Ensuring a steady income is not just a financial concern for your medical practice; it’s a matter of survival. However, maintaining this stability can be a challenge regarding billing. Issues like late payments denied claims, dissatisfied patients, and wasted time could significantly impact your practice.
To safeguard your financial health, it is crucial to avoid common billing mistakes and proactively implement prevention strategies. Therefore, following the best medical billing practices and outsourcing the billing side to medical billing companies in the USA can help ensure transparent billing and maximum revenue. Keep reading to learn about common medical billing and the best ways to avoid billing errors.
Top 5 common mistakes in medical billing
Not Checking Insurance on Time
The main reason for denied claims is often because the staff needs to check if the patient’s insurance is still valid. Sometimes, they assume the insurance has stayed the same if the patient visits regularly.
To avoid this, checking the patient’s insurance every time they come in is essential. This involves ensuring their insurance covers the visit and checking for issues like coverage ending, services not being approved, not being covered by the plan, or reaching the maximum benefits.
Integrating an insurance check into your billing process is a proactive measure that can effectively prevent issues with denied claims.
Missing Info on Claims
Sometimes, leaving even one empty box on a claim can lead to rejection. Basic stuff like gender, date of birth, and when the accident or medical emergency happened often gets forgotten.
Have someone else review each paper or electronic claim before sending it off. If you’re using e-claims, make sure your software reminds users to fill in all the needed info before they can send it.
Not Putting Enough Details
Insurance companies sometimes reject claims because they are not coded with enough detail or are shortened in an unnecessary or wrong way. A skilled coder understands that every diagnosis must have the longest possible code using the most digits.
If your team is not an expert in coding, they may need to learn to make these mistakes. It is essential to educate them: show your billers what shortened codes are like so they can correct them before submitting claims.
Missing Deadlines for Filing
Some insurance companies give you a two-year window to file medical claims, while others allow only 30 days. If you do not file on time, you are out of luck. It is tough to fix missed filing denials.
Keep a list of when your primary insurance companies need claims in your office. Could you put it on your team’s to-do list? Check often for claims you still need to file. Use reminders on your calendar to help you remember.
Coding Errors and Typing Mistakes
Simply put, sometimes you make errors. It could be entering a wrong code, charging twice for the same thing, mistyping a patient’s name, or messing up a date. It can mess up an insurance claim, even if it’s an honest mistake. Mistakes can happen quickly when you’re busy with medical billing and coding, especially when juggling other tasks. Here are some common mistakes to avoid if you can:
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Putting in the wrong information for insurance, patient, or provider (like names, addresses, dates of birth, policy numbers, etc.).
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Using ICD-10-CM codes with too many or too few digits.
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Need to include codes in a claim.
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Using the wrong CPT codes.
5 Ways For Flawless Medical Billing and Coding
Check for Mistakes
Sometimes, medical bills are a problem because of the doctor, not because of the insurance company. But there are also times when the issues are your fault.
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Do you make mistakes in billing?
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Do you get denied a lot?
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Are your billers too busy with other things?
Find out where you are weak and fix it. (You can also hire a medical billing service to help you—it might be cheaper.)
Look at How You Work
If your practice does not have clear billing rules, it might confuse patients. If you do not have a step-by-step plan for handling payments, you should make one. Write down your billing rules. If you already have rules, check if they are still good and helping you work well.
Stay Updated on Changes in Medical Billing and Coding
Medical billing codes change often due to new healthcare rules, newly discovered illnesses, and new treatments. Keeping track of these changes is essential to avoid common mistakes when coding medical bills.
Avoid Billing Twice for The Same Service
Another way to avoid mistakes in medical billing is to make sure you don’t bill for a service more than once. This might happen accidentally, especially if different people are entering information. It’s essential to check each patient’s bill carefully to prevent problems and errors in billing.
Be Careful with Mistakes in Billing Codes
Sometimes, people might try to cheat the system by adding extra charges for services patients did not get (upcoding) or leaving out charges to avoid getting caught (undercoding). But guess what? Doing either is against the law and can get you in big trouble.
Sometimes, though, mistakes happen by accident. This can be because someone is new to billing and coding, the staff is busy and making errors, or nobody is keeping up with the latest industry rules.
Conclusion
Your clinic helps your patients stay healthy, but are you also looking out for the revenue side? Mistakes in medical bills can cause big problems for patients, especially if they think their doctor is not helping them understand the charges or fix any errors.
Only some clinics can help patients with billing problems, often because they need more revenue or staff. However, to improve your patients’ experience, you should ensure they have someone to support them with medical billing issues.
In healthcare today, some clinics can partner with third-party medical billing companies to get the maximum revenue possible.