Insurance billing is a vital part of your daily operations. Helping patients might be the end-all-be-all of your calling, but consistent and proper billing is necessary for the doors to stay open for long. For many smaller offices, staying on top of the billing and getting it right can be an ongoing challenge. This is even more complicated for substance abuse treatment since this can be a specialized form of medical billing with even more potential pitfalls. The best way to keep your revenue cycle on track and prevent the slowdown of resubmitting claims is to avoid the most common mistakes that substance abuse billing companies make.
There are many different ways that coding mistakes can negatively impact your business and revenue cycle. First, the ICD-10 codes are complicated and change regularly. Staying up-to-date on additions and changes to this coding system is sometimes its own full-time job. Using the wrong code (like using a 30-minute session code for one that was actually only 15 minutes) can lead to rejections. Undercoding or upcoding can as well. Finally, Telehealth treatment is increasingly popular, but it complicates billing. Telehealth has its own specialty codes and requirements, and failing to follow them could lead to claims being rejected.
Claim denials are the result of insufficient documentation, so everyone in the practice should ensure that your biller has everything they need to submit the claim, including getting in notes and orders in a timely way.
Speaking of having everything in on time, missing deadlines is another reason many claims are denied. Trying to submit claims as soon as possible is the best practice, but sometimes your billing specialist will end up waiting on documentation. They must know the different filing deadlines to know when to push for that documentation and when they can let their coworkers have a little more time.
Duplicate billing is when a claim gets filed twice accidentally, often because of missed appointments or rescheduled consultations. While it is usually not on purpose, duplicate billing runs a double risk. If the same bill comes through twice, it is more likely to be denied, but double billing could also result in fines for your practice.
If you’re doing all of your medical billing in-house, how many people are working on it? In the vast majority of offices, the answer is one person. The truth is that most in-house medical billing is prone to errors, and this is mainly because most in-house medical billing is understaffed. If you only have one person doing all the billing for your practice, there will be mistakes. If you want to keep the work-in house, you need a system of checks and balances that supports your staff to complete the work correctly. Otherwise, you should consider outsourcing the work to a company that understands the nuances of substance abuse billing.
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