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Posts from 2018-10-19

Common Medical Billing Mistakes to Avoid

Doctor Pointing at Tablet Laptop Running a successful medical practice comes with its own set of challenges. New practitioners have to overcome a large learning curve when it comes to the dos and don'ts of starting their own business for the first time.   

In addition to all of this, it is common for health care professionals to make mistakes when it comes to their medical billing process.

Unfortunately, these mistakes can cost their practice dearly when it comes to revenue and their bottom line. To assist practitioners in avoiding these costly errors, we have compiled a list of some of the most common medical billing mistakes.

By taking note of this list, your practice can improve its chances of increasing revenues and building a solid foundation for success.   

Unbundling Codes 

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Often times, there is one code that can successfully capture payment for multiple parts of a medical procedure. Sometimes health care professionals incorrectly use multiple CPT codes for various parts of a single procedure, when it is this single code that should be used for everything.   

Medical practices that unbundle their codes can do so out of a lack of understanding or in an attempt to increase their bill on purpose and fraudulently. To learn more about unbundling and how to avoid it, contact a medical billing service provider.    

Upcoding   

When health care professionals incorrectly change billing codes so they show a more serious diagnosis or service, "upcoding" occurs. Upcoding is highly illegal and falsely inflates patient bills. For example, if a practice meets with a patient for only 15 minutes but charges them for a full 45-minute session, this would be upcoding.   

Other frequent upcoding violations include things like listing a name brand medication when a generic brand was actually the one used or stating a normal office visit was a more specialized one.   

Consequences of upcoding can be quite serious, as practitioners can be fined hundreds of thousands of dollars or even be excluded from participating in various medical programs.   

Billing Multiple Times for the Same Service  

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Double or triple billing can occur when different members of a practice charge a patient for the same thing. For example, medication could be billed at both the time of prescription either on purpose or unintentionally. Sometimes hospitals also bill patients for the first few days of their stay, multiple times.   

This happens because the first few days of a hospital visit often cost more than days later in the visit. Multiple billing is one of the biggest reasons behind high medical bills.  

Be sure to keep an eye out for potential situations within your practice that could be vulnerable to multiple billing. Setting some safeguards to prevent this from happening can make a big difference.   

Mistakes in Patient Information  

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If your practice makes any mistakes in listing a patient's information, insurance companies can easily reject your claim. Errors in medical billing are pretty common thanks to the fact that medical bills come under contact with so many different people at a time.  

Mistakes can fall through people's fingers and be passed down to the next individual in charge. Enforcing safeguards when processing patient information is key to avoiding additional mistakes that could affect your claims.   

There just a few of the most common billing mistakes healthcare providers make. By becoming familiar with these frequently occurring errors, medical practitioners can get their new businesses off to a strong start.  

Take the time to set some safeguards so your practice doesn't get sued or fined by different medical organizations. It only takes a few mistakes to lose the trust of your patient base or get fined so much money that your practice has to shut down.   

To learn more about how you can prevent medical billing mistakes, contact us by clicking here