Medical billing errors are extremely common in our country. Many healthcare providers are struggling to communicate effectively with medical coders which ultimately leads to incorrect billing. If you want to ensure the accuracy of your claims, here are a few common medical billing errors that you always want to try to avoid.
Whether you outsource your medical billing or complete it in-house, all information needs to be checked for accuracy. Since billing is often done in large quantities, mistakes are common. Claims can be rejected from the smallest typos. There needs to be accurate patient information which should include a person’s name, insurance ID and date of birth. The provider needs to include patient demographics such as name, address and contact information. The Insurance information should have pieces of information such as the correct policy number and the electronic payer ID.
Duplicate billing is surprisingly common in the healthcare industry. This occurs when services are accidentally billed multiple times. In most cases, this is due to a lack of clear communication within an organization. This can happen when two members of staff bill a patient for the same service. For this reason, patients need always to check their medical bills if they seem high.
Insufficient Medical Diagnosis
Coders need a full and accurate diagnosis from the medical provider to generate the diagnosis code required for billing. When they do not provide with the necessary information, it is likely that the insurance company ultimately denies the claim. The documentation relating to a procedure or a visit needs to be complete, accurate and legible. When this is not the case, the coder needs to get in touch with the provider to sort out insufficiencies.
Unbundling is when charges that usually are lumped together get categorized separately under a billing code. This is a problem because this can cause a bill to skyrocket. When services are bundled, they are discounted. For example, if multiple procedures are under the same code but are charged separately.
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