How to Prevent Medical Billing Mistakes - The Smiling Heart

How to Prevent Medical Billing Mistakes

Although the government has instituted standardized coding for medical billing, a huge amount of mistakes are made annually and by one account mentioned in the Wall Street Journal, those mistakes are made on 30 to 80 percent of all medical bills. While this particular article was written just prior to the institution of standardized coding laws, it may even be a greater problem now due to the legislated standardized codes put in place.

Just imagine thousands upon thousands of codes for anything from a visit to the doctor to surgery to pharmaceuticals. You can see how easy the transposition of just one digit could represent a major change in price, up or down. Whether you are a doctor in private practice or the administrator of a clinic or large healthcare facility, it is vital that you ensure all codes and costs are accurate. Here are a few ways you can prevent medical billing mistakes.

Work Only with Certified Medical Billing and Coding Professionals

It may be tempting to let your office staff take on the responsibility of billing insurance companies and patients, but this could be a huge error in judgement on your part. This is one task which could end up costing you a serious amount of money notwithstanding the fact that some errors may be seen as an attempt to defraud the system.

If you choose graduates of the Best Medical Billing Coding schools, you can rest assured that any new laws or standards will be understood and followed. Don’t make the mistake of keeping overheads low by cutting out this very necessary expense. One mistake can cost you more than a year’s contract or wages you’ve paid to a professional.

Check and Double Check Before Submitting

One of the biggest errors in Medical Billing and Coding is entering wrong information or failing to update any patient information. It is up to you, as the provider, to ensure you have the latest contact information, insurance company and anything else which could be grounds for denying a claim.

Also, as mentioned above, one single letter or digit could be grounds for denial of payment. If you had checked and rechecked everything on the claim prior to submitting it, you probably would have caught the error. As a biller or coder, you must ensure that you have all the latest information from the provider you are working or contracting with.

Time Is of the Essence When It Comes to Your Bottom Line

Insurance companies and government bodies are notoriously slow at paying claims. One mistake sent back for review could tie up that bill for literally months. With that being said, of all the things you can do to ensure accuracy in the process of billing and coding is to work only with fully qualified professionals. Just one change in coding legislation or one new industry standard could set you back thousands of dollars each and every month if you have numerous patients with the same diagnosis. So, the bottom line is to work only with professional coders and stay current on government standards.