Some Common Medical Billing Errors You Must Avoid In 2023
Delayed payments, Denied Claims, and Legal troubles!
Do these words scare you?
Well, they should, as they can seriously put you into hectic situations. But you can avoid them by avoiding a few common medical billing errors. The medical billing industry usually has a fast-paced work environment where minor mistakes are common. But, little do you know, these minor mistakes can cause immense trouble later on. Therefore, it’s good to keep note of these mini mistakes.
❛ Small medical errors can happen when focusing on premium patient care services.❜
By the end of this article, you’ll have access to the crucial information that will help you to stay clear of the most commonly occurring medical billing errors. Consequently, this will help to leave an overall positive impact on your bottom line, save your staff time, and enhance profitability. Eternity Healthcare Services works efficiently under the assistance of experts, aiming to acquire each penny. You must take care of a few significant medical billing errors.
When the wrong codes are used or entered incorrectly, they can result in blunders. These are very common errors in medical billing. But these common mistakes can come up with troubles like denied claims, delayed payments, or even underpaid bills. It’s common when a medical practice bills a patient for the wrong services or even those never received. This is known as wrongful billing, and it can also happen when a patient is billed for a scheduled service that is canceled. Even omitting vital information on a claim can lead to claims being denied. These errors may seem small, but they can significantly impact your center in three ways. Firstly, they can negatively affect your finances by showing more revenue than you are making, leading to extra work for your staff to fix the issue. Secondly, your practice can incur penalties for fraud, even if the errors were inadvertent. Finally, these errors can damage your reputation among your patients, fellow practices, and the community. It’s hard for people to recommend a medical practice that bills twice for the same procedure or a service that was never provided. The good news is that there are ways to eliminate these errors. One effective solution is to use electronic software that categorizes billing. This eliminates errors, keeping your reputation and bottom line intact. At Eternity Healthcare Services, our staff stays trained on all the leading billing software so we can jump into any facility’s system and start producing results immediately.
It is important to note that upcoding can occur in two different situations. In the first scenario, a diagnosis is inflated to a more serious condition, which may require a more expensive treatment or procedure. The second situation occurs when a patient is billed for a service that is covered instead of one that was administered because the administered service was not covered under Medicare. Both scenarios can inflate revenue and demand higher payments than rightfully owed.
In addition, when a provider leaves off a medical billing code for less costly procedures in order to avoid an audit or save a patient money, it can result in under-coding. While this can occur due to simple oversight, it can appear suspicious and have severe consequences for your practice.
The impact can damage your reputation and credibility if your practice is caught upcoding or undercoating. Your practice may also incur penalties and spend unnecessary hours repairing the damage. To avoid these issues, it is crucial to have a checks-and-balances system in place that reduces the likelihood of errors. Consistently following hospital billing guidelines can help eliminate these headaches and ensure your practice remains reputable and compliant.
It’s important to be aware of unbundling in healthcare billing. Unbundling is when a healthcare provider bills separately for services that should be billed as a single procedure. This can lead to a higher reimbursement rate, but it’s also considered fraudulent. Some hospital medical billing codes are designed for various procedures frequently performed together, so when these services are billed under different codes, it’s known as unbundling. It’s essential to note that unbundling is illegal because even a simple error can inflate profits for the practice or center. The consequences for unbundling can be severe. But you can avoid such mistakes. Staying up-to-date on billing and coding trends is crucial, as medical billing codes frequently change to abide by updated healthcare regulations, newly discovered illnesses and conditions, and new treatments. Providing your staff with the necessary resources to stay updated on all new codes and billing procedures is important. This method may sound time-consuming. But, at the same time, it can help you save your time, money, and resources a long way.
It’s important to be mindful of duplicate billing in your healthcare practice. This can create unnecessary work and confusion for your staff and the payer. Double-check whether a patient has already paid for service before billing again. Additionally, be sure to obtain prior authorization from the insurance company for any services that require it to avoid claim denials or delays.
It is important to avoid entering incorrect patient information, such as the wrong name, date of birth, or insurance information, as this can lead to a claim being denied or delayed. Additionally, healthcare providers must document all services in the patient’s medical record to avoid claim denials or delays. To prevent these errors, it is crucial to use the correct codes, document all services provided, obtain prior authorization when necessary, and verify patient information before submitting claims. Working with a professional medical coding and billing service may also be beneficial to ensure accuracy and compliance.
If an insurance company finds a claim unpayable, it is considered denied. This usually happens due to billing errors, patient coverage issues, or omitted information. However, some denied claims can be appealed and reprocessed if the reason for the denial is determined and corrected. On the other hand, a claim can be rejected if there are errors like incorrect patient or insurance information. If a patient’s identification number contains transposed digits, it can result in a claim rejection. When the error is fixed, the claim will have to be resubmitted.
If your practice experiences hospital billing service errors or incorrect patient information due to staff oversight, it can negatively impact patient trust in your practice, and your staff will need to spend extra hours correcting the mistakes. To minimize denied and rejected claims, it is crucial to ensure that your staff is well-trained and checks with you if they have any questions about billing or for what service to bill. They can also follow up with patients before submitting claims to ensure all information is correct. Doing your due diligence initially can minimize issues after claims are submitted.
At Eternity Healthcare Services, we offer mistakes-free billing services. With decades of experience, Eternity helps you get paid quickly and hassle-free. We understand that it can get hectic with billing when focusing on providing patients with gold-standard services. But, with our expertise, you can avoid mistakes and generate regular revenue without setbacks. If you wish to avail of Eternity Healthcare services, you can reach out to us via +1-631-203-6568 or drop a mail at info@eternityhc.com
