What potential outcome can result from failing to follow coding guidelines?

Failing to adhere to coding guidelines can lead to the denial of claims, which is a significant consequence in revenue cycle management. Coding guidelines are established to ensure that diagnoses and procedures are documented accurately and consistently. When these guidelines are not followed, it can result in discrepancies between what was billed and what was documented in the patient’s medical record. Insurance payers rely on accurate coding to process claims; any inconsistencies or errors can trigger a denial.

Denial of claims not only affects immediate cash flow for the healthcare provider but can also have longer-term implications, such as increased administrative burdens to address the denials, potential loss of revenue, and negative impacts on the provider's relationship with payers. Additionally, repeated denials may lead to audits, resulting in further compliance scrutiny and even penalties if found to be consistently noncompliant with coding protocols.

In contrast, the other outcomes mentioned—improved patient care, increased billing accuracy, and enhanced revenue cycle management—are generally associated with following coding guidelines rather than failing to do so. Accurate coding contributes to proper billing practices and supports overall effective revenue cycle processes, in addition to ensuring that patients receive the correct care based on their documented needs.