Given the complexity of medical billing and coding, it is understandable that mistakes can occur during the process. The most common errors, regardless of how insignificant they may appear, can result in claim denials, revenue loss, fines and penalties, and may even affect patient care. By understanding how to prevent medical billing and coding errors, you can decrease the number of rejected claims, increase payments, and maintain patient satisfaction.
We continually strive for a level of expertise and analysis that is unparalleled in the industry. We are committed to aiding the financial success of any medical practice. Here are some insights for avoiding errors in medical billing and coding:
1. Ensure Patient Information is Accurate and Aligned Correctly with Data
If a medical biller is not careful, information can be mismatched when managing a medical practice. Incorrect or missing patient names, addresses, birth dates, gender, insurance information, and treatment dates may constitute grounds for claim denial. Sometimes, busy billing departments may overlook these details.
Taking the time to double-check all fields and verify all patient information before submitting a claim can prevent the submission of inaccurate data.
2. Avoid Upcoding
Upcoding occurs when a medical coder reports a procedure with a higher reimbursement cost than the one the patient actually underwent, such as when tests are performed by technicians but coded as performed by physicians. This can occur when the billing staff enters incorrect diagnosis and treatment codes, or if the employee misunderstands the physician’s instructions. This illegally inflates your revenue because codes for specific procedures and tests demand higher payments. Upcoding will not only result in claim denials, but can also result in an audit or a penalty for your practice.
3. Utilize the most up-to-date medical coding manual
Medical coding guidelines are constantly evolving; therefore, if you submit a claim using an out-of-date reference manual, it may be denied, affecting the reimbursement procedure. It is essential for medical coders to be familiar with the most recent billing rules and regulations. This can be accomplished if coders have access to the most recent coding manuals and attend seminars to update their coding strategies. By remaining up-to-date on current codes, claims can be processed efficiently, in a timely manner, and without revenue loss.
4. Prevent Duplicate Billing
This occurs when a patient is billed multiple times for a procedure that they only received once. This common error can increase the likelihood that claims will be denied, resulting in payment delays, a poor reputation in the industry, and possibly a fraud investigation. This can occur when there are large amounts of data due to disorganization when submitting claims, even though it may seem easy to avoid. To prevent this, use auditing to reduce errors. By conducting chart audits, you can prevent the accumulation of these errors.
5. Confirm Insurance Coverage and Benefits in Advance
A medical practice’s failure to verify insurance coverage is one of the causes of rejected medical billing claims. When it comes to the services they cover, insurance companies have varying coverage policies. Moreover, policy details are subject to change at any time. Even if a patient is a recurring client, a practice cannot simply utilize their most recent data entry. This can lead to errors if the patient’s policy limit, terms of service, or insurance provider have changed.
In order to prevent claims from being denied, your practice must independently verify the patient’s eligibility each time services are rendered. Verify and communicate information regarding healthcare benefits, insurance coverage terms, and copayment options. All of this information is required for accurate patient billing.
6. Hire A Qualified Medical Biller
By maintaining a dependable and effective system for processing insurance claims, medical billers are tasked with ensuring the financial stability of medical practices. It is not a simple task. Medical billers are constantly confronted with obstacles, including the rejection of claims and the need to contest them. But when you or your employees are responsible for billing and revenue cycle management, you not only increase workplace stress, but you also increase the likelihood of medical billing errors that result in income loss.
Having a team of skilled medical billers and coders who can keep track of hundreds of medical codes, diagnostics, and treatments will help you reduce claim denials. This also means that your staff will no longer be required to spend time on billing issues, allowing them to devote more time to patient care.
MedBill Collectors has a staff of seasoned medical billing and coding experts. No matter the size of your practice, we are the leading provider of medical billing and RCM solutions, and we can assist you. Utilizing industry-leading technology, MedBill Collectors enables you to focus on patient care while maintaining financial independence and cultivating financial success. In addition to helping you save money, we also assist you in locating lost revenue, collecting past-due payments, and reducing the time required to manage your AR.
Hiring the best medical billers will have a positive impact on your practice in many ways. You can save your practice time and money by using a streamlined workflow, a regular payment schedule, accurate code usage, and prompt claim submission. To learn more about how better revenue cycle management can make your clinic run more efficiently, get in touch with MedBill Collectors right away.
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