According to studies of healthcare billing, 49%–80% of medical bills contain at least one error.
Some common causes of medical billing mistakes include incorrect insurance information, incomplete or inaccurate patient information, typographical errors, and charges for procedures that were not performed.
Knowing this, medical billing professionals should know what can cause mistakes. Here is a list of common medical billing mistakes and how to avoid them.
1. Not Following Medical Billing Deadlines
One of the most common medical billing mistakes is not following medical billing deadlines. This includes both submitting and paying bills.
It is crucial to submit bills as soon as possible to receive timely payment from insurance companies. Similarly, it is crucial to pay medical bills quickly to avoid late fees and penalties.
To make sure you never miss a medical billing deadline, be sure to keep track of all due dates and set reminders for yourself.
The medical billing deadlines you should be aware of include:
- Claim submission deadlines
- Insurance company response time frames
- Medical records release dates
- Payment due dates
These medical billing deadlines vary between medical practices and insurance companies. It is best to research medical billing deadlines for your specific practice or insurer to avoid missing a deadline.
Once you know the medical billing due dates, be sure to set reminders for yourself. Also, help your staff remember them too! Having multiple people remind each other about medical billing deadlines will help keep them on track.
2. Poor Claim Submission
Another medical billing mistake is poor claim submission. This includes incorrect medical billing codes, missing information, and untimely submissions.
To avoid this medical billing mistake, be sure to double-check all medical records before sending them out for coding. Be sure that the correct insurance company has been selected and that the correct patient name and identification number have been entered on the claim form.
If a health care provider submits a bill with inaccurate or incomplete medical records attached to it, the insurance company is likely to reject the claim. This will result in a longer wait time for payment and could also lead to penalties from the insurance company.
To avoid this medical billing mistake, be sure to submit accurate medical records with each claim. Double-check all the information before submitting the claim and ask your staff to do the same.
3. Duplicate Medical Bills
This mistake occurs when duplicate bills are sent to the insurance company for a single procedure.
This mistake can be costly for medical practices as it can lead to denied claims and late payment penalties.
To avoid duplicate medical bills, make sure you submit only one bill per procedure. If you need to send additional information or documentation to the insurance company, be sure to do so in a separate envelope or package.
If you have any questions about submitting a claim, be sure to contact your billing specialist. They will help you with the process and ensure that duplicate bills are not submitted.
In addition, ask your staff members to double-check all patient information before submitting a claim. This will help reduce the chances of sending duplicate bills.
4. Mistakes When documenting Patient Information
Another common medical billing mistake is having incorrect patient information. This includes spelling errors, duplicate names, and incomplete or inaccurate addresses and phone numbers.
This mistake can lead to duplicate medical bills, rejected claims, and late payments.
To avoid this common medical billing mistake, make sure you are using the correct patient name on all claim forms, as well as their identification number or date of birth.
Make sure that all addresses listed are accurate, including cities and states. Also, be sure to double-check phone numbers before submitting a claim.
If you have any questions about how your practice should submit a bill for payment purposes, please contact your billing specialist for assistance with this issue. They will know what information is required when filling out different insurance forms.
5. Not Following Up on Denied Claims
This medical billing mistake can be costly for your practice.
When the insurance company denies a claim, it is often because of incorrect or incomplete information on the claim form. This means that the healthcare provider has an opportunity to correct the problem and resubmit the claim.
However, if this does not happen and the denial goes unchallenged, the healthcare provider will likely not receive payment for that particular procedure.
To avoid this medical billing mistake, make sure you follow up on all denied claims. If you do not know why a claim was denied, ask your billing specialist for help in determining the reason. They will tell you why the claim was denied and how to submit it correctly.
Another option is to work with a billing specialist that has experience dealing with medical claim denials. They will know what needs to be done for you to receive payment on all denied claims, making your job much easier.
6. Not Using an Electronic Medical Billing System
Some healthcare providers still send paper claims to their insurance companies. However, this is one of the most common medical billing mistakes that can negatively impact your practice.
The electronic age has changed how orthopedic medical billing takes place. All practices need to use an automated system to process their electronic claims. They can also use these systems to communicate with patients about upcoming appointments, bills due at specific times, etc.
By using a state-of-the-art technology platform, you are making it easier for your practice to submit accurate and timely claims. This will help reduce the chances of denied claims and late payment penalties.
Medical Billing Mistakes to Avoid
Many medical billing mistakes can impact your practice. However, by following the tips in this article, you can avoid these costly mistakes and ensure a smooth and reliable billing process.
If you have any questions about medical billing or would like more information on electronic claim submission, please contact your billing specialist. They will be happy to help.
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