A reliable and steady revenue stream is requisite for running an efficient medical practice. If your billing errors are not optimized for success then it’s difficult to achieve it.

Whether they incur denials, delayed payments, lost productivity, or client complaints; medical billing errors can inflict detrimental effects on your revenue cycle management. Eliminating medical billing errors is integral for your bottom line, so you have to narrow down common billing mistakes that your practice is prone to make and craft strategies to prevent repercussions.

Certain medical billing complaints are costly and they may lead to severe financial crises and even loss of significant revenue if not addressed efficiently. Here are a few medical billing and coding errors along with their coping strategies.

Common Medical Billing and Collection Mistakes

1.   Insurance verification failure

The primary reason for claim denials is insurance malfunctions. The overreliance on routine may cause a failure to verify stems. For instance, when patients visit the practice frequently the staff may assume that their coverage plan or insurance provider hasn’t changed, resultantly they don’t check the eligibility.

As insurance information is prone to change at any time, the Implementation of a verification step into the billing process is quite mandatory. This implies that you have to check all four potential reasons for all insurance-related claim denials.

1. Services not authorized.
2. Coverage terminated or otherwise ineligible on date of service.
3. Maximum benefits reached.
4. Services not covered by the plan.

By implementing these steps into your medical billing and collection workflow, medical billing companies verify the patient’s insurance at every visit. In this way, you can minimize the policy-related issues that may lead to claim denials.

2.   Disorganized and scattered claim fillings

Accurate medical coding and billing lie at the heart of efficient medical claims. A single unchecked and empty section is all it takes for a claim denial. In most cases, even the fundamental field like date of birth, time of accident, or gender are left blank.

Timely claim fillings are also critical for smooth RCM. Deadlines play a pivotal role in claim acceptance or rejections. The overdue claim fillings adversely affect the cash flow and resultantly profit diminishes.

An efficient system for claim fillings, medical billing, and collections is the easiest way to prevent claim denial mishaps. The automated system of medical billing companies considerably reduces the tardy filling and reduced cash flow possibilities.

3.   Lack of specifications

Insurance companies often deny claims that are truncated (unnecessarily shortened) or not coded with a high specificity level. The trained coder is well aware that each and every diagnosis is required to be coded with the absolute highest level.

With the ever-changing requirements for medical billing today, staying on top of the new codes, rules, and documentation is truly a full-time job. The best approach is to outsource medical coding to a medical billing collection company, so your staff can focus on other responsibilities.

4.   Miscoding and typing error

When your staff is heavily involved in coding along with other responsibilities it’s common to make general medical billing errors. These errors can be in the form of a duplicate charge, incorrect date, unbundled code, or miskeyed patient name. Even honestly accidental mistakes can lead to a derail insurance claim. The upcoding and under coding mistakes are illegal and they may lead to heavy fines or criminal persecution.

5.   Lack of follow-ups

In case you haven’t noticed your medical practice is leaving a lot of money on the table by not following denied claims. Your staff can be overwhelmed with tasks and they may stop consistently following outstanding payment denial claims. When claim denials remain unmonitored, they adversely affect the bottom line and cash flow is interrupted.

To Wrap Things up!

Medical billing and collection is a complex area that can create big problems for healthcare providers. Managing medical billing and collections is not an easy task. It requires a lot of knowledge, skill, patience, and determination. Outsourcing medical billing and collection has proven to help medical practices in maximizing revenue by lowering claim denial rates.

Our experts at Dominion Revenue Solutions make use of the best policies and systems to aid your Medicare practice in increasing the clean claim ratio and maximizing RCM.