What is a Physician Query and Why is It Important?

What is a Physician Query and Why is It Important?

Properly coded clinical reports are one of the cornerstones of an effective healthcare practice, and that’s why it’s often one of the most substantial parts of compliance training for institutions. In the best of circumstances, every report is clear, coding is straightforward, and there’s no need for additional clarity — but this is often not the case.

This is where a physician query can come in handy, even if many medical professionals get uncomfortable dealing with them. Learn more about physician queries here.What Is a Physician Query?

A physician query is a request made by a coder for additional information from the physician. They’re typically used to determine the best way of coding some nuanced aspect of clinical care for insurance purposes, which can sometimes lead to friction between clinicians and the medical coders if mismanaged.Why Do Physician Queries Matter?

Medical coding ensures that a healthcare institution can get fairly compensated for the care they provide. With healthcare costs on the rise and insurance companies becoming increasingly strict about what requirements must be met before paying providers, it’s become more important than ever to document all aspects surrounding a diagnosis in order to receive compensation.

It’s not unusual for a physician to view a query as a challenge to their clinical judgment, but that is often a misunderstanding that can be cleared up fairly easily.
When a Physician Query is NecessaryThese situations require additional explanation because they can change how a patient is treated when it comes time to bill for the treatment they received from the clinician.

Under no circumstance is a coder’s query a challenge to the physician’s judgment. Treating patients can be a unique situation with various pressures that sometimes result in imprecise documentation of the symptoms that led to a diagnosis. If a coder requests additional information, physicians sometimes respond with a detailed clinical description to defend the position, resulting in lost time and increased frustration as two members of the organization work to fulfill their respective roles.

For more information about handling physician queries or to learn more about credentialing solutions that cover them, call the MedTrainer team today!