16 May The Five Negative Effects of Medical Coding and Billing Errors
If your medical practice is dealing with the effects of numerous insurance billing and coding errors, you’ve become aware that such situations can have a cumulative effect. Some may be more apparent than others at first, but in time the negative effects associated with such mistakes can grow to jeopardize your practice. Here are five situations that can develop when one has experienced numerous billing and coding errors.
If you submit a medical insurance claim with errors, that is questionable in some way, or incomplete, the least that will happen is it will be rejected. That rejection will result in more time spent on that claim, as mistakes are corrected and it is resubmitted.
If mistakes are redundant and are found on multiple claims, that can result in large amounts of reimbursement money being delayed. Fiscal stress and financial instability can set in, making it difficult for your medical practice to meet its financial obligations.
If you are experiencing ongoing errors in billing, that may trigger an audit. Along with being time-consuming and stressful, audits can put a drain on staff time and cause distraction. If an insurance company audit reveals problems with past claims and reimbursements, your practice may be required to repay the insurance company. The best way to stay away from an audit is to make sure that whoever is handling your medical billing and coding is doing a complete, accurate, and thorough job the first time.
Medical billing errors can jeopardize a patient’s ability to receive treatment or be reimbursed for expenses. It can affect their life in many ways, as they may lose basic medical services, benefits, and their ability to see specialists and receive rehabilitative services. The appeal process they must undergo can be complex, time-consuming, and, if legal action is in order, expensive. Plus, they may have other legal recourse if the error that caused their problems is connected to the medical provider and medical insurance claim errors.
Repeated billing errors, questionable billing practices, and inconsistent or inadequate documentation can trigger questions concerning fraud. The government is focused on medical fraud, as the FBI estimates that the cost per year is in the trillions of dollars. A fraud investigation will tax your time, wallet, and nerves. Sometimes the reasons for errors are completely benign, but any whiff of suspicion can bring a full investigative effort into your life, disrupting your medical practice and putting your livelihood at risk.
Legal actions associated with medical insurance claims can come from any of various entities, including state or federal law enforcement, insurance companies, and individuals, including patients. This worst-case scenario is a reality for many doctors.
Each year for the past three years, the FBI has charged large groups of healthcare professionals with having committed hundreds of millions of dollars in Medicare fraud; plus hundreds more have been charged individually each year. Leaving the question or hint of possible fraud out of your medical insurance billing and coding process is important.
Responsible Services Essential
In order for a medical practice to thrive, there must be responsible billing and coding professionals involved. That is, healthcare professionals require experienced, properly trained, and highly knowledgeable professionals who are completely current on all aspects of the industry.
If you require premium services from those who understand each and every aspect of the medical insurance billing and coding profession contact Medical Practice Management Resources, Inc., today. We will be happy to discuss and explain our services, consult with you concerning your needs, and offer you convenient, efficient, and cost effective solutions. Medical billing and coding should not be a haphazard activity or a part-time job. There’s too much at stake.
MPMR has been the nation’s best medical billing company for over a decade. Both physician billing services are provided along with ambulatory surgery center billing. The firm helps practices maintain stellar billing practices while also increasing revenue and efficiencies at the same time.
Call today for a free consult!