How to Avoid Medical Billing Errors?

March 27, 2015

According to reports from an elder care coaching organization; 90% of medical bills have errors. Errors at the time of billing costs not only the doctors but it adversely affect the clinics, physician groups, hospitals and so on. Alarmingly, this could result in revenue loss of thousands of dollars which impacts the practice significantly.

Overbilling too can be a problem. In a scenario where a physician over bills the patient he may have to pay a penalty as high as $ 11,000 per claim, plus three times the amount of the claim and legal fees.

Mistakes in medical billing can arise due to common errors like typographical or data entry errors or they could be of high magnitudes as well and as mentioned earlier; overbilling too can prove to be detrimental. Fact is even a small mistake may consume lot of time to detect when it comes to tracking

Common Errors committed:

  • Entering an insurance identification number incorrectly. This is a common mistake that is committed. This can be done either by the front office staff or the physician
  • Digits’ getting transposed is another recurring error. One needs to make sure that the numbers are fed in correctly. Transposing of digits can happen in several cases but one that occurs frequently is with the date of birth
  • Another error is the claims are sent to the wrong insurance company. This could happen if the form is not vetted properly or the person entering insurance information does not get a copy of the insurance card
  • Procedure and diagnosis codes tend to change on an annual basis. Hence, it might happen that one of the codes that is billed regularly might change and it is not considered by the physician which will lead to it being denied

Action Steps Recommended:

  • It is imperative that we make sure right at the beginning that the correct ID numbers are entered
  • It is advisable to get a front and back photocopy of the insurance card and have a trained and vigilant front office staff that selects the correct insurance company in the practice management system
  • Physicians and practitioners need to make sure that they have the updated list of codes. Moreover, they should proactively check if the codes that they use regularly have changed or not

One of the ways to avoid medical billing errors is to create a proven medical billing and coding process. A medical biller needs to understand the myriad spectrum of medical treatments. These mistakes can be avoided by having a good understanding of medical billing and coding procedures. Being a certified medical biller and coder can help in being more astute and this way lesser mistakes will happen. Partnering with MedicalBillersandCoders.com can help as they have a team of certified medical billers and coders who can take care of the physicians’ different medical treatments. They can make sure that mistakes are avoided and claims are reimbursed.


Category : Best Billing and Coding Practices