A medical practice can grow financially and reputably when the entire team of specialists, assistants, attendants, and other medical professionals provide the best healthcare to the patients. Judicious supervisors maintain the accounts and keep a check of the costs incurred by the practice, including unpaid cases, planning issues as well as increased expenses of using a software system that is outdated and functioning erroneously.
Sometimes these include mistakes in the patients' bills occurring, which angers them and prove to be a huge burden for your practice. In order to prevent these issues, it is essential to know what they are first. All the different types of issues that occur can be classified under two broad categories- data entry and coding.
Types of Data Entry issues
Sometimes mistakes are made in something as simple as entering the information of the patients and their healthcare. This shows an adverse effect on the medical billings of the individuals. They are as follows.
- Inaccurate patient information
One of the mistakes that are very commonly seen in medical billing cases is errors in entering the correct patient information. Sometimes, the authorities misspell a name or note down the wrong policy number in the file. This causes the patients to lose their insurance options and face major trouble.
- Imprecise calculation
Another common medical billing problem is calculating the dosage of the medicine required by the patient incorrectly. In cases where patients are admitted for a long duration, a miscalculation can occur in counting the number of nights that the patient has stated there.
Types of coding issues
Sometimes, certain errors in the coding of the billing software itself cause the payment statement of a person to fluctuate.
- Under-coding/Upcoding
A major error that occurs in the matter of medical coding is when all the services provided to the patient have not been properly stated in the final bill. The patient can even take legal action against the medical practice if they find out the mistake in the bill.
- The discrepancy in the examination and subsequent treatment plan
Sometimes the cost of the treatment that has been prescribed in accordance with the diagnosis and the diagnosis itself does not match each other. The patient can be billed more than they should because of this. In such cases, the staff of the hospital are held liable for their negligence and can face serious punishments. It is, thus, better to be careful and double-check.
- Not checking if the patient has insurance
It is important to ask the patients if they have insurance before performing medical tests. Not doing so can result in the claims being denied.
- Unbundling
Sometimes the provider mistakes the related services and the bill to be separate and charges them accordingly. Therefore, it is important to train the staff beforehand about the medical codes that each factor falls under to avoid such mistakes.
Solution
For any health clinic to run smoothly, medical billing plays a huge role. The billers need to recognize the different rules and regulations and be aware of the various insurance policies, both public and private. They need to learn about collections management, appeal submissions, adjusting the bills and posting payments, claim denial resolution and claim follow-up. The revenue of any workplace automatically increases with improvement in these areas.
The coding and medical billing specialists from New York which is Emerald Health LLC can help in the problems in the medical practices – like payment processing, information entry, etc and free the doctors and staff to focus on their work better. They assist in managing patient records, their diagnostic tests, checking out the reimbursement claims, processing the health insurance information, to name a few.
