Most Common Errors in Medical Billing

25 Jul

Errors can occur in medical billing if you are using the paper system. These errors lead to many other problems like patients being overcharged because of unintentional switching of billing reports by the staff. You need to automate medical billing in your health facility to minimize these errors. Outsource the revenue cycle management services for your medical billing services. These services are affordable. They also provide custom services specifically designed for your medical center. You will save time for retrieving billing reports of patients. You will also use minimal space because of the elimination of file cabinets. When considering this, here are some of the common medical billing mistakes that are encountered in medical centers.

The diagnosis of the patient can be tampered with due to unbundling and upcoming errors. Upcoding inflates the diagnosis of the patent to a more severe health condition that needs a more expensive treatment procedure. The patient is billed with a medical service that is covered by their health insurance policy instead of the one that they were given. This happens when the one accesses a medical service at the health facility that is not covered by the patient's medical insurance cover. The staff can separate codes of billing that should be included in one code and cause the bill to differ from the accurate one. This causes the unbundling error. For example, the codes for laboratory services are the same, but for some reasons that confuse, the clerk separates the services and codes them differently. The automatic medical billing software will alert the authorized Peron to correct the unbundling and upcoming errors.

Duplicate errors are common. A patient is billed more than once for the same medical procedure or service. Wrongful billing occurs when the patient is billed for a service that they did not access because it may have been scheduled but canceled later, but it was not deleted from the account of the patient. The staff can also bill the wrong account of patients intentionally. The names and codes of patients can be confusing for the staff. The patient can sue the health center for fraud because some malicious staff members commit this error intentionally to steal from clients.

A staff member can misunderstand an Explanation of Benefit (EOB) form because they are complicated. One needs to determine the right payment they received from the insurer, reasons the claim was rejected or accepted by the insurance company, and so on. The insurer may pay a percentage of the claim or refuse to pay the whole claimed amount. You have to get the right procedure of resubmitting the claim for the proper amount to be paid if the insures pays a percentage of the claim. You should not accept the portion of the claim paid before confirming with the insurance company if they paid the correct amount or not. Learn more from these examples.

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