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An error in medical billing poses a challenge for even the most well-organized billing departments. Unfortunately, the smallest error in medical billing and coding can make the difference between a payment being made, claims denials, and delays in payment.
We can all agree that human errors are often inevitable, however, lost fees can really drain the finances of a healthcare provider. This makes medical coders and billers work really hard to keep the mistakes to a minimum.
So, the question remains, what is it solution? Can common medical billing errors be avoided entirely? Read ahead to learn the different ways Unify Medicraft has given to prevent common medical coding errors. Let's delve into all the details you need to know!
Some of The Common Medical Billing Errors
Incorrect Procedure Codes
Putting a wrong number or letter when writing medical code can mean a different procedure is entered in the system. This medical coding error can also happen when there is a mistake in patient documentation before it gets to the medical billing department.
Are you always experiencing claim denial because of inputting the wrong codes? There’s a chance that your coders aren’t following the right coding and are not up to date with the new coding regulations.
Upcoding
Upcoding usually happens when healthcare providers bill their patients for more procedures than they receive. It can also occur when healthcare providers submit claims for procedures that were never performed. This is considered a serious medical billing fraud that can lead to fines and lawsuits.
Upcoding can also be due to miscommunication, entering the wrong treatment codes, or when the healthcare provider does not provide accurate information. But the penalty remains the same in most cases.
Not Linking Current Procedural Terminology
Mistakes can happen anytime during the medical billing process if diagnosis codes are not correctly linked to the Current Procedural Terminology. Although this is often not the fault of the medical coders, they should ensure everything they need to get the right code is provided by the healthcare provider. Also, there should be proper diagnosis information as this miscommunication can cause coding problems.
Missing Information
Omitting some specific information is also one of the big reasons that claims are denied, and the ways to prevent it in this situation are very straightforward. Firstly, always double and triple-check all fields before submitting all medical claims. When you miss significant details such as names, addresses, sex, insurance information, birth dates, and many more, it can cause claim issues.
Wrong Patient Information
When wrong or incorrect patient information is entered into the system, it can cause a considerable coding error leading to denials. Administrative staff must cross-check all patient information when they book appointments and review for mismatches to avoid any common errors.
Using Invalid Codes
Sometimes, diagnosis and procedure codes may be input incorrectly because there has been an update in the industry that your medical coders are not aware of. Therefore, always have a list of updated procedure codes before a claim is made. Check and review more than one time for the current billing codes to prevent making these common medical coding errors.
How To Avoid These Common Medical Billing Mistakes
Claim Accuracy Before Submission
When you verify the accuracy of all medical claims before submitting them, it prevents denied or delayed claims, incorrect patient data, and other common medical coding errors in the billing process.
Reviewing medical claims also helps ensure compliance with industrial regulations and insurance standards. You should also ensure every task is based on the line-item status of claims to get reimbursed faster.
Process Claims On-Time
Processing medical claims in a timely manner is essential for receiving reimbursement and avoiding any denial. By submitting claims fast, healthcare providers can reduce the chances of misplaced and forgotten claims to be misplaced or otherwise forgotten about. It also helps with your overall cash flow and avoids unnecessary delays.
Avoid Technical Errors
While technology is great for seamless processes in the healthcare industry, it is often complicated and can lead to billing errors. The billing process should be as clear-cut- as possible so that every step of patient care and billing goes smoothly. Any incorrect use of software can lead to payment delays, and no one wants to deal with this.
Seamless Coding Process
The most common medical billing mistakes are often found in the coding process. Therefore, it is important for medical coders to be as familiar as possible with all medical treatments they deal with in order to recognize codes easily. This also includes having a knowledge of new codes that come out every year in the yearly update.
Healthcare providers must hire only certified medical coders to excel in their billing process. They can also offer software solutions, like Unify Medicraft, that include reminders and checklists so that their medical coders can train and keep up with the appropriate codes to not create room for error.
Use Claims Clearinghouse
Another way to prevent common medical billing errors is by using a claims clearinghouse. This claim clearinghouse is used for checking claim errors before they are sent to the insurance company. Once detected, it will send the claim back to you to fix it. With reliable software as Unify Medicraft, you can reduce the number of errors in your claims and save any frustration along the way.
The Final Thought
The best prevention for medical billing and coding errors is not just one particular thing, but a collection of many procedures that healthcare providers should put in place.
Also, medical coders and billers play a huge part in every successful claim, so you can consider hiring a professional coder and establish a stable and efficient method for processing insurance claims.
Handling the responsibility of billing by yourself will not only add to the stress at work but also increase the possibility of medical billing errors, which might result in revenue loss.
Unify Medicraft makes it easy to reduce common medical billing mistakes by providing software that provides everything they need. With Unify Medicraft, you will improve claim accuracy and accelerate cash flow seamlessly.