Ways to Avoid Common Medical Billing and Coding Errors

In knowing the complexities of medical billing and coding, it is unsurprising that errors can occur during the process. The most prevalent mistakes, no matter how minor they appear, can result in claim denials, revenue loss, fines and penalties, and might even influence patient care. By understanding how to prevent medical billing and coding errors, you can reduce rejected claims, increase payments, and keep your patients satisfied.

With more than 20 years of combined expertise in several healthcare specializations, including hospitals of all sizes and more, Practolytics offers customers with specialized solutions and high-touch partnerships that you won’t find at a large medical billing company.

We are continuously striving for a level of expertise and analysis that you will not find elsewhere. We are committed to assisting any medical practice in achieving financial success. Here are some tips for avoiding medical billing and coding errors, making your life simpler by minimizing revenue cycle issues, reducing your risk, and boosting your collections.

Make Sure Patient Details Are Correct And In Sync With The Data

If a medical biller is not cautious while managing a healthcare practice, the patient’s details can be mismatched. Incorrect or missing patient names, addresses, date of birth, age, insurance data, and treatment periods can result in a claim rejection.

Incorrect information can be prevented by double-checking all forms and validating all pieces of information about a patient before filing a claim.

Prevent Upcoding

Upcoding occurs when a medical coder reports a service that has a larger reimbursement cost than the service that the patient had been provided, such as when tests are conducted by technicians but coded as being handled by specialists.  This can occur if the coding staff makes an error when entering treatment and diagnostic codes, or if the person misinterprets the physician’s information. Because codes for certain operations and tests need greater fees, this fraudulently inflates your income.

Upcoding will not only result in claim denials, but it can also subject your practice to an audit or penalty even.

Use the Most Updated Medical Coding Manual

Medical coding rules are always changing, therefore if you use an old reference handbook, your claim can be rejected due to an outdated coding being billed, affecting your reimbursement process. It is crucial that medical coders stay up to speed on the recent billing standards and regulations. This can be accomplished by coders having the most recent coding guides and attending seminars to refresh their coding methods. You can also avoid income loss by staying up to date on the current codes.

Eliminate Duplicate Billing

This happens when a patient gets billed many times for a procedure that they only had once. This frequent blunder can increase the chances of claims being rejected, resulting in not just payment delays, but also a negative reputation in the industry and perhaps a fraud probe. To avoid this, use auditing to reduce errors.

Check-in Advance the Insurance Benefits and Coverage

One of the primary reasons medical billing claims are denied is when a medical practice fails to verify health insurance coverage. Insurance providers have various policies regarding the sorts of services they cover. More significantly, the specifics of a policy might change at any time. A clinic cannot just utilize the most recently submitted information from a patient, even for the most regular patients. If the patient’s insurance limit, conditions of service, or health insurer have changed, this might lead to denials.

To avoid claim denials, your clinic must verify the patient’s eligibility each time services are provided, as well as verify and discuss details like medical coverage, plan terms, and co-payment alternatives with the insurer.

Work with a Qualified Medical Biller

Medical billers are accountable for keeping practices financially stable by establishing a stable and efficient method for processing insurance claims. It’s not a simple task. Medical billers are regularly confronted with difficulties, ranging from having claims denied to having to address disputed claims. When you handle the responsibility of billing and revenue cycle management by yourself or give it to your staff, you not only add to the stress at work but also increase the possibility of medical billing errors, which might result in revenue loss.

Having a crew of expert medical billers and coders who can effectively keep track of hundreds of medical codes, diagnostics, and treatments will assist you in decreasing claim denials. This also means that your personnel will no longer have to spend time dealing with billing issues, which in turn would help devote more time to patient care.

Practolytics has a team of experienced medical billing and coding professionals in hand. We are the leading provider of medical billing and RCM solutions, and we can assist you no matter how big or small your practice is. Practolytics will enable you to focus on patient care while maintaining financial freedom and cultivating financial success by using industry-leading technology. By outsourcing all billing and coding to us, we not only assist you in saving money, but also assist you in locating lost revenue, closing payment dues, and saving the time it takes to handle your AR.

Strengthen Your Medical Billing and Coding Systems with Practolytics

Hiring the top tier medical billers will offer your practice many benefits. From a simplified workflow and regular payment schedule to accurate code usage and prompt claim submission resulting in you saving your practice both time and money. Contact Practolytics, the leading provider of medical billing services right away to discover more about how an improved revenue cycle management can make your clinic run more smoothly.

To know more about Medical Billing Solutions & Services, you can contact us at [email protected] or Call us at (803) 932-9624

 

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