If you have one of your employees doing your medical billing and coding, you are most likely going to encounter a mistake here and there. Making even a simple mistake can unfortunately lead to a loss of time, causing major delays in payment, which can lead to a loss of finances to your facility, clinic, or office.
If you leave this daunting task to a professional medical billing and coding companies, you can avoid worrying about making the following mistakes on your medical bills.
Wrong patient ID.
Entering the wrong identification number is something that can be very easy to do when the person handling this task is not paying attention. Medical billing claims will either be denied and sent back to the hospital or mistakenly sent to a patient that happens to have the ID number that is on the claim.
Like entering the wrong patient ID number, it is easy to misplace a digit in a long line of letters and/or numbers. An honest mistake of missing a digit or getting two digits switched can lead to denial of a claim and delays in payment.
Medical billing and coding companies dedicate their time to these tasks so they make sure all their information on the claims are correct.
Forwarding claims to wrong insurance provider.
This is another common billing mistake, yet it is easier to avoid than getting a number wrong. This typically happens when the employee entering the information on the claim doesn’t receive a copy of the insurance card or fails to observe it entirely. Each insurance card belonging to a patient must be scanned front and back to verify which insurance provider is partnered with the patient in question.
Wrong diagnosis or procedure code.
Diagnosis and procedure codes are typically changed yearly, so it is likely that one of these codes that you bill will be different or removed by the following year. Your bill will be denied if you bill for an obsolete code. This can be very confusing. A medical billing service will have all the right information for you.
Diagnosis and procedure codes don’t match up.
Medical necessity is demonstrated when your employee links the procedure code with the diagnosis code. When these two codes are matched, it shows the insurance provider that the doctor’s performed procedures were necessary from a medical standpoint, and it gives the provider the reason to pay for the medical bill. In other words, the right diagnosis and procedure codes will get an insurance company to pay on behalf of the patient. You will not get paid for the claim if the code linkage does not show medical necessity.
It is important to get all your medical claims accurate with an outsourced medical billing service so you can get receive reimbursement accordingly.