Common Medical Billing Errors and How to Avoid Them
Medical billing errors usually stems from mistakes made during data entry or typing. Medical billing errors are not to be taken lightly as this can make a huge difference between the transaction being made ? or not at all. Its human nature to make some small mistakes every once in a while. There will always be a margin of error to be accounted for and these human errors are allowed, but losses caused by these simple lapses can leave a huge impact on the finances of a certain healthcare facility, this means medical billers are working hard to not make these human errors. Good communication is key to keeping these mistakes at bay and stopping them from becoming a problem down the line. Medical billers make mistakes every now and then, listed below are the most common medical coding errors and billing mistakes that occur as well as how to prevent them from occurring.
Accidentally hitting the wrong key can lead to a different procedure code to be accepted into the system. This can also happen in the event of the documentation being incorrectly coded before it gets sent to the billing department. It is highly important that this mistake is to be prevented, your staff should continue with their coding training to ensure that they will input the proper codes from the start. Accurate coding is the key to having little to no mistakes.
There are times when the payer pays too little or too much causing the claim to not process correctly. Underpaid claims have to be rectified immediately as well as overpayements. Whichever the case, interest payments need to be properly processed if applicable, if the payer did not follow the right procedure or failed to follow the process properly, the provider should immediately notify them.
Lack of Data
Problems can happen rather quickly if the diagnosis codes aren?t linked correctly to the Current Procedural Terminology(CPT) which results in payment delays or even claim denials. This isnt always the error of the coding employee. If a physician did not provide the proper diagnosis info, this kind of miscommunication can be the root cause of the problem. Making sure that the physicians provide the proper codes all the time can prevent this issue from happening.
Upcoding happens when patients are charged for procedures they did not receive or for more procedures than they have actually received.. This is mainly due to some bills for procedures not performed are submitted. This issue is much more complicated and needs to be thoroughly investigated.
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