Writing a medical billing invoice is not an easy task. Many common errors can happen. These health billing services errors can be as simple as forgetting to put the diagnosis on the invoice or as complicated as using out-of-date codes that have been replaced by new ICD-10 for billing. Medical billing professionals should be aware of these common errors and know how to avoid them at all costs to keep their hospital clients satisfied.
Several common billing errors are encountered in healthcare billing services. They result in unnecessary administrative and financial costs for the provider.
Missing patient information
Mistakes in medical billing occur most frequently when essential information is left out of submitted claims. Incomplete information on the patient’s part, such as the date of the accident, the full name, the date the patient used the emergency service, etc., is a common cause of medical billing errors. It is critical to double-check all fields before submitting the claim to prevent a refusal. Using a gateway to manage and save patient information simplifies crucial data management.
Lack of timely claim submission
Another standard error in medical billing is missing the deadline for submitting claims. When completing a claim form, the first day of the patient’s service is the starting date. The deadline set by the medical claim service must be adhered to.
A claim is more likely to be denied if it is not properly submitted within the allotted time frame. To ensure prompt processing of claims, they must be filed before the deadline.
Missing or Incorrect Patient Data
Incorrect patient information is another frequent cause of claim rejections in medical billing. Claims are often denied because of typos in the patient’s name, inaccurate dates of birth, or the wrong sex being entered. There should be no mistakes in the patient’s insurance policy number, insurance payer’s name, or the patient’s link to the insured.
Examining these sections and the critical patient information and insurance details is time-consuming, but it is essential. Errors can be reduced or eliminated by adopting advanced software for medical billing and coding. Verifying all data entries helps cut down on claims rejections.
It is the intent of some hospital medical billing codes to be used for a set of related treatments. Unbundling refers to the practice of billing for these components separately. Importantly, unbundling is forbidden since it artificially inflates a business’s earnings, even if the mistake was made accidentally. Unbundling may have dire repercussions.
Fortunately, there are methods available for preventing the unbundling error. To comply with updated healthcare legislation, newly identified illnesses, and novel therapies, medical billing codes are constantly evolving; therefore, it’s important to keep up with the latest trends in billing and coding. Provide the means for your personnel to learn about the latest coding standards and billing practices. Although it takes some effort now, in the end, you will avoid further hassle in the event of a legal dispute.
Upcoding, undercoding, and other violations of hospital billing policies
There are two scenarios when upcoding is possible. In the first, a condition is inflated from a lesser severity, such as mild, to a greater one, necessitating a more extensive and costly course of therapy. The second type of situation arises when a patient is billed for a treatment covered by Medicare but not actually provided to them because the service provided was not covered by Medicare. Both scenarios can artificially inflate your income by resulting in excessive fees.
Medical undercoding occurs when a physician fails to include a billing code for a less expensive service in the hopes of evading an audit or saving the patient money. This is something that can happen due to simple carelessness, but if it does, it can give the wrong impression and have disastrous effects on your practice.
In most cases, medical billing errors are the result of human error. However, in the age of technology, some of these errors can be traced back to an automated system.
These errors can range from duplicate billing for a service to billing for a product never delivered. One major error that is seen frequently is when an insurance company or payer is billed without any notification or authorization from them.