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How to Avoid Common Medical Billing and Coding Errors

October 27, 2020
Given the many intricacies of medical billing and coding, it is no surprise that mistakes can occur during the process. The most common errors, no matter how trivial they seem, can lead to claim denials, loss of revenue, fines and penalties, and may even impact patient care. Therefore, by knowing how to eliminate medical billing and coding errors, you can lower rejected claims, maximize your reimbursements, and keep your patients happy.

With more than 100 years of combined experience in various healthcare niches, including hospitals of all sizes, anesthesiology practices, and more, Coronis Health offers customers tailored solutions and high-touch relationships you won’t find at a “Big Box” medical billing company. We are composed of the top medical billers in the country, pooling our global resources to bring customers the best in medical billing and revenue cycle management.

We constantly seek a level of professionalism and analysis you won’t find elsewhere, and we are committed to helping any medical practice reach the next level of financial success. Below are ways to avoid medical billing and coding errors, making your life easier by eliminating the headaches of the revenue cycle, lowering your risk, and increasing your collections.

Ensure Patient Information is Correct and Properly Aligned with Data

When managing a medical practice, information can be mismatched if a medical biller is not careful. Incorrect or missing patient names, addresses, birth dates, gender, insurance information, and dates of treatment can be grounds for claim rejection. Busy billing departments can sometimes overlook these details. 

Inaccurate information can be avoided by taking the time to double-check all fields and verifying all pieces of information about a patient before submitting a claim.

Avoid Upcoding

Upcoding is when the medical coder reports a procedure that has a higher reimbursement cost than the one the patient actually underwent, such as when tests are performed by techs but are coded as being done by physicians. This can occur when the billing staff makes a mistake when entering diagnosis and treatment codes, or if the employee misunderstood the information provided by the physician. Since codes for certain procedures and tests demand higher payments, this illegally inflates your revenue as well. Upcoding will not only lead to claim denials but can also cause your practice to undergo an audit or be penalized.

Utilize the Latest Medical Coding Manual

Medical coding guidelines are constantly changing, so if you are using an outdated reference manual, your claim may be denied, impacting your reimbursement process. It is important that medical coders are up-to-date with the latest billing rules and regulations. This can be done by coders having the latest coding manuals and attending seminars to refresh their coding strategies. By keeping abreast of current codes, you can have a seamless processing of claims in a timely manner without loss in revenue.

Avoid Duplicate Billing

This occurs when a patient is billed multiple times even though they only underwent a procedure once. This common error can magnify the chance of claims being denied, leading to not only delays in payment, but also a bad reputation in the industry or possibly a fraud investigation. While it may seem easy to avoid, this can occur when there are large amounts of data due to disorganization when submitting claims. To avoid this, turn to auditing to minimize errors. By carrying out chart audits, you can prevent these errors from accumulating.

Verify Insurance Benefits and Coverage in Advance

One reason why medical billing claims get rejected is because of a medical practice failing to verify insurance coverage. Insurance companies all have different policies regarding what types of services they cover. More importantly, the details of a policy can change at any time. Even if a patient is a regular client, a practice cannot simply use their recently entered information. This can lead to errors if there has been a change in the patient’s policy limit, terms of service, or insurance provider.

To avoid claims being denied, your practice must independently verify the patient’s eligibility each and every time services are rendered. Verify and communicate details such as healthcare benefits, coverage terms with the insurer, and co-payment options. All this information is necessary for billing the patient without errors.

Hire A Professional Medical Biller

Medical billers are responsible for keeping practices on solid financial ground by maintaining a reliable and efficient system for processing insurance claims. It is not an easy job. Medical billers are constantly faced with challenges, from getting claims rejected to having to dispute them. But when you place the responsibility of your billing and revenue cycle management on yourself or your employees, you are not only adding to the stress at work, but also increasing the likelihood of medical billing mistakes, resulting in loss of income.

By outsourcing to a professional medical biller, you can avoid mistakes that are caused by inexperienced medical billers and coders. Having a team of qualified medical billers and coders who can expertly keep track of the thousands of medical codes, diagnoses, and outpatient procedures can help you reduce claim denials. This also ensures that your staff will no longer need to spend time on these billing concerns. You and your staff can then use this freed-up time to focus on patient care.

Recognized by Healthtech Outlook as one of the Top 10 Medical Billing and Coding Solution Providers in 2019, Coronis Health offers experienced, courteous, and professional staff members dedicated to providing comprehensive medical billing and coding services. We are a full-service provider of medical billing and revenue cycle management solutions, and no matter the size or scope of your business, we can help. By using industry-leading technology combined with high-touch relationship building, Coronis Health will allow you to focus on patient care, maintain financial independence, and cultivate financial success. Not only do we save you money by outsourcing all billing and coding, but we help you find lost revenue, close aged payments, and lower your time in AR. We are invested in your financial success. 

Improve Your Medical Billing and Coding Systems With Coronis Health

Hiring the best medical billers will provide your practice with countless benefits. From a streamlined process and consistent payment schedule to the correct usage of codes and submitting claims in a timely manner, you get to spare your practice from undue stress while safeguarding your practice’s revenue into the future. To learn more about how Coronis Health can help your practice function more smoothly with an optimized revenue cycle, contact Coronis Health today, or request a free financial checkup.

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