Accurate primary care medical billing is critical to the financial health of any medical center. The ramifications of medical billing and coding errors can be substantial. Loss of revenue is just the start of these severe consequences. Zero-tolerance government policies can result in practices losing out on billing opportunities involving Medicare and Medicaid.
According to Access Project, a healthcare advocacy group, up to 80% of all medical bills contain errors. A separate report by Kaiser Health indicates that medical billing errors result in $68 billion losses in healthcare spending.
How can primary care physicians reduce the mistakes in their medical billing and coding? Here are six tips to consider.
1. Pick Out a Primary Care Medical Billing Company
Professional medical billing services can help practices maintain solid financial health through the use of a powerful system to track the processing of insurance claims. Outsourcing to a medical billing company allows your facility to take advantage of the firm’s expertise, software, and economies of scale to streamline your revenue acquisition process. In addition, you can focus on your primary goal: offering quality patient care. You can let the experts handle your billing and coding, rather than taking time away from your patients.
2. Use the Latest Medical Coding Manual
Using an outdated medical coding manual can significantly delay your reimbursement process. Coders need to ensure that they stay up to date with the latest billing rules and regulations. Your medical billing department may need to have the latest coding manuals and attend seminars to refresh their billing strategies.
3. Check for Patient Information Mismatch
Trivial errors in inpatient data such as patient name, policy number, birthdates, and treatment dates can be grounds for a rejected claim. It is quite easy to overlook this information if the patient is a regular client. Your medical staff and coders may need to ensure that they double-check all the fields and verify all of the patient’s information before submitting the claim.
4. Leverage Available Technology
One of the main causes of medical billing and coding mistakes is simple human error. Billing systems that incorporate EHR records can help independent practices check for any errors before the claim goes out automatically. Maintaining proper patient records on the EMR can also help reduce the number of rejected claims due to wrong patient information.
5. Train Your Clinical Staff
Your medical staff may need ongoing education to keep up with the latest developments in medical billing and coding. Your primary care medical billing firm might be able to conduct regular training for your employees. Your billing company may offer to educate them on the claim information requirements and proper use of the EHR systems.
6. Verify Insurance Benefits and Coverage
You can prevent a huge chunk of medical billing errors by verifying insurance coverage. Insurance companies have different policies regarding the services provided. In addition, the patient’s policy can change at any moment. Whether the patient is newly registered or has been a long-time visitor to your facility, you may need to verify and communicate details about their health benefits, co-payment options, and coverage terms with the insurer.
Medical billing and coding errors can have huge financial implications for your independent practice. You may have to hire a primary care medical billing firm to optimize your revenue cycle and reduce the mistakes on your billing. To learn more about orthopedic medical billing services or how your practice’s billing process can be optimized, contact Sentinel Billing.
