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Reduce & Avoid Medical Billing Errors: Best Practices

 
 
 
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Best Practices to Reduce and/or Avoid Medical Billing Errors

 
 
 
 
 

As you probably already know, medical billing requires a great deal of critical thinking and attention to detail. It can be hard to focus solely on billing when there are other demanding tasks to be completed. So of course, due to human error, especially if you’re new to the billing process, mistakes are made. In fact, several mistakes are often made. If this is something that you are experiencing, adhering to some best practices, can help you reduce or even avoid medical billing errors.

 
 
 

Now, you could always outsource your medical billing and leave it to the more seasoned RCM experts to prevent errors and maximize your revenue. If you want to learn how Majestic Medical Billing can help you do that, Contact us. We’d love to!

 
 
 

In this blog, I’ll share some best practices to help reduce or even avoid your medical billing errors. Be sure to read and understand each tip before implementing them just to be safe.

 
 
 

BEST PRACTICES TO REDUCE AND/OR AVOID MEDICAL BILLING ERRORS

 
 
 

Studies show that many medical claims are coded inaccurately, while other claims, are missing the required documentation.

 
 
 

To avoid these types of errors, a few simple best practices can help. I’ll cover those practices in the following outline.

 
 
 
  • Avoid Duplicate Claims

Many issues can arise when services are billed more than once. This can happen when there are more than one person entering information. To avoid this error, you should make it a habit to check the patient’s medical bill history before creating a new claim.

 
 
 
  • Insurance Verification

Insurance issues may be one of the biggest issues faced when filing a claim. There are many errors related to medical insurance coverage , especially when that insurance coverage has not been verified.

 
 
 

To avoid insurance errors, make it a habit to verify coverage before each visit. This will allow you find out if coverage has been terminated or if a particular service is not included or covered. Also you can check for co-payment obligations.

 
 
 
 
 
 
 
 
  • Timely Filing

When filing medical claims, timely filing rules apply. Sometimes depending of the volume of patient visits and services provided, the pressure of filing medical claims on time can be a bit much. This can be especially true when you have other assigned tasks outside of filing medical claims. Creating a list of the most common claims and setting up a recurring task reminder for your staff can help avoid the error of missing timely filing dates.

 
 
 
  • Information Verification

Another common mistake that medical billers make entering the incorrect information, causing a mismatch, when filing a medical claim. Mismatched information can cause a claim to be denied. Best practice to avoid these types of errors is to double check the patient’s demographic information and the medical information before submitting a claim. This is also common when you have other assigned tasks outside of billing.

 
 
 
  • Provide Complete, Accurate Data

In a lot of cases, coders make errors. This can happen when you’re not focused on the information provided. Best practice is to ensure you have to provided complete, accurate data by reviewing and verifying all information provided by the healthcare provider. Make it a habit to provide the most accurate service possible. If you feel overwhelmed, maybe hire a seasonal RCM expert.

 
 
 
  • Avoid Upcoding

Upcoding is an unintentional process. No matter if you are new to the coding process or an experienced medical coder, it can happen to you. To prevent these types of errors, you have to avoid upcoding as much as possible. Best practice is to verify the information provided using the codebooks(s) if necessary and enter codes as accurately as possible to prevent medical claim rejections.

 
 
 
  • Use Most Updated Coding Manuals

Best practice is to use the most up to date coding manual to reduce or avoid medical billing errors. Using outdated coding manuals can cause several issues because codes are constantly updated and new codes are constantly being added. There other ways to keep yourself updated. There are even seminars you can attend to learn about advanced coding strategies. It’s helpful for both provider and patient.

 
 
 

Conclusion

 

Following these best practices, will make it easier to reduce and/or avoid medical billing errors and provide better service. Plus, it’s more essential when the focus is medical billing. You may want to consider outsourcing with a good revenue cycle management team. Be sure to research the company before you contact them.

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