6 Steps to Eliminating Billing and Coding Errors

6 Steps to Eliminating Billing and Coding Errors

Medical care providers have a lot of things happening at the front desk and behind the scenes in their administrative offices. While many physicians prefer to deal with only the task at hand, patient care, they must at least be familiar with the billing process and how their funds are collected and distributed each month.

This is not only a good business practice, but in many states is also becoming a requirement to combat the growing rates of fraudulent or otherwise inaccurate patient billing and insurance claim submissions. There are some easy reminders and hints that make eliminating billing and coding errors a cinch. Here are six of them.

  • Hire experienced staff. The first step to providing quality care and accurate billing is to have qualified personnel in place to properly code medical procedures and office visits. Most of the billing errors that result in insurance company denial of claims are due to improper coding. Written procedures should be available for all employees who work with billing or coding systems. This may mean hiring an outsourced medical billing firm such as MPMR who has many years of experience in all aspects of physician billing and practice management.


  • Use reputable software. Technology makes things very easy and the latest software applications can add value and simplicity to the medical billing process. Standard medical codes are commonly used for routine procedures, lab referrals, and office visits. These can be preprogrammed into software programs and saved to patient profiles to avoid duplicate billing errors. Representatives and technical support agreements are recommended, so that office staff has adequate assistance if the system malfunctions or in case any questions arise.


  • Have a double-check system. Even qualified personnel and exceptional software combined cannot guarantee an error proof system. A proofing system is very important to oversee regular procedures and to confirm that entries have been processed correctly. This could be a random spot check or a more formal system that includes regular daily reviews of all data entry items for coding and billing accuracy. New employees should always work with a senior billing assistant and have their work thoroughly reviewed until they are very familiar with the process.


  • Stay consistent. Whenever possible, the same associates should process the same types of claims and billing documents. The office should have a transparent cross-training policy, so each medical billing associate is familiar with and knows how to do other job functions. However, each member of the team should primarily be responsible for one or two competencies. Keep billing cycles consistent within divisions. If past due invoices are sent on the first day of the month, do not change the pattern. This can cause confusion and promotes both human error and duplicate system entries.


  • Have a backup in place. This actually refers to two different systems. The cross training of employees is important for consistent billing and coding procedures between departments, and also provides contingency support for employees who are out for illness or vacation or who leave the partnership. Having systems in place and written instructions from a person who did the job regularly are vital for providing consistent support. The backup also refers to the software and data systems. This contains private patient information as well as vital record keeping data and need to be secured and backed up regularly onto a secure server or mobile hard drive.


  • Offer continuing education. Every office staff member needs to stay current with local, state, and federal requirements for patient information and storage. There are also frequent changes to medical assistance and Medicare procedures. At least annually, a comprehensive training program should be presented to cover any changes and new guidelines that have been added. Likewise, insurance company contact information may also change so employees need to be aware of the most current practices on an ongoing basis.


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