Medical Billing Errors Definition

August 21, 2014

Even though initially considered to be just an aid to a flourishing medical practice, the medical billing services have carved an indispensable place in the medical field over the years, especially due to their role in simplifying the financial aspects of the whole process of healthcare by acting as a bridge between the healthcare providers and the insurance companies.

What is Medical Billing?

The term ’Medical billing’ entails harmonizing the medical claims of the patients through follow ups with the insurance companies whether private or government, hence ensuring smooth, error free and timely implementation of the insurance program. This process thus depends directly on the interface between the healthcare service providers and the insurance companies, who are the payers for the services. With the medical field becoming one of the biggest sectors of service providers, the scope of medical billing aspirants is bound to grow by huge numbers. Although as per the law, medical billing may be practiced by anybody skilled for it, some of the certifications like CMRS, RHIA acquired through exams definitely equip the candidates with a better insight into the field.

Since the outcome of medical billing process depends on the interactions between the medical personnel and the insurance companies, it may span over weeks to months for the final resolution with the implied need to maintain a track of every interaction in the form of records thus avoiding any confusions thereafter. Just like most other fields, online medical billing is a major improvisation step to maximize the access and speed of these services. To make the entire process more organized, specific codes are allotted to a patient after his thorough examination by the doctor. While the hospital staff maintains a detailed record of the patient’s medical condition, the diagnosis and procedure codes help the insurance company to assess the need and the ideal coverage plan for the patient. So, the primary job of a medical biller is to streamline this flow of information about the patient's insurance needs to the insurance company, which is mostly done electronically these days in contrast to the paper forms used earlier.

What are Medical Billing Errors?

Irrespective of however simple this online procedure may sound, it is actually as susceptible to mistakes as any other process which can get grave enough to warrant attention to every single step of the medical billing process at times. Hence, there is a need to understand the various levels at which these errors can creep in.

Broadly speaking, these errors can either be simple and explicable accountable to a human mistake or it could be the more complex form resulting from a faulty interpretation which becomes a little tricky to explain. The errors could be the result of any detail missed out or on the other hand, any extra detail recorded by the medical staff affecting the final charges on the bill payable by the insurance. At the same time, there are a couple of other people like, the insurance company staff, the hospital billing staff and last but not the least, the collection workers who share equal responsibility of keeping the whole process error free in the best interest of everybody. Some of the more common mistakes committed by the billers are incorrect procedure code entered, adding the charges of an extra day of hospital stay in the bill when the patient had actually been discharged, another common folly is repeat billing, u incorrect room charges as most of the hospitals generally have different types of rooms with varying prices to be availed as per the need of the patient, etc.

Thus, the need to engage medical billing services of a reputed agency cannot be ignored for this utmost important task in a healthcare practice. MedicalBillersandCoders.com is a natural choice among the highly reputed individual as well as hospital practices all over the US because they are the largest & most proficient groups of billers and coders in the outsourcing industry from last 14 years.


Category : Best Billing and Coding Practices