Medical Billing and Coding: Fixing Errors Before They Happen

Medical Billing and Coding: Fixing Errors Before They Happen

Any error on a medical claim form submitted to an insurance provider or to a government benefits program results in instant rejection. That rejection means more work, as the corrected form is sent back on appeal. Although that process may result in a practitioner eventually being paid for their services, the fact is it costs money, involves extra time, and demands more effort. A lot of energy could have been saved if the errors were caught before the medical claim was filed.

If you are having problems with rejected medical claims, forms that contain errors or are incomplete, or getting easy access to patient information that is current and accurate, the following suggestions may help you remedy your situation. Here’s how to fix errors before they occur.

Accurate SOAP Notes

Keep SOAP notes that are accurate and complete and make sure that the medical codes assigned to that patient are in syncopation with your notes. Along with serving to document a patient’s condition and the treatments you prescribe, SOAP notes serve as the foundation for any charges that are listed on a medical claim form and patient’s bill.

Coordinate Information

Information regarding visits, exams, consultations, services and procedures must be carefully coordinated. Timely updating of patient files and making sure that all information necessary to complete a medical claim form is in one central location is important. Whenever a patient has an appointment always check to make sure that you have their current health insurance provider on file

Fact Checker

This may seem like an extravagance but having someone who can be the fact checker on information can greatly reduce errors before they occur. They may be part of your medical billing staff or someone on the administrative staff whose primary obligation is making sure that all information needed to complete a medical claim is available. It’s best if this person is not someone who is working with the patient, but, rather, someone apart from that process, as they will be more objective and more likely to spot errors or missing information.

Medical Billing Liaison

Your medical billing liaison may be the same person as your fact checker. They are the person who coordinates the information that is shared by the doctors and other medical personnel with the medical billing and coding professionals. This person is especially important if you have outsourced your coding and billing, as they will be the one person that your billing company can contact when they have questions or a problem concerning a claim.

Demand Quality

The best way to fix medical billing and coding errors before they occur is to demand quality from yourself and those with whom you work. Set an example by keeping your notes and records current, by utilizing codes properly, and by encouraging communication amongst your staff and your medical billing and coding team. Setting up a system of checks and balances that spots problems before they become part of a medical claim that’s submitted to a payer will save time and help to expedite payments.

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