Top Reasons To Medical billing and coding services

You probably think of ways you can improve your bottom line when you think about medical practice management. While these are important aspects of good management, we often forget to address the critical component of medical billing and coding.

Even the most well-organized healthcare organization can make mistakes in medical billing. Providers are familiar with the administrative burden associated with in-house billing. If your practice is subject to high levels of denials, has difficulty submitting clean claims or uses poor RCM services providers, it can be difficult to avoid these problems.

How can a medical office avoid this situation? Can you create accurate billing statements? These common mistakes in medical billing can be avoided if you use the right combination billing technology.

Medcare MSO Medical Billing Services can help you avoid common mistakes in medical billing, even if you have outsourced it to an expert. Below are the top five medical billing mistakes and their solutions for your practice. Contact us to learn how our medical billing services can help you and all your staff reduce errors in medical billing and increase insurance reimbursements.

Top Reasons To Medical billing and coding services

Medical billing and coding services
Top Reasons To Medical billing and coding services

Insurance not being verified

Insurance issues are the most common reason for claims being denied. These denials are often caused by a dependence on routine. Staff members who see the same patient repeatedly may assume that their insurance provider or coverage plan is the exact same. This could lead to insurance ineligibility.

Insurance data can be modified at any time. This is why you need to ensure that you verify each visit. It is crucial to verify all possible reasons for insurance-related denials in order to avoid them.

  • Expiration of insurance, or ineligibility at the service date.
  • Unauthorized services.
  • The plan does not provide coverage.

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By implementing steps into your billing workflow to verify that the patient’s insurance is valid at each appointment, you can avoid denied claims. This will ensure that there are no policy-related issues.

Insufficient information

Insurance companies often deny claims because they are not coded at the highest level possible. A trained coder will usually code every diagnosis to the highest level with the code, meaning the most digits.

If your staff is not proficient in coding, they may continue to make these types of errors without realizing it. Your billers need to be educated in order to fix truncated code. Before filing, make sure your billers are familiar with truncated codes.

Incomplete information about the claim

A single unchecked or empty box in a claim can cause denials. Most often, the most basic information such as gender, birth date, and emergency time is left unchecked. To ensure that all fields are correct, double-check your electronic and paper claims files. Your software should notify you when a user misses a field or needs to amend it before they can submit an electronic claim. 

Failure to file timely

You might have a two year “timely filing window” depending on which payer you are dealing with. Or you might only have 30 days. If you do not file your claim within the time limit, you are out of luck. The best chance of a claim being denied is if it’s filed in time.

Keep a list of the most frequent payer deadlines in your billing office. This list should be included on the to-do lists for your team members. Regular audits will ensure that no unfilled claims fall through the cracks. This issue can also be solved by using recurring reminders and calendar events.

Miscoding and errors in transcription

Everybody makes mistakes from time to time. An honest mistake, even a small one, can cause an insurance claim to be canceled. When you are involved in medical billing or coding, it is easy to make an error. Here are the top ones to avoid.

  • Incorrect information about insurance, provider, or patient (e.g. name, address and date of birth), can result in the loss of coverage.
  • Too many or too few digits are added to ICD-10-CM codes.
  • No codes are required to add to a claim.
  • CPT codes entered incorrectly

Medcare MSO Medical Billing Services Can Help You Get Rid of Medical Billing Mistakes

Working with a professional agency will help you avoid common mistakes. For practices that want to increase their revenue and reduce claim denials, it is possible to have medical billing done by third parties.

Medcare MSO Medical Billing Service is a trusted partner of hundreds of medical practices regarding medical billing, coding and other billing services. We have the expertise and knowledge to implement various EHR systems and practices. We can help you put in the right policies and systems to maximize your revenue cycle and reduce claims.

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