5 COMMON MEDICAL BILLING ERRORS TO AVOID
• In the medical billing and coding world- any error can turn out to be a costly affair. It is a well-known fact that healthcare providers receive the largest percentage of their revenue through processing successful claims. • One wrongly spelt name, one transposed digit, a badly written documentation, can have a domino effect when filing claims. • Hence to help aid in minimizing rejected and denied claims, certain steps and back-checks are very essential.
Wrong or misspelled information: This could be disastrous for the patient or insurance provider. Misspelled names, wrongly entered Insurance identification number, or even inaccurate patient name can lead to rejection or denial of claims which would mean a loss of revenue affecting the Revenue Cycle Management process • Solution: Don’t accept forms blindly, but run a check to ascertain that all basic information has been properly entered
Verification of Insurance coverage: This is very essential at the initial stage, even before filling in the patient’s name. Here the front office needs to be very vigilant about the patient’s insurance coverage. Solution: Double check with the front office and verify member’s eligibility insurance coverage every time service is provided as coverage can be terminated or change.
Transposed or invalid diagnosis code: Inputting an invalid code for Diagnosis and/or procedure can lead to claims be denied and/or rejected. Codes for both are updated annually, so great attention has to be paid when one bills for codes commonly employed in your practice as they may change or be deleted. Solution: Always ensure one has the most updated version of the coding books, and recheck the commonly billed codes every quarter/year.
Documentation: This in very essential in any healthcare service provided – be it at a specialist provider’s clinic or a hospital or even when providing ambulatory service. Documenting every aspect of the service provide to the smallest detail is essential for coders and billers to avoid all the above mistakes Solution: Being Meticulous and diligence and conducting the medical billing process with great vigilance is very essential to minimize errors and make the medical claims process effective and efficient.
Thus, being aware of the nuances like knowing the difference between rejected and denied claims, and knowing the simple slips or errors that can be made can help avoid or at least minimize errors to facilitate a healthy and effective Revenue Cycle Management (RCM) process.
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