Common Billing Mistakes and How to Fix Them

For any billing professional, submitting error-free claims and obtaining correct reimbursement for insurance claims is the most important yet challenging task. Unfortunately, things don’t always go this smooth. In fact, sometimes situations get even worse due to common billing mistakes.

After observing some of the best medical billing services Pennsylvania, we have summed up the most common billing mistakes as well as ways to fix them. If you are too struggling with billing errors and claims denials, you might need to check these fixes.

This article has discussed in detail what are common billing errors and how to prevent billing and coding mistakes in the first place. Now just scroll down and carefully listen to all the details.

Common billing errors and their fixes:

Following are the top 7 billing mistakes that have been observed in medical billing and coding services. Check them out and learn how to avoid them.

1. Poorly crafted patient’s financial policy:

A financial policy is an important step in the healthcare revenue cycle. It communicates the facility’s financial expectations to the care receivers. Poorly crafted financial policy means you are missing out on potential revenue. Improper policy planning will lead to shrinking collections and accounts receivable headaches.

Therefore, to fix this, you need to create a clear and well-understood patient financial policy. The document must contain:

• A clear and accurate policy that explains collection methods and processes.
• A financial billing agreement detailing all care receivers keeping a payment method on file.

2. Inaccurate/incomplete data collection:

Another common billing mistake is inaccurate data collection. Whether it’s payment collection or billing an insurance company, collecting accurate data is crucial in every step. Collecting incomplete or wrong information can cost your healthcare provider a big chunk of their revenue. Also, the time consumed in chasing patients for data collection delays revenue collection. To avoid such mistakes, the following are the recommended course of action;

• Create a form that asks all the essential questions important to bill a patient. The form must include:
  • Patient’s address
  • Driver license
  • Cell-phone number
  • E-mail
  • Hardline phone

• For further details, you must:
  • Get a copy of the insurance cards (front and back)
  • Complete contact details
  • Mention payment option on file (ACH or Credit Card)

3. Failure in eligibility and benefits verification:

We have seen several healthcare providers making this common mistake. As a billing professional, it is your job to verify a patient’s eligibility and benefits for insurance on every visit. Failure to do so will cost you both time and money. Therefore to avoid this mistake, you must do the following:

• As soon as a patient books an appointment, verify their insurance details and eligibility.
• Also, you can add this question to your data collection form to make it easier.

4. Expired Insurance Coverage:

One of the reasons for claim denials is expired insurance coverage. If a patient has expired insurance coverage and still the biller submits the claim to an insurance company, it results in denied claims. Therefore, in order to save your precious time, it is important to check the patient’s insurance status at the time of the initial visit.  You can do the following things to confirm if your patient has active insurance:

• Check the patient’s insurance eligibility details as soon as they book an appointment.
• Call the insurance provider before administering treatment.

5. Failing to Track on Patient’s AR:

Another reason for errors and delayed payments in medical coding and billing is due to failure to track patients’ accounts receivable. If you, as a biller, fail to keep track of a patient’s payment from the initial visit, you will be missing out on the rendered services’ revenue, especially if you don’t have an automated system to send pending payment reminders to the patients. In this case, the recommended course of action is:

• Install card readers at the check-in desk to avoid time wastage in documenting credit card information and give instant verification
• Shift to an automated revenue management tool to improve your payment collection process and send reminders to the patients.
• Keep your patient’s credit card information to improve the payment process.

6. Failure to provide a quick payment process:

Patients look for convenient payment options, especially at a healthcare facility. Failing to provide a quick payment process can result in revenue loss. Therefore, create an easy payment process to improve patients’ experience. For that, you can do the following things:

• Provide a PAY HERE button on your website with a link to the payment portal in order to make the payment method easier for patients.

7. Untrained staff:

When your revenue cycle is at stake, you must have expert billers to ensure your healthcare system’s monetary success. Poorly trained staff means coding errors, lack of due payment follow-ups, denied claims and whatnot. These major mistakes can eat up a big part of your revenue. In order to avoid them, you need to

• Organize consistent training sessions for your staff on the latest technologies and updated coding regulations.

8. Not covered by the insurer:

Often times, claim denials occur when the rendered services have been added to the claim but don’t come under the patient’s benefit plan. When such a claim is submitted to the insurer without proper verification, it results in a denied payment with a patient bearing the total damage. This could take a toll on the patient’s well-being. Here is how to avoid such mistakes.

• Check the patient’s insurance eligibility before rendering any service
• Directly contact the insurance provider to cross-check if the insurer covers the requested treatment or not.

Conclusion:

Revenue loss is a major issue across the US due to incorrect medical billing and coding. Every year around $125 billion are left on the table due to poor billing practices. A survey revealed that 80% of the bills contain errors that are being prepared on a daily basis. That’s how big the issue is.

The aforementioned methods will surely help you improve billing practices and prevent revenue loss. Without proper billing and revenue management, practicing your business for a long would be hard. If you wish to be as successful as medical billing services Pennsylvania, stay updated and prevent errors rather than fixing them.