As any physician knows, it is quite difficult to ensure that the correct procedures are performed, and the correct tests are ordered to ensure the highest level of patient care. However, one area that has received a great deal of attention recently in terms of its impact on healthcare is medical billing errors and their implications on your practice and your patients. This article discusses some of the most prevalent errors doctors are likely to encounter and some tips on how to minimize the chances that they will occur within your practice.
When submitting claims to an insurance company, you must get all of your information correct. Mislabeled fields or missing required data will lead to rejections and delayed payment. Mistakes can also be costly; incorrect information in a claim can raise your costs and even result in penalties from third-party payers. While medical billing systems have become quite efficient at catching errors, human error still occurs occasionally—an inevitability given how complex medical bills are today. A single billing system can include several thousand lines of code, so minor mistakes happen all too often.
This is a common error in medical billing, with nearly 25% of all medical claims being sent back to providers for corrections. The main reasons for mistakes in detail are easily preventable if you check your work. You must proofread every claim that goes out and ensure that every piece of information you’ve entered into your computer system is accurate. This includes spelling names of both patients and practitioners, addresses, phone numbers, and insurance details; it only takes one mistake to delay payment on a claim significantly. If you’re not comfortable proofreading yourself, recruit someone else to do it for you.
A coding error is any incorrect information included in your medical claims. Errors can occur when searching for and selecting diagnosis codes, procedure codes, or supply codes. Coding errors can sometimes be simple mistakes that aren’t necessarily very costly, resulting in financial consequences. The most expensive coding errors usually involve selecting incorrect diagnosis or procedure codes; these mistakes lead to denied claims or getting paid less than what you were entitled to get. Claims can be rejected because they do not meet requirements set by insurance companies or other third-party payers.
Communication is an essential aspect of any business, so it’s vital to ensure that everyone on your team understands what they need to do and that they’re able to convey all necessary information clearly when communicating with clients or among themselves. The best way to avoid medical billing mistakes due to miscommunication is by having policies and procedures in place for every situation and following them!
This might seem like an inconsequential mistake. After all, why does it matter if your client’s bill was filed on time? Even a couple of weeks’ delay in filing can result in penalties from Medicare and commercial insurers—potentially hundreds or thousands of dollars, depending on how much money you collect from them each year. In addition to damaging your professional reputation with those companies (they’ll view your billing as late and inconsistent), any penalties paid for untimely filings will come out of your bottom line—the same place you’d otherwise be reaping those profits.