Healthcare Revenue Cycle Management Market Growth – Insights

Healthcare Revenue Cycle Management Market Growth – Insights

Healthcare revenue cycle management (RCM) refers to the process of handling billing, payment processing, and revenue collection in healthcare practices. RCM comprises front-end processes such as patient appointment scheduling, insurance eligibility verification and authorization, upfront collections, and back-end processes such as payment posting, accounts receivable, and denials management. Professional medical billing companies provide comprehensive accounts receivable management services ranging from charge capture to payer/insurance follow-up, accounts receivable analysis, and ongoing monitoring and reporting of receivables risk exposure.

According to a report from Global Market Insights, the healthcare revenue cycle management market size that exceeded USD 98.3 billion in 2020 is expected to reach USD 230.3 Billion by the year 2027. The market is anticipated to grow at a CAGR of over 12.9% from 2021 to 2027.

Key factors that are expected to drive the market growth are:

  • Growing demand for health insurance in countries like the U.S.
  • Increasing optimization of healthcare revenue cycle management
  • The surge in technological advancements
  • Growing demand for health insurance in North America
  • High preference for big data analytics
  • Technological advancements in HRCM solutions
  • Increasing healthcare expenditure in developed and developing economies

However, factors such as frequent changes in healthcare regulatory compliance and lack of trained professionals are among the pitfalls and challenges related to market growth.

How Big Data Analytics Helps Healthcare Revenue Cycle Management

High preference for big data analytics and its integration in the healthcare revenue cycle management process is expected to create more growth opportunities. Ranging from genomic testing to large imaging studies or any payment transactions, big data analytics can handle exploding amounts of medical data, worldwide. Hospitals in developed countries are using big data analysis and AI applications in the areas of coding and billing, denial prediction, and insurance pre-certifications.

The utilization of big data analytics software helps healthcare practices to

  • store a large amount of data
  • reduce operational costs
  • increase the efficiency of services provided to patients
  • benefit from efficient data processing and analysis

By managing vast amounts of data using big data analytics and machine learning, many healthcare providers have improved productivity in their revenue cycle management process.

The report divides the market on the basis of Product, Function, Deployment, and End-use.

By product, the market is divided into Integrated and Standalone segments. The Integrated segment accounted for USD 79.7 billion in 2020. Rising demand for integrated systems is predicted to promote the healthcare revenue cycle management market progression. Large healthcare service providers prefer integrated systems to process large databases.

These end-to-end systems can

  • combine front and back-office data flows
  • provide easy access to clinical data from electronic health records, and
  • streamline the complete healthcare revenue cycle management process

The rising interest of customers in integrated healthcare revenue cycle management solutions comprising patient appointment scheduling, medical billing, and electronic health records applications is expected to drive the segment growth during the forecast timeframe.

By function, the market is segmented into Claims & Denial Management, Medical Coding & Billing, Insurance Eligibility Verification, Payment Remittance, and Others. Growing demand for claims & denial management programs is expected to accelerate the industry expansion.

With the increasing awareness among people residing in developed countries regarding available reimbursement scenario, the claims & denial management segment held around 28.5% of revenue share in 2020. Rising interest in reimbursement policies will increase the demand for claim and denial management systems, thus augmenting the industry progression during the forecast period.

On the basis of deployment, the market includes On-premise and Cloud-based solutions. Increasing preference for cloud-based solutions is expected to push the market demand. The cloud-based segment in the market reached more than USD 74.7 billion in 2020. Being a cost-effective option, cloud-based systems are of relatively high preference as compared to on-premise software systems. Cloud-based solutions ensure ease of operations and provide timely updates for a better user experience.

End users of the Healthcare RCM market are Hospitals, Physician Offices, Diagnostic Labs & Ambulatory Surgical Centers, and Others. The Hospital segment accounted for 37% of the market share in 2020. High acceptance of healthcare revenue cycle management software in hospitals to optimize revenue by enhancing management of coding, accounts receivable, claims processing, self-pay collections and insurance follow-ups is further predicted to motivate the segment expansion. The use of HRCM software helps hospitals with increasing cash flow that helps them in achieving sustainable financial performance.

Geographically, the market is divided into North America (U.S., Canada), Europe (UK, Germany, France, Italy, Spain, Russia), Asia Pacific (Japan, China, India, South Korea, Australia), Latin America (Brazil, Mexico, Argentina), Middle East & Africa (Saudi Arabia, UAE, South Africa). Rising healthcare expenditure in North America will drive the market growth. Owing to the notable changes in regulations that have positively influenced the organization, finances, and delivery of healthcare services, this region has dominated the market and captured over 47% of revenue share in 2020. The increasing number of hospitalizations is predicted to increase the need for healthcare revenue cycle management solutions, thereby driving the regional growth. Also, the growing prevalence of chronic diseases such as diabetes, cancer, and others contribute to the increased demand for healthcare services and subsequent increase in healthcare expenditure.

Some of the key players operating in the market are Accretive Health (R1 RCM), AGS Health Inc., AllScripts, Athenahealth CareCloud Corporation, Cerner Corporation, Conifer Health Solutions, Change Healthcare (Emdeon), Experian Information solutions, Inc., Gebbs Healthcare Solutions, McKesson Corporation, Optum (The Advisory Board Company), and SSI group among others. These companies are implementing various growth strategies to maintain competition and secure a prominent position in the market.

What Are CPT Code Modifiers? How Are They Used?

What Are CPT Code Modifiers? How Are They Used?

Modifiers are codes that provide additional information about a procedure. They are added to CPT or HCPCS codes to communicate certain circumstances regarding the performance of a procedure or service. Appending the correct modifier to provide more specificity to payers about the service or procedure rendered will facilitate appropriate reimbursement. Likewise, an incorrectly used a medical billing modifier on a claim will lead to denials. Experienced providers of medical billing and medical coding services can help practices file clean claims by assigning the correct codes and modifiers to support the services rendered.

Types of Medical Coding Modifiers

As we know, CPT codes are five-digit numbers and primarily used in office and outpatient settings to report medical procedures and services in claims submitted to insurance companies. These codes are assigned based on the physician’s documentation in the medical record. Modifiers provide a way to convey specific circumstances related to the performance of a procedure or service.

The two broad types of modifiers used in medical billing are:

  • Level I Modifiers – Level I CPT modifiers consist of two digits and are maintained by the American Medical Association (AMA).
  • Level II Modifiers – Level II modifiers or HCPCS modifiers are alphanumeric or have two letters and maintained by the Centre for Medicare & Medicaid Services (CMS)

Specifically, a modifier provides the mechanism to:

  • Report or indicate that a service or procedure has been performed and altered by some specific circumstance without changing the meaning of the CPT code.
  • Provide additional information about the service that has been performed more than one time or services that have occurred unusually.
  • Provide details not included in the code descriptor
  • To report codes in connection with specific payer programs

CPT lists additional situations when a modifier may be appropriate:

  • The service or procedure has both professional and technical components
  • More than one provider performed the service or procedure
  • More than one location was involved
  • A service or procedure was increased or reduced in comparison to what the code typically requires
  • The procedure was bilateral
  • The service or procedure was provided to the patient more than once

Commonly Used CPT Code Modifiers

  • CPT Modifier 22Increased Procedural Service – This modifier describes an increased workload associated with a procedure. Modifier 22 is used in unusual circumstances such as surgeries that took significantly more time than usually required to complete, which includes increased intensity, time, technical difficulty of procedure, severity of patient’s condition (such as unusual or excessive bleeding during a procedure).
  • CPT Modifier 25 Significant, Separately Identifiable Service – Modifier 25 is applied when there is a significant, separately identifiable evaluation and management (E/M) service done by the same physician or other qualified health care professional on the same day of the procedure or other service. It is used to report surgical procedures, labs, X-rays, and supply codes that are documented as a separately identified E&M service performed on the same day as another procedure. If the patient presents to the office and a procedure was not anticipated, modifier 25 can be reported with the E&M service.
  • Modifier 26 Professional Service – Modifier 26 indicates the professional component when a service has both professional & technical components. For e.g., in radiology services, the physician’s note on the scans is considered as the professional component while the machinery used is counted as a technical component. The professional component may include technician supervision, interpretation of results, and a written report. Append modifier 26 for the following:

    • To bill only the professional component portion of a test when the provider utilizes equipment owned by a hospital/facility.
    • To report the physician’s interpretation of a test, which is separate, distinct, written, and signed.
  • Modifier 50 Bilateral Procedure – Modifier 50 indicates that bilateral procedures were performed in the same session. For e.g., when billing for a bilateral mastectomy, CPT code 19303 (Mastectomy, simple, complete) would be reported with this modifier. Before applying this modifier, it is important to check the CPT code definition to confirm that bilateral is not included in its descriptor.
  • Modifier 51 Multiple Procedures-Modifier 51 is used to denote multiple procedures (other than E/M services) performed by the same physician during the same session. Modifier 59 is used to indicate:

    • Additional or different procedures performed at same session
    • Same procedure performed multiple times at same site
    • Same procedure performed multiple times at different sites

    The primary procedure may be reported first without the modifier. Additional procedure(s) may be identified by attaching modifier 51 to the code(s).

  • Modifier 52 Reduced Services – Modifier 52 indicates that the physician has elected to partially reduce or eliminate the service or procedure. The basic service described by the CPT code has been performed, but not all aspects of the service have been completed. When a physician performs a bilateral procedure on one side only, append modifier -52. For e.g., if a physician performs a unilateral tonsillectomy on a six-year old child, report CPT code 42820) and append modifier 52.However, if the CPT code description includes “unilateral or bilateral,” (e.g. unilateral nasal endoscopy CPT code 31231) do not append modifier 52.
  • Modifier 59 Distinct Procedural Service – This modifier indicates that a procedure is separate and distinct from another procedure on the same date of service. It identifies procedures or services that are not usually reported together. Indications for the use of modifier 59 are:

    • Different session or encounter on the same date of service
    • Different procedure distinct from the first procedure
    • Different anatomic site
    • Separate incision, excision, injury or body part

    Both modifier 52 and 59 should not be applied to an E/M service.

  • Modifier 76 – Modifier 76 is used to report repeat procedure performed on the same day by the same physician and is also consequent to the original procedure. For instance, CPT code 94640 signifies treatment of acute airway obstruction with inhaled medication and/or the use of an inhalation treatment to induce sputum for diagnostic purposes. If more than one inhalation treatment is performed on the same date of service, code 94640 should be reported by appending modifier 76.

Ensure Accurate Medical Billing and Coding with Professional Support

The AMA publishes CPT coding guidelines each year on coding specific procedures and services. Proper use of modifiers is crucial for accurate coding and also because many modifiers impact providers’ reimbursement. Not using a modifier or using the wrong modifier can result in claim denials and lead to rework, payment delays, and potential reimbursement loss. Incorrect use of a modifier can also result in excess of the amount payable for a service rendered or receiving payment when payment is not due, which if not reported by the practice, can lead to heavy fines and penalties.

Getting professional support can go a long way in ensuring that the billing and coding cycle runs smoothly. Top medical billing companies have expert coders who are knowledgeable about CPT codes and modifiers and can help physicians report their services with the utmost specificity. They will ensure that modifier codes are reported only when they are relevant and supported by specific documentation in the patient’s medical record.

National Influenza Vaccination Week (NIVW): December 5-11, 2021

National Influenza Vaccination Week (NIVW): December 5-11, 2021

In the United States, the flu season occurs in the fall and winter. Flu can be a serious illness, mainly for people in high-risk groups such as pregnant women, people 65 or older and those with conditions such as asthma, heart disease, diabetes or any diseases that impact the immune system. Getting flu also puts them at a higher risk for other illnesses such as bronchitis, pneumonia or sinus infections. Getting flu vaccines on time is the best way to avoid flu. As medical practices step up their vaccination efforts, medical billing companies must ensure that their coding staff are up to date with the latest codes to report flu accurately.

In 2005, the CDC established National Influenza Vaccination Week (NIVW) to highlight the importance of continuing flu vaccination through the holiday season and beyond. In 2021, National Influenza Vaccination Week will be observed from December 5-11. CDC and its partners have chosen December, the holiday month for NIVW to remind everyone that even though the holiday season has started, it is not too late to get a flu vaccine. According to the CDC, the overall burden of influenza (flu) for the 2019-2020 was an estimated 35 million flu-related illnesses, 16 million flu-related medical visits, 380,000 flu-related hospitalizations, and 20,000 flu-related deaths. The CDC estimated that flu resulted in 9 million to 41 million illnesses, 140,000–710,000 hospitalizations and 12,000–52,000 deaths annually between 2010 and 2020.

Getting flu shots is the best way to prevent getting sick with flu and passing the flu to others and reduce the risk of illness, hospitalization, and death. The CDC recommends that everyone over 6 months old, including children and healthy young adults to get flu shot every year. Getting vaccinated is especially important for people with chronic conditions such as cancer, asthma or other lung diseases, diabetes, and heart disease who are at a higher risk for severe flu-related complications.

Influenza vaccines cause antibodies to develop in the body about two weeks after vaccination, which provide strong protection against infection with the viruses that are used to make vaccine. Available influenza vaccines include quadrivalent inactivated influenza vaccine [IIV4], recombinant influenza vaccine [RIV4], or live attenuated influenza vaccine (LAIV4).

ICD-10 codes for flu symptoms

Common flu symptoms include cough, fever, headaches, sore throat, stuffy nose, aches and pain, fatigue, and more. Such symptoms can also be reported in claims using related ICD-10 codes such as

  • R05 Cough
  • R50.9 Fever, unspecified
  • R51 Headache
  • R06.02 Shortness of breath
  • R06.7 Sneezing

Influenza vaccination

Z23 code represents the flu vaccination, which is the same for any immunization.

  • Z23 Encounter for immunization

CPT vaccination codes

CPT codes to report influenza virus vaccine include –

  • 90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
  • 90672 Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use
  • 90674 Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use
  • 90682 Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use
  • 90685 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use
  • 90686 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use
  • 90687 Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use

HCPCS codes

  • Q2034 Influenza virus vaccine, split virus, for intramuscular use (Agriflu)
  • Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria)
  • Q2036 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval)
  • Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluvirin)
  • Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone)
  • Q2039 Influenza virus vaccine, not otherwise specified

As a person’s immune protection from vaccination declines over time, annual vaccination is crucial for optimal protection against flu. Preventive actions the CDC recommends to stop the spread of germs are – avoiding close contact with sick people, covering coughs and sneezes, washing hands often with soap and water, not touching your eyes, nose, and mouth, and cleaning and disinfecting surfaces and objects that may be contaminated with viruses.

Physicians can rely on professional medical billing and coding services to assign the correct codes and bill flu shots and treatments.

Get involved in National Influenza Vaccination Week – spread awareness about the importance of getting vaccinated within the recommended time.

How Does The New Surprise Billing Rule Affect A Medical Billing Company?

How Does The New Surprise Billing Rule Affect A Medical Billing Company?

On July 1, 2021, the US administration released a rule that restricts excessive out of pocket costs to patients from surprise billing. Surprise medical bills result when a patient unexpectedly receives care from a physician who is not in their health plan’s network. The No Surprises Act that takes effect in January 2022 aims to protect patients against surprise billing. The new law applies to payers, physicians and other clinicians, facilities, and air ambulances, and as such, will also impact medical billing companies.

What are Surprise Medical Bills?

The term “surprise medical bill” describes charges that arise when an insured person inadvertently receives care from an out-of-network provider. Though the patient goes to a hospital that accepts their insurance, they may end up being treated by out-of-network providers like emergency physicians or anesthesiologists. When patients get care from a provider outside of their insurer’s network, the physician or hospital subsequently bills them for the amount not covered by their insurance. This bill amount can be hefty. It generally has two components:

  • The high amount the patient owes their plan, which is the difference in cost-sharing levels of the in-network and out-of-network service. For e.g., a plan may have a 20% coinsurance for an in-network provider but a 50% coinsurance for an out-of-network provider.
  • Balance billing, which is billing a patient for the difference between the full amount providers charge the patient and the amount that the patient’s insurance pays. For e.g., if the provider’s charge is $100 and the allowed amount is $80, the provider may bill the patient for the remaining $20.

According to a 2020 JAMA infographic based on data from the Kaiser Family Foundation (KFF), 1 in 5 insured adults had an unexpected medical bill from an out-of-network provider in the previous two years. The prevalence of surprise bills varies widely between states. KFF found that 70% of individuals with bills they couldn’t afford didn’t know the provider was out-of-network when they received care.

The No Surprises Act will protect patients from surprise medical bills and has important implications for patients, physician practices, and health plans.

Provisions of the No Surprises Act

The new rule restricts out-of-network providers in the ability to balance bill patients. Patients will enjoy protections against surprise billing and also new price transparency tools. The rule bans

  • Surprise billing for emergency services
  • Balance billing – providers cannot bill a patient for the remainder of a surprise bill after the patient’s health plan pays the in-network rate.
  • High out-of-network cost-sharing for emergency and non-emergency services
  • Out-of-network charges for ancillary care
  • Other out-of-network charges without advance notice

In their press release, the HSS noted: “These provisions will provide patients with financial peace of mind while seeking emergency care as well as safeguard them from unknowingly accepting out-of-network care and subsequently incurring surprise billing expenses”.

Role of Medical Billing Companies

With the challenges involved in coding and claims submission, most medical facilities outsource revenue cycle management. Outsourced medical billing services create claims for practices by registering patients, verifying their benefits, coding and billing services, and auditing claims before submission to payers. Insurance verification services provided by a medical billing company play an important role in helping patients learn about the costs of care.

Healthcare providers and insurance companies and need to keep patients informed about the costs for potential services. This involves calculating the total costs of their treatment and the portion that the insurance will cover. Patients should have clear information about whether providers they receive care from are in or out of their network and what costs they may face.

Patient eligibility verification services involve checking the extent of a patient’s network coverage before their next medical appointment. This is an important step in informing patients about how their insurance works, their benefits, and what costs they may face. Among other things, benefits verification includes:

  • Checking ahead of time to see if the facility accepts the patient’s insurance plan. An insurance verification specialist will call the insurance company to verify plan information as data available online may be outdated.
  • Before any care is provided, they will check if the provider is part of the patient’s “insurance plan’s provider network”.
  • Verifying the patient’s benefits and getting preauthorization from the insurance company to cover a specific service before the service is provided.

The cost of treatments are determined by their billing codes. A medical billing company can help providers submit an estimated amount of billing and service codes for all expected services prior to the provision of treatment. This is a requirement for greater health care cost transparency under the No Surprises Act.

Health plans must provide enrollees with an Advanced Explanation of Benefits (EOB) prior to scheduled care or upon request so that enrolees will be informed about not only the total cost of the out-of-network care, but their likely out-of-pocket expenses. The No Surprises Act also requires providers to submit regular updates to health plans to help insurers maintain up-to-date, accurate directories of their in-network physicians. This will allow beneficiaries to choose healthcare services covered by their insurance plan.

By ensuring comprehensive insurance verification and accurate coding to support the physician’s documentation, reliable medical billing and coding companies help providers maintain price transparency. Reduce patient confusion about out-of-pocket expenses and medical billing helps them make informed decisions about their healthcare and ensure that fewer claims go unpaid.

How To Document Celiac Disease – A Chronic Autoimmune Disorder

How To Document Celiac Disease – A Chronic Autoimmune Disorder

A serious autoimmune disorder, celiac disease occurs due to an immune reaction to eating gluten that leads to damage in the small intestine. Also called celiac sprue or gluten-sensitive enteropathy, celiac disease can occur at any age after people start eating foods or medicines that contain gluten. If left untreated, it can lead to serious health problems like malnutrition, bone weakening, nervous system problem, infertility and miscarriage. Coding staff for healthcare facilities and medical practices providing treatment for celiac disease must have adequate knowledge about the related diagnostic and procedural codes. For accurate clinical documentation of this autoimmune condition on the medical claims, physicians can rely on the services of medical billing companies.

As per reports from, celiac disease tends to affect 1 in 100 people worldwide. It is estimated that as many as 2.5 million people in the United States may have undiagnosed celiac disease and are at high risk for long-term complications. The condition is often hereditary as people with a first-degree relative with celiac disease (parent, child, and sibling) have a 1 in 10 risk of developing celiac disease. The signs and symptoms can range from mild to severe, change over time and vary from person to person. Children are more likely to develop digestive symptoms than adults. Symptoms may include-abdominal pain, bloating and gas, chronic diarrhea or constipation, nausea and vomiting. Variations in symptoms may depend on several factors like – age, damage to the small intestine, and the amount and age at which gluten consumption began.

Diagnosing and Treating Celiac Disease

Diagnosis of celiac disease is quite difficult as the condition shares several symptoms that are similar to other diseases such as – irritable bowel syndrome, lactose/gluten intolerance, pancreatic insufficiency, small intestinal bacterial growth, and Crohn’s disease of the small intestine. Diagnosis may begin with a medical history evaluation of the patient and his/her family. People with celiac disease often have high traces of antiendomysium (EMA) and anti-tissue transglutaminase (tTGA) antibodies in their body which can be easily detected with blood tests. Common blood tests like complete blood count (CBC), serum albumin test, liver function test, cholesterol test, and alkaline phosphatase level test will be performed to accurately diagnose the condition. If any of these blood test results indicate celiac disease, physicians may request endoscopy or biopsy to view the small intestine and assess the damage to the villi.

Serologic tests (blood tests that check for antibodies) that are recommended are – tissue transglutaminase (tTG) immunoglobulin A (IgA) and tTG immunoglobulin G (IgG) tests, endomysial antibody (EMA) -IgA test and deamidated gliadin peptide (DGP) -IgA and DGP-IgG tests. The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.

CPT codes used to report these procedures include:

  • 86255 – Under Qualitative or Semiquantitative Immunoassays
  • 83516 – Immunoassay for analyte other than infectious agent antibody or infectious agent antigen
  • 82784 – Gammaglobulin (immunoglobulin)

To report gastrointestinal endoscopy, these codes are used –

  • 43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic includes brushing or washing when performed
  • 91035 Esophagus, gastroesophageal reflux test, with mucosal attached telemetry pH electrode(s) placement, recording, analysis and interpretation

    91035 code involves placement of a capsule in the esophagus with the use of a detachable probe. It is also important to use the right modifiers applicable to these codes.

Treatment modalities for celiac disease include making diet modifications (by permanently removing gluten from the patient’s diet) as this allows the intestinal villi to heal and begin absorbing nutrients properly. In addition, physicians may prescribe vitamin and mineral supplements and other medications (like steroids) to manage nutritional deficiencies and control intestinal inflammation.

ICD-10 diagnosis codes to report celiac disease–

  • K90 Intestinal malabsorption

    • K90.0 Celiac disease
    • K90.1 Tropical sprue
    • K90.2 Blind loop syndrome, not elsewhere classified
    • K90.3 Pancreatic steatorrhea
    • K90.4 Other malabsorption due to intolerance

      • K90.41 Non-celiac gluten sensitivity
      • K90.49 Malabsorption due to intolerance, not elsewhere classified
    • K90.8 Other intestinal malabsorption

      • K90.81 Whipple’s disease
      • K90.89 Other intestinal malabsorption
    • K90.9 Intestinal malabsorption, unspecified

K90.0 Celiac disease code is applicable to celiac disease with steatorrhea; celiac gluten-sensitive enteropathy; non-tropical sprue.

Gastroenterologists and other specialists providing treatment need to document various diagnosis tests and other procedures using the right medical codes. Professional gastroenterology medical coding services can support these specialists in their medical coding and ensure submission of accurate claims on time.