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Improving Medical Billing and Coding Vital to Reduce Claim Denials

October 31, 2013



Claim denials are experienced by every medical practice; however, the percentage varies on the basis of how effectively medical billing tasks are handled. Providers can bring down denial rates below 5% if they invest time and money in improving their billing performance. It will not just improve their revenue cycle and increase their cash flow but also decrease staff costs.

Common coding and billing mistakes that must be avoided:

Have you ever tracked the cause of claim denials? There are certain preventable errors within the practice that result in denials. Apart from input oversights, manual errors and time constraint, there are some common medical coding and billing mistakes that need to be sorted in order to reduce claim denials.

  • Every diagnosis will have to be coded to the highest level for that code to make the claim specific. A dialog needs to be started between billers and coders and quality training should be given to them so that errors can be avoided before claim submission
  • Documentation will have to accurate to ensure there is no missing information (date of medical emergency, date of accident etc.). Lack of supporting documentation and missed fields cause denials and double the time it takes to turn around a claim. So, all claims should be examined clearly before submission
  • Timely claim filing is vital for improving medical billing procedure. Every payer operates on a different deadline schedule so practices need to be attentive. For instance, the claim-submittal period for Medicare providers has been reduced from 15-27 to 12 months

How can practices avoid these mistakes?

Practices need to invest time and money in choosing and buying the latest software that can help identify claims with maximum chances of denial. Billing software will not just improve collection speed but also decrease the workload of in-house staff.

A well-trained team of in-house coders and billers will have to be in place for handling the complexities of coding and billing reforms. From handling ICD-10 to ensuring HIPAA compliant billing, quality training will have to be given to the team so that minor mistakes don’t lead to denied claims. For the same, physicians will either have to hire expert coders or conduct training for the existing staff. 

Physicians will also have to spend more time on making sure that documentation is accurate because only then error-free coding will be possible. Staff will also be required to identify and document reasons behind every single claim denial. This will help in avoiding the same mistakes for future submissions. Policies and processes will have to be constantly updated to eliminate any chances of errors.

At Medicalbillersandcoders.com we help practices eliminate the headache of hiring and training coders and billers. We have the largest consortium of expert billers who will handle your medical claims, insurance needs and provide customized billing services. Our team will conduct an examination of your medical resources and suggest the best solutions in terms of consultancy or medical billing services.

 

Category : Best Billing and Coding Practices