Thursday, March 10, 2016
When you’re dealing with dozens of data points, mistakes happen. The key is knowing where problems usually occur in the process and how to prevent them.
Not Entering the Right Amount of Digits on a Code
With so many minute details, it’s easy to overlook a letter or digit. Not entering the correct number of digits for a code is one of the top mistakes made during the medical billing process. ICD codes are designators for symptoms, diagnosis and causes of death. It helps decrease confusion because the universal codes are understood by health providers around the country.
Being just one digit off can create serious issues during the billing process. This can also affect the patient’s medical records if it isn’t corrected. Billing specialists have to be familiar with the current codes and have a way to verify codes before filing.
Inputting the Wrong Code
Another common problem is inputting the wrong code entirely. Using the wrong code on a medical bill is one of the top reasons claims are rejected and denied.
Often it is the ICD-9-CM and the new ICD-10 codes that are incorrect. Because there are multiple code sets and ICD codes are updated regularly, it can be difficult for billing specialists to determine which code is correct. Online management systems like Practice Suite's free ICD 10 code lookup can help circumvent this common medical billing mistake. These systems have tools that help billing specialists look up the latest codes, which are significantly different for ICD-10.
Treatment and Diagnostic Codes Are Mismatched
One other common billing mistake related to ICD codes is mismatched coding for treatment and diagnosis. Usually one of the codes is correct but the other is not, and it’s clearly unrelated. Here again a billing management system with updated ICD code tools can help billing specialists find and use the right codes before sending out the bill.
Incorrect Patient Information
The front desk and doctor may be very familiar with a patient, but that doesn’t mean the medical billing specialist is. Incorrectly inputting patient information is much easier than most people realize. Again, one wrong letter or number in the patient information is all it takes for a claim to be rejected.
A patient management system with built-in billing functions makes this mistake near impossible because the patient’s information is automatically populated in electronic claims.
Incorrect Insurance Information
The insurance company information also has to be 100% accurate on the billing records. Even though these types of errors can be slight, it can be enough to delay the bill processing and payment.
It’s also fairly common for the patient’s insurance information to be incorrect on bills. Patients can switch health insurance plans or providers from one year to the next. Their plan may also be updated or changed, sometimes without the patient realizing it. For this reason, medical billing specialists have to verify insurance coverage before filing a claim.
Incorrect Health Provider Information
Some medical billing specialists work for multiple health care providers. Juggling the information of various providers makes it easy to accidentally input the wrong name, address or contact information.
Without a management system that documents and tracks billing, it’s easy for the same medical service to be billed twice. It usually happens when more than one person in the office reports that the services were performed. The billing specialist should catch this on a superbill, but a patient management system that’s shared by everyone will help eliminate duplicate bills.
Medical ethics extends well beyond the examining room. Proper handling of patient information and billing is a joint effort between the physician, administrative staff and billing specialist. Each person must be honest and accurate in their documentation or mistakes are going to happen.
This is a blog post by Nancy Evans.
Posted by MedFriendly at 3:34 PM