging, each of the changes in your house should be done to improve your home’s attraction to potential buyers.

Home staging guidelines

The home staging process might take a few weeks to complete, but the changes needed inside your home are not hard to accomplish. Here are some guidelines:

1. If you don’t have the funds for buying new cabinets, it’s time to maximize the buyer appeal of your existing cabinetry. Remove all of your cabinets and clean the old installation spots. Have the room repainted before putting the cabinets back.

Clean the cabinets thoroughly. If the cabinets are from the kitchen, the surface of the wood will have a thin grease film from all the cooking vapors that you produce during your normal use of the space.

Remove the grease film with a wood-safe de-greasing agent. Sand the cabinets and apply a generous layer of accent paint or varnish, whichever is best.

2. You can make the best possible impression on potential buyers if you create a visual atmosphere that is young, fresh, and vibrant. No one likes to live in a house that looks, smells, and feels ten or fifteen years old.

When a person is out to buy a house for their family or for themselves, they want a property where they can start fresh. So it’s very important to remove all traces of occupancy, including worn counter tops.

You have several options when dealing with old counter tops. The ideal option is also the most expensive: have the old counter tops removed so that granite can be put in.

The second option produces good results (for the price) but isn’t as expensive as the first option: Formica or laminate counter tops.

The third option is also the newest approach: non-invasive resurfacing. Ask your private contractor about these three options and pick the one that suits your needs and budget.

3. Since you are already moving out after the sale of your home, it won’t hurt to buy new appliances. Pick nice appliances and put these in your home for showcasing. Just make sure that you tell the buyer that the appliances are not part of the package and are just there for showcasing purposes only.

Now, if you want to buy even better appliances, you may want to consider buying new appliances, increasing the price of the home to include the cost of buying new appliances (plus interest), and then buying better appliances for your new home.

4. Take a look at your bathroom – does it look like a million dollars to you? If not, you may want to have the tiles, lighting, and bathroom fixtures removed and replaced. Adding a vanity space to your bathroom will also boost the overall value of your property.

Is Insurance a Necessary Evil?

I have been experiencing an insatiable thirst to seek to answer this nagging question about whether insurance is a necessity in our country today. While the subject of insurance is broad and multi-faceted, I will seek to break down the perception of this subject so that our minds for a moment are not engrossed with the surreptitious picture of insurance agents’ incessantly cold-calling potential clients or pursuit of claims arising out of insurable risks by claimants.

Data from the Insurance Regulatory Authority (IRA) shows that the level of uptake of insurance in Kenya is at an all-time low of 3.3 percent. This cannot be compared to developed economies like South Africa where the numbers are at 14%. Many explanations have been advanced to show why Kenyans are still averse to taking up Insurance related products. One prominent argument is that the Per capita income (GDP) of the average income earner cannot be enough to support payment of premiums. The other school of thought is that the savings culture of Kenyans is still wanting.

While the arguments above may hold water, the fundamental understanding of insurance has not been taught to most of us from an early age. The subject of insurance I dare say is still shrouded with a lot of secrecy and misunderstanding akin to the mysticism surrounding ancient religions. The language used is still rather technical to the average person. I realize that at this point I must correct myself quickly and note that every profession has its language; for an engineer has to use engineering language, an architect the same etcetera. Insurance also has its language but if its proponents profess that it benefits almost all of humanity, shouldn’t it be clothed in language that is not so grandiose but easily palatable to the common man?

The responsibility of the stakeholders in the insurance industry is to bring customers’ perception to how insurance works in a language they can understand. This would entail offering a basic insight on what informs the underwriting decisions on various insurance products by insurers. I want to suggest that it would benefit insurers to have open days where they invite people and educate them on the fundamentals of insurance, on the meaning of risk, why insurance is important to any economy and most importantly the benefits of insurance at a personal level. Apart from honing their sales skills, sales professionals need to align themselves properly with the market in order to understand and respond well to their customers’ needs. More often than not, sales people are perceived to be aggressive, over-achieving individuals who are not honest and are quick to point to clients the dotted lines in the application document. This negative perception must stop. Insurance sales people contribute immensely to the overall economic growth and offer important services without which an economy could not function well.

Now back to our overarching theme. Any society is fraught with risks. The risk of death by accidents, accidental injury leading to permanent or temporary disability, the risk of fire arising out of man-made or natural sources e.g. lightning, subterranean fire etc, the risk of accidental injury at the place of work owing to the nature of employment, loss of luggage while travelling and many more. What insurance does is simply to classify the above mentioned risks and price them into premiums. The premiums are then pooled and it is from this pool of funds that claims are settled. The guiding principle here is that a risk should be quantifiable. A close analysis of your immediate environment will reveal many known and unknown risks. Insurance companies manage losses that arise out of insured risks. Think for a moment the costs borne by the insured if there was no insurance to mitigate these risks. Imagine a petrol station owner being held liable for damage by fire arising from his petrol station to his neighbors. If the owner does not have public liability insurance, he may find it difficult to raise money to meet his legal fees and hence may not protect his business. This is because the cost of a claim can far exceed what a business is able to raise and necessitate the shutting down of a business altogether. Many examples abound where insurance solve practical problems and mitigate a host of risks that can cripple businesses and slow economic growth. At a personal level, medical insurance is very vital. Think for a moment the rising cost of Medicare and consultancy fees not to mention the increasing costs of pharmaceutical medicines.

But there is an antithesis to such a healthy explanation and this is advanced by some who argue that risks are only imagined hazards. They posit that a risk is imagined and only ceases to be a risk when an actual occurrence happens. Some even counter a proposal to take up insurance dangerously by arguing that they have, for example, not been admitted to hospital for a number of years and see no need to take up a medical cover. While it is important to live healthy and avoid the hospital and its attendant costs, it would be farcical for one to wish they had a medical cover in the face of a medical emergency.

In conclusion, insurance is necessary to any growing economy like Kenya in spite of the low uptake. It not only creates employment and puts in abeyance the worry of meeting risks; it is an indicator of economic growth and a sign of a thriving economy. More needs to be done to educate the masses with regard to this subject. The responsibility lies squarely at the court of the regulator to put pressure on insurance companies to increase the uptake of insurance in the country. Incentives must be given to companies that have the highest level of penetration to make sure they maintain their influence and widen the market. Is insurance necessary? Indeed it is. Next time someone dissuades you from taking up an insurance plan, think again.