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How to prevent incorrect medical bills

How to prevent incorrect medical bills

Medical practices do everything they can to run successful businesses and keep their revenue where it should be. A big part of ensuring this happens is by submitting clean medical claims as often as possible. While it’s easier said than done, there are a number of ways to reduce the amount of claim errors you’ll see at your practice. It’s nearly impossible to completely eliminate errors, but the following are some of the best ways to reduce the number of errors at your practice and prevent incorrect medical bills. 

Follow the latest medical billing codes and trends

There are thousands of existing medical billing codes, and new ones are constantly added to keep up with new illnesses and treatments. The Covid-19 pandemic has shown that the healthcare industry can change on a dime, and as such, the ability to add new codes to accompany emerging viruses is crucial. It’s important to keep your billers and your entire practice up to date on new billing codes, along with any new protocol that may come with them. Pay attention to requests from your payers to see if they require new formatting or any additional information for new codes. 

Don’t submit duplicate claims 

This may seem like an obvious thing to avoid, but if more than one person is dealing with billing, as is often the case, it’s easy to accidentally file two identical claims. A duplicate claim is one that has been filed for the same patient and service, on the same date, with the exact same information on the claim. If duplicate claims are filed and submitted, there’s no way to tell whether one was a mistake or contains errors, therefore they will be rejected. Using web-based medical billing software is a great way to make sure these types of claims aren’t submitted. 

Don’t upcode or undercode claims 

Upcoding and undercoding are both illegal practices, most often done on purpose when companies are trying to get more money out of claims. But these things can happen unintentionally, too. Upcoding is the process of entering codes for more expensive services so that the provider receives a greater reimbursement in return. Undercoding means the opposite—a code for a less expensive service is entered to try to save the patient money. In either case, there could be some serious repercussions, so it’s important to make sure all codes are correct in the claims your billers submit. 

Verify insurance coverage before submitting

Insurance ineligibility is one of the biggest reasons a claim is denied. Too often, front-end staff assume that returning patients’ insurance benefits haven’t changed. They don’t verify insurance coverage for the services a patient is seeking and don’t realize their mistake until the claim returns unpayable. This is a simple step to add to your appointment process—ask your front-end workers to confirm insurance eligibility and information before the appointment begins. This way, you’ll know you have this part of the process covered before the patient even sees a doctor. 

File claims before their deadlines

You’d be surprised at how easy it is to lose track of deadlines. While insurance companies often offer generous deadlines for claims to be filed, there is in fact a true deadline. If billers push off a batch of claims that aren’t due for months down the line, it’s easy to forget about them entirely. Make sure your deadlines are noted somewhere that your billers will see them—not tucked away in a drawer somewhere on a half ripped piece of paper. If a claim is submitted late, it’s extremely hard to appeal the denial later on. 

Make sure all information is entered correctly 

When it comes time to enter all claim information, make sure everything is spelled right and entered accurately. Incorrect ICD codes, incorrect insurance information, and incorrect patient information including name, address, date of birth, policy numbers and more will result in rejected or denied claims. Sometimes these mistakes date back to the original collection of patient information, and other times they’re simply entered inaccurately. This is why it’s so important to verify information before an appointment and have a reliable data-input method when it comes time to create claims. One of the best ways to track this data and make sure everything is entered accurately is through an electronic method, such as medical coding and billing software. 

Submit claims with medical billing software 

Medical billing software is incredible for a number of reasons. It speeds up the billing process, frees up billers’ schedules, allows for better collaboration among your team, and of course, it reduces the amount of claim errors you see. When you bill with software, you increase productivity among your team members, see reimbursements faster, and have the ability to focus on bettering your business overall. Ready to make a difference at your practice? Book your free demo with the Claimgenix team today to see our billing software in action!

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