Medical billing and coding is a complex and tedious process that, nevertheless, plays a vital role in ensuring the smooth functioning of healthcare services. As much as you would like to believe otherwise, errors in claims forms are alarmingly common. Even a small and inadvertent error can result in claim rejection or delay in payment by the insurance company. This, in turn, can reduce the revenue of your medical practice and bring it under financial strain.
While most medical practitioners take utmost care when it comes to medical billing and coding in Tampa FL, the complexities of the medical billing process can make things quite challenging for physicians.
Let’s take a look at five such common medical billing errors that your medical practice can easily avoid:
At times, especially in emergencies, incorrect or incomplete patient information can be entered in the records. In such a situation, both the healthcare staff and family members are in a rush to provide medical care. Therefore, there is a high possibility that some information about the patient is omitted or wrongly entered in the records. Such mistakes may remain undetected and could lead to claim rejection later on.
This is one of the most common types of errors in medical billing. Duplicity results when a medical practitioner submits a claim for providing the same service to a patient that was included in a previously submitted claim. This leads to confusion and the insurance company can deny such a claim. At times, the physician submits a claim for a test or medical procedure performed on a patient without ensuring whether or not that procedure has even been reported. Duplicate billing often leads to a delay in claim settlement or sometimes even a claims denial.
All tests and procedures have different codes that must be correctly entered while submitting a claim to the insurance company. Upcoding happens when codes are entered for services that an individual did not receive. Upcoding also occurs when codes are entered for a more intensive and expensive procedure than what was actually performed. It increases the value of the bill and generates more revenue for the healthcare facility. It must be noted that upcoding is not an error but a fraud and must be avoided at all costs. Upcoding can complicate the medical claim settlement process and may lead to audits and inspections causing unnecessary delays.
Just like entering incomplete or incorrect information in patient records, incorrect codes can also be entered mistakenly. One may enter too few or extra digits to a code due to a simple slip of fingers. At times, the medical staff is not updated about the new codes, which may result in errors. ICD, CPT, and HCPCS codes are updated every year. It is important for billers and coders to attend regular training sessions to keep themselves updated about the changes so that only the correct ones are entered.
Telephone and video consultations are becoming increasingly common, thanks to the rise in technology and more recently the COVID-19 pandemic. While it has made health services more accessible, the billing process has become more complex. Telemedicine visits are different than in-person visits and, therefore, have to be coded differently. The coders have to be very specific when it comes to using correct code modifiers. Many coders end up using incorrect codes while processing bills, which results in payment delays.
Medical billing and coding errors mentioned above can result in rejection of claims, loss of revenue, and even federal penalties. The most effective way to ensure accurate medical billing and coding in Tampa FL is to use the services of a reputed medical billing company. It will make it easier for you to avoid all types of billing errors and will also help you save a significant amount of time and effort as well as costs.
Partner with GMB
Specialists at Gables Medical Billing (GMB) can take care of your medical billing process. With years of experience behind them, our billing experts continually strive to serve you in the best manner possible. For more information related to effective medical billing contact GMB or call our medical billing team at 786-725-2120 today.
Gables Medical Billing has adapted to the ever-changing medical billing environment, modifying and adding to its services to proactively meet the needs of its clients.