What Are The Most Common Mistakes That Occur In The Medical Billing Process?

The Medical Billing Process

Healthcare practitioners should follow quality standards while providing patient care services. It would help them to deliver satisfactory patient experience and make a loyal customer base. Also, they need highly skilled administrative staff to supervise revenue cycle management. So they can provide streamlined medical billing solutions that ensure error-free medical billing and coding processes.

Those medical providers who take care of these fine details can expand their business growth with less stress. By recognizing major areas of problems, they can easily adapt preventive measures to avoid such errors in the system in the future.

Therefore, practitioners should invest in medical billing solutions to make significant improvements in their practice. Otherwise, they can a host of financial challenges due to the following mistakes that usually occur in an inefficient medical billing system;

#1 Inaccurate Medical Coding:

If medical coders don’t pay attention to medical coding standards then they may head towards abusive billing practices i.e. unbundling and upcoding.

Upcoding is a procedure of charging patients more by mentioning medical codes for more expensive medical treatment than the actual services delivered. Mostly, billers and coders prefer this practice to earn more money more easily. Although, they are liable to face legal penalties due to such activities.

Practitioners must ensure that their medical billing and coding staff are following federal guidelines while preparing and submitting claims. Most importantly, you should make sure that your medical coding staff is following the up-to-date codebook.

This practice would embrace error-free medical billing and coding processes. Moreover, practitioners should make that their medical coding is highly skilled and knowledgeable. Because it is essential to make sure that they are not unbundling your services in the medical claims.

Unbundling is the concept of using a multitude of medical codes for the set of closely related medical services that can be included in a single medical code. Such a medical billing strategy can also make you face legal suites for fraudulent revenue collection tactics.

Therefore, practitioners should not take a risk to rely upon unqualified or inexperienced medical billing and coding staff. Instead, they should consult with highly professional medical billing companies.

Because a medical billing agency has all that a practitioner admires in a streamlined revenue cycle management team. They have well-experienced resources that take care of your accounts with great dedication. In fact, they have all the essential equipment to execute error-free medical billing and coding processes.

#2 Duplicate Medical Billing:

If healthcare practitioners bill patients for the same services (treatment/procedure/diagnostic test) for a particular visit more than once then it is called duplicate medical billing.

It may happen due to a human-mistake or may be deliberate. But it will also bring about negative results for medical practice. Therefore, practitioners should make sure that they have an advanced practice management system. It will automatically organize the data of a high volume of patients.

#3 Wrong Medical Billing:

It refers to the process of billing a patient for the services never delivered to that particular patient or for inaccurate medical services. It may also happen if a patient has scheduled a diagnostic test but it gets canceled out. And the administrative staff didn’t cancel that amount from the patient’s account.

Certainly, it is apparent that it happens due to clerical mistakes or human error. Therefore, practitioners should not neglect their medical billing department. The better solution to this problem is that they should hire a professional medical billing agency that has a remarkable track record of error-free medical billing and coding processes.

#4 Misunderstanding Of EOB:

It can sometimes become very difficult for medical practitioners to understand complicated EOB statements. In that case, they can also misperceive how much they are paid. Most importantly, if a claim doesn’t get the approval from clearinghouses or insurance companies and returns back in the form of denial or rejection.

Then it is a very time-intensive and complicated task to recognize the reasons behind claim denials. Therefore, practitioners also need to have well-developed denial management in place to deal with such issues. Although it is comparatively expensive than outsourcing medical billing services.

Because a well-established medical billing company always provides an all-inclusive medical billing solution. Hence, you can get stress free from such issues. Primarily, they sign a contract that they would reduce claim denial rates to a great extent. And somehow if it would ever happen then they would appeal it and remove every error from your existing revenue cycle management system.

In this way, you can get satisfied with error-free medical billing and coding processes. Also, you can reward yourself with the right amount for your hard-earned services.

#5 Neglecting Clearinghouse Reports:

After the pandemic of COVID-19, healthcare practitioners are highly engaged to deal with a massive amount of patients. That’s why medical offices have become busier places than ever before.

But it also leads to another problem. Because it has become very difficult for healthcare providers to review clearinghouse reports. Therefore, practitioners should take some steps to overcome this challenge.

They can also get professional assistance from reliable medical billing companies. These agencies would closely monitor all the paperwork and detect all the administrative problems at the right time.

It would also allow them to quickly rectify all the inaccuracies and appeal claims immediately. So you have to never lose hope from your revenue anytime. Isn’t the idea of this “error-free medical billing and coding processes” amazing?

Yes, it is, it will help you to drive an optimized revenue stream for your practice without any difficulty. Moreover, you can prepare a fully optimized revenue cycle management system for future business growth. That will keep your practice hit the business success goals with greater proficiency and efficiency.