29 Nov Most common medical billing errors and tips to eliminate them.
Mistakes often arise in medical billing due to minor overlooking of errors in verification, data entry, or typography. Even though the error may be small, it may cause a delay in claim reimbursement. The medical practice becomes fragile without a steady revenue and ample amount of missed payments. The key is to avoid these errors initially so they don’t end up costing a chunk of money to the practice.
While dealing with these issues head-on, you will need to eliminate coding mistakes and processing errors when making claims. Healthcare facilities generate a tremendous amount of revenue through successful claims. Hence, if done incorrectly, this could potentially become devastating for a medical practice.
The Most Common Errors
Let’s have a look at the common difficulties and obstacles practices have to face when dealing with medical billing.
- Error in Identify Verification
If the front office desk acquires the wrong information about the patient altogether, it becomes challenging to conduct the processes that follow. This could happen if the information is entered incorrectly, which would require the provider to resubmit claims with corrections. Taking the time to recheck patients’ eligibility and to ensure their ID numbers would save your practice a great amount of time and money.
- Wrong Digits
When entering the patient ID number, it’s easy to make a common mistake to transpose digits. The thoughtless and unintentional error of switching two numbers with one another is fairly common. This could lead to a denial of the claim and delay the insurance process. It’s always better to double-check those digits!
- Incorrect Insurance Company
One of the most prominent mistakes is addressing a claim to the wrong insurance company. This usually occurs when proper information is not provided to the practice like an insurance card or wrong mailing address. To prevent this from happening it’s significant for the front desk to check the system and choose the right insurance agent.
- Invalid codes
Procedure and diagnostic codes are updated regularly. This makes it essential to update invoices. If this happens and you do not look into the invalid codes, your claim will get rejected promptly. To prevent this mistake from occurring it’s best to keep updated coding books and review them every year to look out for any changes.
- Codes Don’t Link
Linking medical codes to the procedures is an important task. This would mean that the patient has received the appropriate procedure for their diagnosis, hence making the billing process smoother and more convenient to understand. If the code applied does not link to the diagnosis, the patient can make a claim. This would delay payment and increase workload at the practitioner’s end. As a medical provider, the more organized and accurate codes are, the more revenue will be promptly generated. If there is a claim on the bill, it would be more costly to find the errors and to refile them.
Prevention of Mistakes
The errors we put before you are quite common in a practice. To avoid them, there are precautions and steps you can take.
• Keep an eye out for details and ensure verification of codes and numbers. Double-check spelling and patient details.
• Insist on rechecking the insurance details of the patient on every visit. A medical provider must be aware of deductibles, coverage, and limitations if any.
• Keep a close eye on the changes in laws and regulations. The staff must be trained to have a complete understanding of medical coding.
• Communication between departments and team members is essential. It’s dire to maintain an accurate record of details at the front desk, so the back office does not face obstacles during proceedings.
• The doctors and physicians on board must have extensive knowledge of medical coding so all the procedures are correctly linked with the diagnosis. This would largely cater to mistakes that result in time-consuming and expensive consequences.
• Any questions or queries coming from the patient should be addressed promptly before they end up making a claim. Claims can become complex, so it’s always better to avoid them altogether.
A practice must be mindful of these factors to avoid any outstanding obstacles to generating revenue. Many times, medical billing fraud has been reported. In a case where you notice consistent mistakes and errors, it’s best to look into it personally. Medical providers are held accountable for mistakes. The consequences of overlooked mistakes can often result in legal action. This would become an even longer process, and tough to recover from as a business. Before these small mistakes become prominent, medical providers must address them.