13 Aug Medusind Can Fix Your Common Medical Billing Mistakes
Avoid These 11 Common Billing Mistakes to Get Your Claims Paid
It’s easy to get a claim rejected: you only have to make one medical billing mistake. Considering how much money you might have tied up in delayed or rejected claims, you should be aware of common medical billing mistakes—and how to solve them.
Missing a Claim Deadline
Don’t do this. More than anything else, this is the one inexcusable and non-negotiable error in medical billing, and it will doom your claim faster than anything else. Every claim is subject to what’s known as a “timely filing rule.” If you miss this deadline, then your claim will be denied based on a failure to file on time. If you miss this deadline, you could lose money forever.
Instruct your team that no claim should ever be late—and drill it into them. To help your staff avoid claims lost due to timely filing, create a reminder that’s hard to miss in your front office. You can also post or distribute for individual payers in a document to your practice reminders.
By outsourcing your billing to a medical billing service like Medusind, we can keep on top of these deadlines to submit claims well ahead of the required deadline.
Missing Claim Information
It’s because your claim is full of so many specific data points that it’s easier for it to be rejected; just get one detail wrong, and your claim is invalidated. You must double-check all entries. Make sure you’ve got the correct patient’s information, diagnosis codes, CPT codes, and anything else need to get the claim processed.
A medical billing service like Medusind can guarantee that each is every claim is filled out correctly, greatly increasing their changes for acceptance and payment. We can also relieve your overworked staff of this tedious extra workload.
Wrong or Switched Numbers
This billing mistake falls under incorrect claim information, but it merits special attention. When filling out a claim, it’s easy to make a typo, like adding an extra zero, or to transpose two numbers. A simple error like this can easily tank your claim.
Hard-to-Read Manual Submissions
Most of your payers might accept electronic claims, but some might still require manual submissions, which can be a problem if you’re used to submitting electronic claims. Manual submissions can be messy, imperfect, or have illegible print, so payers can’t read the information properly when they try to scan them into their systems on receipt. Before sending your claims off, be sure your billers always look them over and confirm they’re readable.
Insurance Verification Issues
Did you properly verify your patient’s health insurance before they proceeded with treatment? One of the most common billing mistakes that triggers claim denials is not verifying your patient’s correct insurance coverage. Insurance information is constantly changing, for both the insurance company and your insured patient. It’s crucial that you verify eligibility every time you deliver services to a patient. Make this second nature for your staff, since patients can often change insurance providers while they’re under your care.
Wrong Codes
Nothing can mess up a claim like using the wrong codes. Insurance companies will reject your claim immediately. The problem is, codes are changing all the time, and they’re hard to keep up with. Also, your billers might be entering too many or too few digits for the code that describes a symptom, diagnosis, or treatment.
Medusind maintains an army of over 350 professional trained coders, and we make it our job to keep up to date on the latest coding changes. We’re motivated to make sure your claim gets accepted—and paid out.
Mismatched Diagnosis and Treatment Codes
If the diagnosis and treatment codes don’t match on the claim you submitted, your claim will be rejected. Why is the patient being diagnosed with COVID, but they’re being treated for a pulled back muscle?
Upcoding
A member of your medical billing staff might use the wrong code that causes you and your patient to be charged for a more expensive procedure or product than what was delivered. If this is done intentionally, it’s considered illegal.
Duplicate Charge
Your staff charges twice for the same test, procedure or product. The insurance company will spot this right off the bat and bounce your claim.
Unbundled Charges
If a group of certain procedures occurs together, you should charge them under a single code. But often medical billing staff will “unbundle” or separate services into individual charges, which isn’t allowed. Insurers will spot that immediately and reject your claim.
Service Not Received
Your staff goes ahead and incorrectly adds to the bill a test or procedure that wasn’t performed during a patient’s visit. While the insurer might honor this erroneous claim, your patient won’t be happy when they receive a charge for a service they never received, and you’re going to have to resubmit the claim.
Avoid These Mistakes
When you submit claims, be sure to avoid these common medical billing mistakes. But there’s another solution: Medusind is a national leader in medical RCM, with over 20 years of experience. We know very well how to avoid these common medical billing mistakes. Contact us and see why, when you partner with Medusind, you get up to a 25% improvement in collection rate and a 40% improvement in days in A/R.
