Medical Billing

Avoid Putting Your Practice’s Reputation at Stake and Learn how To Correct Medical Billing Errors

how to correct medical billing errors

Medical billing errors are nothing short of a nuisance for practices, patients as well as healthcare organizations. Would you be willing to pay $100 extra after doing your grocery shopping exactly as per the list of things you have compiled? Certainly not! You would double-check the bill and see every item purchased to ensure that you make the incorrect amount go away. But when it comes to medical billing errors, it’s easier said than done. Perhaps, this is the reason you are looking for an answer to the question “how to correct medical billing errors?”

It is an open secret that medical billing frauds and errors are very common and thus people should be vigilant instead of paying their bills without a second thought. According to Healthline, almost 80% of medical bills contain errors and this number alone should explain why you should double-check before paying up your bills.

Medical billing errors patient rights

Understanding medical billing errors and patient rights is crucial as consumers are the ones getting financially devastated the most. When a patient or the service consumer has a poor charge on their credit card by a healthcare agency due to a billing error, it appears as a disgrace to the practice they have visited.

Medical billing errors cost consumers not millions but billions of dollars in the US and resolving those errors can be lengthy as well as tricky especially for large-scale healthcare groups. Thereby, regardless of the practice, it is important to prevent billing errors in all cases.

How to correct medical billing errors?

There are a few tips and tricks using which you can save money on your medical bills before even receiving it, however, all these measures can only do so much. When you get your bills, we hate to be the bearer of bad news, but it will be like a trip to the emergency room.

So we advise you not to give up and instead read this article to find out how to correct medical billing errors.

Importance of medical billing

The significance of medical billing in the cost and reimbursement process cannot be overstated. Hospitals cannot get reimbursed for insurance claims if a large number of patients claim that their medical billing is not right. Any medical billing inaccuracy should not be overlooked by the medical biller. The revenue cycle of hospitals or practices might sustain severe damages if there are medical billing errors – regardless of the nature of error. As a result, it is critical to address invoicing problems. Given below are a few strategies for reducing and also eliminating medical billing errors.

Medical codes should be considered

The medical biller should ensure that the codes are input correctly during the billing process. Medical codes that are incorrect, mismatched, or overlooked might have an impact on insurance claims. This is because the patient, as well as the insurance company, are both charged for the therapy based on the hospital’s medical codes. To produce the correct charge, the medical biller must keep up with current medical codes.

Improve quality assurance

Preventing claim inaccuracies is essential for your practice’s financial health. However, after a claim is approved, the billing and collection procedure continues. Medical providers can keep a better eye on their cash flow by using generally accepted accounting procedures to post and record payments.

Maintaining a transaction record with each receipt and sending it to the billing team can help improve account balance accuracy. The log should contain all necessary information and ensure appropriate posting and also make it simple for a reviewer to certify that the correct payment amounts are sent to the accurate accounts.

The following essential information should be included in a record:

  • Account number
  • The number on the check/cash receipt
  • Name of patient
  • Referral reference number or date of service
  • The payment amount
correct billing error

Explanation of benefits is mandatory

A claim might be refused for a variety of reasons, including faulty paperwork and in absence of explanation of benefits. To avoid denial, the medical biller should attach the explanation of benefits as a must to every insurance claim.

Prepare to succeed

Each insurance provider with which your firm does business would have its specific series of rules. An insurance carrier may require you to provide chart notes with new patient claims in order to establish a primary healthcare connection. Insurers, on the other side, may request chart data just to justify follow-up treatments or non-standard review information.

Improve and enhance the training programs for employees and include factors that help the billing staff swiftly locate essential registration requirements as well as patient files. This ensures that each carrier will have the information they need to handle claims as quickly as possible after you apply them.

Up-coding/under-coding should be avoided

It’s easy to believe that only insurance claims result in fraud. Medical bills, on the other hand, can be modified to commit fraud. It is where the concepts of up-coding and under-coding come into play. Under-coding occurs when a medical biller removes a service code out from the bill on purpose. Up-coding is the process of adding a bogus procedure code to a bill. The former assists a patient in saving money but the latter collects additional funds from a patient. The medical biller must prevent such misleading methods by only charging the patient for treatments and procedures that they receive.

Improve and maintain documents of patients

How can you assume to accurately manage medical billing claims if you don’t have correct information on all of your patients? For each appointment, you will have to remind administration staff to double-check the patient’s insurance information. What is the point of this? For instance, a patient may also have moved jobs and switched insurance companies or s/he may also be covered by the new provider.

The type of insurance may also have changed as well when a patient updates to one of the costliest plans with lower premiums or downgrades to a less expensive plan with considerably higher out-of-pocket costs. Take the initiative of explaining the procedure as you update their information so that they are not surprised because of an unexpectedly higher charge. Ensure that you check the registration details and user information twice. It is critical that all these characteristics verify the records of third-party payments.

Key Takeaway

It is critical to train your team so that they know how to correct medical billing errors and provide them with the facilities they need to conduct accurate document management for the billing process. The best way to go about it is hiring a professional medical billing service provider that knows the ins and outs of the industry and has a proven track record.