It’s 2018, and cutting-edge tech is commonplace in the healthcare industry. Nowhere is this more evident than when it comes to medical billing. What would once take doctors and administrative staff hours and hours of diligent transcribing can now be done with a couple of clicks. Even better, medical billing can sometimes be automated saving staff more time.

Still, these advances don’t come without some drawbacks. Keep reading for the top five mistakes healthcare providers make with medical billing and don’t hesitate to contact us today for your free billing assessment.

Coding Issues or Mistakes

Entering an incorrect code can be the difference between a timely insurance reimbursement and no reimbursement at all. While entering the wrong code may be public enemy number one, there are numerous other coding issues and mistakes that can occur.

These include:

  1. Using an out-of-date codebook
  2. Providing insufficient documentation of services rendered
  3. Upcoding – using a code that reflects a more severe diagnosis or a more involved treatment
  4. Missing or incorrect code linkage – this is the connecting fabric between the procedure code and the diagnostic code
  5. Duplicate billing
  6. Unbundling – submitting separate bills for services that were performed together in an attempt to maximize revenues by avoiding special reimbursement rates

Any of these mistakes can lead to a denied claim. This highlights the need for airtight medical billing services.

Human Error

The second mistake healthcare providers make with medical billing comes in the form of human error. In fact, this mistake is a common cause of every other medical billing mistake listed here. Someone making an error while imputing a diagnostic code, someone entering incomplete patient information, and someone confusing multiple codes are all common examples of human error.

Human error can also include:

  1. Entering incomplete or incorrect provider information
  2. Missing codes for all of the services provided
  3. Entering the wrong ICD-9-CM code
  4. Failing to obtain pre-authorization for services that require it
  5. And more

While human error is an unavoidable part of the healthcare industry – one John Hopkins’ study suggests it’s the third leading cause of death in the country – it doesn’t change the fact that it will lead to lower payouts.

Not Verifying Insurance

Insurance coverage is one of those areas that can change at almost any time. From one of your patients losing coverage outright to something as seemingly innocuous as their move affecting their insurance provider’s willingness to remit payment – insurance gets complicated fast.

This means you need to verify insurance every time you provide medical services to your patients. This might seem like overkill to many healthcare professionals, but once you’ve had a substantial claim denied due to lack of insurance, you’ll never forget to verify a patient’s insurance again.

Now that you know the top three mistakes healthcare providers make with medical billing, it’s time to make sure you’re not making them. Healthcare Revenue Services is proud to have a 98% first pass acceptance claim submission rate. If you need error-free billing, you need Healthcare Revenue Services.

Call us today at (844) 447-7726 for a free consultation on everything from medical coding to claims management!

Leave a Comment