In medical practice, billing mistakes commonly occurred that can be costly and may lead to serious financial problems and loss of revenue if not quickly addressed. Although a small mistake, billing errors may stop by double-checking every detail, preventing more problems.
This article shows the five common billing errors that may lead to denied claims.
- Failure to Verify Insurance – Insurance often changes even for regular patients. Failure to verify insurance is one of the top reasons for denied medical claims. The best thing to do is to ensure that the medical staff understands the importance of verifying the patient’s insurance by checking the dates, coverage period, deductibles, and copayments.
- Incomplete or Incorrect Patient Information – The accuracy of patient’s information is a must. Mistakes always happen during the registration process. Checking all the details is necessary to avoid delayed payment or denied claims. The basic information – like the name and date of birth – must be recorded accurately because even the simplest mistakes can cause problems in billing.
- Use of Incorrect Diagnosis or Procedure Codes – Coding mistakes happen when an insurance company has received an incorrect diagnosis or procedure code. Reasons such as handwriting mistakes or using outdated procedure codes that may cause errors in coding. It would be better to switch from a paper-based system to an electronic health record (EHR) to improve accuracy and reduce errors.
- Duplicate Billing – Duplicate billing means another processed bill with the same procedure, test, or treatment. These mistakes are due to human error. A practice should need to periodically perform chart audits to ensure correct billing in all claims.
- Upcoding or Unbundling – Upcoding is inflating the procedure level on purpose to receive a higher reimbursement rate of charging a different service than the provided one. On the other hand, unbundling is billing a separate procedure, generally billed as a single charge. Thede mistake is an example of healthcare fraud.
Trusting a medical billing service provider like AI-Care Medical Group is the best option to prevent billing mistakes. AI-Care Medical Group also has other medical services like Urgent Care in Rivera Beach, FL, for immediate medical treatment and Telemedicine in Palm Beach, FL, for digital consultations.
You may contact (561) 462-1799 or email telecare@ai-caremedicalgroupinc.com for more information.
