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5 medical billing mistakes we can help you avoid

October 1, 2019

When you think of good medical practice management, you likely think of all the things you can do to keep your bottom line strong, such as going paperless or being more efficient. Of course, steps such as those are crucial, but it’s easy to overlook another aspect of good practice management that’s just as essential: avoiding mistakes.

It’s impossible to be mistake-free in your medical billing, especially if your office is a busy one. However, if you have a professional medical billing company to help you with managing your medical practice, you can reduce mistakes and optimize your staff’s time and energy, leading to increased profitability.

5 Common Medical Coding and Billing Mistakes and How They Can Be Avoided

Mistake 1: Not Having a Filing Claims System in Place

If you’re like many medical practice owners, you might think that a system for billing and filing claims is unnecessary. However, if you don’t have a structured process in place, medical billing can become untimely and inefficient, which results in delays and reduced cash flow.

In fact, if you don’t consider this essential, and it gets pushed aside, your claim may get rejected and you may not get paid. Many payers have a time limit on filing claims – sometimes as few as 30 days from the date of the service you fulfilled – and they commonly deny claims due to tardy filing.

A system for processing and filing claims, such as ones that an experienced medical billing service can readily provide, is imperative to keeping your cash flow up.

Mistake 2: Not Stressing to Your Biller the Importance of Billing

As hard as it might be to believe, the biller in many offices has other responsibilities, often to the point that his or her medical billing duties get lost in the shuffle. If this happens in your office, make sure to stress that the biller’s first priority is…billing.

As a whole, your office should know that the first priority is patient care. But billing must be your second priority. Your office is a business, and revenue flow keeps you open and allows you to continue offering your patients your expert medical care.

Billing is a detailed process that takes focus and precision to ensure that everything runs efficiently. With a team of dedicated medical billing specialists, you can eliminate simple, unnecessary mistakes that can negatively affect your practice and reduce cash flow.

Mistake 3: Misinterpreting Explanation of Benefits (EOB)

Fully and correctly understanding EOB forms takes training and experience. It can be tricky realizing what was paid and when, why a claim hasn’t been paid, or even if a claim has been was paid fully or correctly.

If you’re relying on a biller who has other responsibilities (and thus, less focus), he or she may simply accept a payment from the insurer thinking it’s a full payment. This can be a mistake if the payment is not checked and verified to be the correct reimbursement.

Sometimes, an insurer will pay a claim partially or even outright fully deny it. A professional billing service can correctly read an EOB to see if an incoming payment is less than you expect. If so, he or she can determine which strategy is best for re-submitting the claim so your practice is properly paid.

Mistake 4: Not Following Up on Claims or Outstanding Reports

Believe it or not, many medical offices don’t follow up on outstanding claims. This leaves money on the table and greatly reduces cash flow.

If you don’t have a process in place for continuously checking claims, you should consider hiring a professional medical billing service dedicated to such actions. Ignored, unpaid claims should not be left to age; running aging reports regularly can identify unpaid claims and payments that haven’t been received.

Mistake 5: Allowing Clearinghouse Reports to Stack Up

It can be easy to allow clearinghouse reports to accumulate, especially if your practice is busy. But when those reports begin piling up, you can’t identify problems or problem claims.

A dedicated medical billing team can help you with good practice management because we can dedicate the time and energy necessary to find those problems claims and get them resolved as quickly as possible so you get paid – and paid sooner.

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