If you’re running a medical practice, the last thing you want to think about is medical records and billing. However, those two things are an essential component of a successful practice. Read on to discover some of the most common medical billing mistakes and how to avoid them.
1. Incomplete or inaccurate patient information. If patient information is incorrect, this will lead to payment denials and will result in time spent re-filing. Make sure the information is complete and accurate the first time by using a medical records solution such as those available at MicroMD.com. Electronic medical records make it quick and easy to get information right the first time.
2. Not verifying insurance. This is a top reason why claims are denied. Denials usually occur either because coverage has been terminated or the date of service isn’t eligible, the service wasn’t authorized, the service wasn’t covered or maximum benefits were already met. Because insurance coverage and information often change, it’s important to verify a patient’s coverage every single time they come into the office – even if they are a regular patient.
3. Incorrect diagnosis and/or procedure codes. Accurate coding is extremely important because it tells the insurance company what the illness, injury or symptoms of the patient were and what treatment was performed. If these codes are incorrect, there may be a denial due to the procedure not matching the authorization or due to lack of medical necessity. Most often coding mistakes occur if an out-of-date coding book is being used or if the handwriting was incorrectly read. It’s a cliche but physicians’ handwriting is often difficult to discern. This is another problem that can easily be solved by using electronic medical records.
4. Duplicate billing. Billing is considered duplicate if the same test, treatment or procedure is billed more than once. Similarly, billing is considered wrongful if the wrong services are billed for or if services that were never performed are billed. Most of the time, the simple human error is to blame. For example, a procedure may have been canceled but never removed from the patient’s account. Unfortunately, your practice or facility can be fined for fraud if it seems these mistakes were made knowingly or willingly. Performing chart audits is a simple and effective way to ensure claims are billed correctly.
While human error can never be completely removed from the equation, using electronic medical records by properly trained staff can go a long way toward reducing the number of mistakes made and helping avoid them in the first place.