17 Oct Common Medical Billing Complaints That May Be Costly
Medical billing errors are a common occurrence in healthcare practices worldwide. In fact, it is estimated that around 80 percent of medical bills have at least one error present and this has become a concern for patients and other consumers. Medical rights activists and politicians have also become involved in medical billing complaints as they are not satisfied with the way medical bills are compiled and presented. It has been reported that the billing information on healthcare provider invoices is done in a way that makes it confusing to determine what services are billed in what manner.
What mistakes are made?
It is understandable that some errors are made along the way and these can be easily fixed by the practice manager or company to whom the medical billings have been outsourced to.
There are mistakes that are made due to different consultations, procedures, examinations, services, and medications having different billing code classifications. These coding errors can result in healthcare professional billing less for their services and are thus being paid less by the patients or their medical insurer.
One of the most problematic billing issues that are dealt with include billing for services not rendered. A healthcare provider, including hospitals and other facilities that offer medical services, may have their billings set on automatic invoicing for certain services so that when these procedures are billed they may include charges that are not relevant to a particular patient.
This may be done in error, but as mentioned above can become a troublesome scenario for those involved. Payment for services may be denied by medical insurers thereby leaving the bill the responsibility of the patient to settle when they are under the impression that the costs will be covered.
Patients being billed more for services rendered, or for services not rendered, may be interpreted by the patient’s medical insurer as the provider performing a fraudulent activity. The insurers can then launch an investigation into the provider’s practice and they may end up being criminally or civilly charged for improper billing practices by the authorities and the provider’s licensing authority, respectively.
Sanctions on these practices may include having to pay back the monies that have already been mistakenly collected and in cases where these billings were performed purposefully, these providers may end up being fined or having to serve correctional sentences, and they may also end up having their license to practice suspended or revoked.
Preventing incorrect billing practices
All healthcare providers are urged to monitor the billing methods and activities of their practices and if they outsource their billings, to make sure that those companies are abiding by the rules and regulation that are put into place. Ultimately, the buck stops at the service provider who needs to make absolutely certain that the correct services and procedures are being billed for and that no additional charges are applied if not indicated.
If the provider has any issues with the way medical billings are performed, or if they query how they should bill for certain services, then it is their responsibility to contact the medical insurers and billing companies to make sure of how to invoice patients appropriately.