17 Sep The Most Common Medical Billing Mistakes
One of the main reasons more and more doctors are choosing to hire a medical billing company is because of issues with medical billing. About 80% of bills contain an error and this makes them all but useless when filing the bill with an insurance company.
The most common mistakes include:
1.Unverified Insurance Coverage
The most common issue faced with billing is unverified coverage. Unless someone checks, it is possible that the patient doesn’t even have proper coverage. Unfortunately, this is missed all too often. It is very common for insurance companies to deny coverage simply because they didn’t give authorization to the provider ahead of time. Certain medical procedures may require pre-authorization or they are not covered.
Another problem is an expired insurance policy. This can happen between a regular patient’s visits, so it should always be checked. In some cases, the patient may have coverage still, but they have already hit their limit for a particular medical service, usually a recurring service, like physical therapy.
2. Incorrect Codes
When the wrong code is written on the bill, it can result in a denial from the insurance company. Often, the incorrect code is simply an issue with messy handwriting, but it may also be due to having an outdated code book. Doctors should always ensure that their IDC codes are up to date and double check online if they aren’t sure.
In some cases, a particular medical service is not covered by insurance. If this is the case, the doctor may decide to use the wrong code, to make it appear that he has performed a different procedure that is covered. While this may help the doctor get paid and patient avoid paying out of pocket, it can also go very wrong, should it be discovered. It is never worth performing fraud in order to be paid.
3. Incorrect Patient Information
Even a simple misspelling of the patient’s name can cause a claim to be denied. All sections of the patient’s paperwork should be double checked and verified with the patient to ensure accuracy. While all this checking can take quite a bit of time, it is essential for accurate results and faster payment.
Tiny details must be carefully checked. A secretary can help with the grunt work, but even so, when many bills are being filed at once, it is possible that some aspect of the paperwork will be overlooked. In fact, it isn’t just possible, it’s highly likely.
While a mistake in the paperwork can usually be filed again, it requires more time and effort to fill out the papers, checking all the information and there will be a delay in payment. For most medical offices, this is a common scenario. Opting to use a medical billing company can save doctors time and money. The company will be responsible for ensuring that all the forms are filled in correctly and that there are no missing or blank sections that could cause issues later. Clinics often spend far more time correcting mistakes and resending the bills than they would if they did things correctly the first time. This costs time and money, making it worthwhile to outsource the task.