Mistakes are common in every field and can be overcome. The biggest threat to any business is neglecting those errors. Sometimes, minor errors and mistakes can lead to severe problems. Especially in the field of medical billing and coding, these errors could cost the physician a loss of thousands of dollars on an annual basis. These errors could be ruled out as a reason for claim denials or payment delays. In addition, repeated errors can cause you to lose your patients, and things can go downhill.
Analyze your medical coders to see if they’re dynamic, persistent, methodical, accurate, experienced, and communicate well even though they’re certified. Then, it’s good for you that your medical practices are headed in the right direction and are in the right hands. Suppose your medical coders aren’t performing their tasks efficiently. In that case, you need to introduce an intense training program and conduct internal quality tests to bring change and improvements in their coding performances.
Most people know the term “Medical Coding” and its importance in medical practices to mitigate the risk of billing and coding errors. No doubt, hiring experienced and skilled teams for medical coding reduces errors, but they can still make mistakes. These coding errors increase claim denial rates and put your company’s revenue at risk.
To sort this out, we’ve curated a few tips on how these errors can be avoided.
The following are the essential steps to avoid billing & coding errors:
The most crucial step is verifying the patient’s information. This includes the patient’s name, policy number, date of birth, and additional required information like matching policy data and group number data where the patient is dependent on a primary insurance holder. Inaccurate and incomplete patient information can lead to billing rejection. Even a small mistake can be a reason for claim denial. So, always check that the information provided is accurate, complete, and up-to-date.
The second major reason is the team’s ignorance of verifying insurance coverage. Not verifying the insurance coverage eligibility can lead to claim denials. Medical companies have different insurance policies about which they cover various medical services. More importantly, even for regular patients, insurance information might change anytime. Providers must confirm their patients’ eligibility each time they provide services. It is critical to check that the patient’s insurance has not been discontinued and that the treatments you provide are covered under the patient’s plan; this will prevent the claim from being denied.
Nothing is constant; everything has a probability of change, even the medical codes. The continuous change in medical codes has also increased claim denial. Some medical coders, especially the more experienced ones, are so comfortable and secure in their profession that they become trapped in specific ways. As a result, they don’t spend time verifying to see if there have been any modifications or replacement codes to ensure they are utilizing the most accurate and up-to-date codes. However, with hundreds of CPT codes, it is possible to mistakenly select the incorrect procedure codes while completing claims, especially if new codes are added, which is why double-checking codes is essential. This will result in a medical coding mistake, which might cost you money. The critical point is that medical coders should push themselves to stay up-to-date on the most recent medical codes and any coding changes.
It is imperative to double-check the information provided and make sure everything is in absolute order. This includes everything from patient information to diagnosis and procedure codes. Make sure that your coders are involved in double-checking the information to prevent the claims from being denied because minor mistakes or inaccurate information can lead to denials. That’s why coders should be detail-oriented and extra attentive to avoid these kinds of errors.
The world of technology is continuously evolving, introducing new and more accurate software day by day. This accuracy can help the team to mitigate the coding errors. These software are designed to ensure that there are no coding errors, repeated numbers, and wrong information in the claims. The information has to be entered only once in the patient’s Electronic Health Record (EHR), which reduces the probability of errors occurring. This means there would be fewer denials, fewer pending claims, and less work for your team. Before putting this software into use, ensure your coding team and staff are trained enough to operate it to eliminate errors from billing.
Medical billers help healthcare providers get financial stability by ensuring that patients’ health insurance claims are processed promptly. They face numerous challenges, like getting denied claims and tracking down the cause of each denial, which take work. A team of professionals, on the other hand, will assist your practice in eliminating errors and avoiding medical billing issues. A staff of expert medical coders who keep track of thousands of codes for medical, outpatient, and diagnostic procedures can assist you in reducing claim denials.
We understand that medical billing is not a walk in the park. It is a complex process and demands expertise. To deal with ever-changing rules, codes, and regulations, every healthcare organization requires a team of experts and professionals who can handle their medical billing and coding. A team that is dynamic, reliable, detail-oriented, responsible, persistent, and certified and takes responsibility for doing medical billing and coding efficiently while enabling healthcare organizations to streamline healthcare operations, concentrate on core patient care services, and remain competitive.