Common Errors that Result in Claims Unpaid

May 13, 2014

Practices are in constant need of well-trained coders and billers who can submit timely, error-free claims. There are certain billing errors that can prove costly if they go undetected, requiring a skilled billing team for reducing denial rate and getting RCM back on track. If a practice fails to catch errors ahead of time, it can lead to delayed payments, loss of revenue and costly fines.

Industry Facts :

Approximately 8 in 10 medical bills issued by hospitals contain billing errors, costing thousands of dollars to consumers and insurance providers every year
More people will be getting insurance coverage in 2014 once the Affordable Care Act takes effect. This will also create more room for errors
According to Kaiser Health News, nearly $68 billon in healthcare spending is lost every year due to billing mistakes and fraud

Common billing errors that are costing your practice:

  • Practices need staff that is diligent with new as well as returning patients because if insurance is not verified, it will costs them time and money
  • Minor inaccuracies in billing also leads to errors and unpaid claims. If the staff is not trained, they won’t be able to reduce denials as they will not know what details need to be checked in the patient chart
  • If coders are not experienced, they will submit claims to insurance company with wrong procedure or diagnosis code
  • Untrained coders and billers will end up billing for same procedures more than once. They will either bill for the wrong service or bill for services never performed
  • If staff is not trained, they will misrepresent a level of procedure or service performed in order to charge or receive more payment

How can skilled billers and coders help solve billing errors?

  • Trained medical billers and coders will be familiar with the broad spectrum of medical treatments
  • They will have a good understanding of coding and billing regulations
  • Experienced coders and billers will submit error-free claims by double checking originating documents like superbills before claim submission
  • They will double check claims for coding errors before sending them to insurance companies. They will have the know-how to make use of latest billing software in order to perform this task
  • Skilled coders and billers will also have the expertise to run reports from practice management software on a routinely basis
  • They will process claims in a timely manner because insurance payers require timely filing and if not submitted within the time frame, they will deny the claim

Handling billing errors with MBC:

By outsourcing billing and coding needs to Medicalbillersandcoders.com, practices can get rid of common billing errors that hamper their RCM. MBC has a skilled team that is trained and updated with industry changes in a constant manner in order to provide effective solutions to healthcare providers across the US. Only the latest technology is used to offer optimum results, reduce practice costs and maximize revenue. This offers additional time to providers to concentrate on quality patient care.


Category : Accounts Receivables / Claims Denials