To answer your question, the physicians are ultimately responsible for every charge and diagnosis they submit with their signature.
However, it would be to their advantage to learn and accept the support of certified coders. With the implementation of EMR, many practices have had to reorganize their workflow; however with providers that have little or no idea of code sequencing, procedural coding and claim edit issues, it would make sense to do complete front-end analysis of all records prior to claim drop. You can then provide training to assist them with code selection, eventually moving to a less intensive analysis.. I disagree with holding a coder responsible if any physician insists on billing or coding inappropriately. However I would strongly encourage coders to always obtain documentation of any coding recommendation or query that the providers disagree with, in case an audit uncovers a problem. This way the coder can show that they made the appropriate recommendation and the provider chose not to follow it. I also disagree that physicians 'don't understand' coding. I supervise a staff who codes for nearly 90 physicians, both primary and specialty care, and I would say that our physicians are extremely coding-savvy...due to the excellent efforts of this staff with education and support. Our external audits range in the 90% accuracy rate, so it's very possible to get your physicians up to speed with E&M, procedures and ICD-9, with or without an EMR.
Initially, with new providers, it is ideal to scrutinize every claim prior to submission, it's nevertheless a cumbersome and costly process. Evenutally, with excellent training, coders can then focus on back-end audits and ongoing education.
Pam Brooks, MHA, CPC, PCS, COC
Dover, NH 03820
If you can dream it, you can do it. Walt Disney