Easier said than done, we know, but we’re the pros. Since we’re the professionals and see submissions of all kinds, to payers of all sorts, we’ve learned a thing or two and would love to share it with you.
Incorrect and Improper Patient Information and Data
This is a common issue, incorrect or mismatched patient information is something as simple as omitting a letter on the patient’s name, accidentally switching a number in their address, or not updating their information. Inaccurate, or incorrect information is something that can easily be avoided by taking time to double-check the fields and verifying all of the information you have on the patient prior to submitting the claim.
Upcoding No More
Upcoding is something that can be entirely avoided and should be. Failing to code procedures as performed and documented may lead to an audit of the practice’s billing procedures and finance. Intentionally upcoding procedures is illegal inflation of your revenue. Upcoding will not only lead to denials, your practice may also be penalized. (The Gables Medical Billing team is equipped with the knowledge and experience to perform a “self-audit” of your billing practices.)
The patient went through one procedure, but for some reason, they’ve been billed multiple times for the same thing. Duplicative billing leads not only to throw off your revenue cycle – it delays payment, gives your practice a bad reputation, and could lead to a potential fraud investigation. This may seem like an unlikely issue but can happen if proper revenue cycle management procedures are not followed. (Gables Medical Billing’s team will flag any inconsistencies with your revenue cycle management process and report to the practice’s administrator to ensure the issue is corrected.)
Coverage and Benefit Verification
Another point that seems self-explanatory and simple, but can derail your entire revenue cycle process. Medical coverages change all of the time, and as “regular” as a patient may be in your practice, verifying their coverages, and confirming their benefits is critical to your practice’s revenue. Verifying eligibility each time services are rendered is essential to the financial health of your medical practice.
If you find yourself searching for help with your revenue cycle management, and checking all of the boxes to receive payment from insurers, our Gables Medical Billing team is ready to aid you in claims submissions, follow-ups, appeals, and payment posting with the sincere and deep dedication.
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.