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How to Avoid Medical Billing Mistakes in Your Practice

July 6, 2018

getty-full-getty-3282-877246890Changing payer requirements, new federal guidelines, unique billing rules, and complex conditions all make billing and coding very complex. Not only are medical practices navigating new payer requirements, they’re also dealing with a higher level of specificity requirements. It can be difficult to stay on top of all the new guidelines for E&M, ICD-10, and CPT coding. The good news – there are some steps you can take to save time and money for your practice while ensuring you’re able to offer an excellent quality of care to patients. 

The Consequences of Medical Billing Mistakes 

Why should your practice pay more attention to billing and coding? Well, medical billing and coding mistakes can have some big consequences. Billing mistakes can come with some stiff penalties. Both the Center for Medicaid Services and the Center for Medicare services take a very close look at fraud and abuse when it comes to the submission of medical claims. Up Coding, unbundling, under documentation, and over-documentation can land your practice in the middle of an audit. This means it’s so important to make sure you get billing and coding right the first time in your medical practice. 

Educating Providers 

One of the best ways to prevent medical billing mistakes is to work on educating your providers. Medical Coding training isn’t something just for new physicians in your medical practice – it’s important for all of your providers. Within the past decade, medical coding guidelines and standards have changed significantly, so even providers who have plenty of experience in the field may not be as accurate as they need to be. 

When Renal and Urology News evaluated a group of physicians, they found that newer physicians often under-coded and over-documented, while more experienced physicians often over-coded and under-documented. The takeaway – all physicians can use more training in medical billing and coding. 

Medical Coding Reviews 

Coding reviews can also help your medical practice take a closer look at the completeness and accuracy of documentation for claims and determine if providers are submitting documentation that supports the claims being submitted to payers. This is so important if you’re going to make sure your medical practice is getting accurately reimbursed for the services that you provide to patients.

Related Article: 6 Key Steps of a Successful Medical Billing Process

Data has shown that when providers see coding review results and the reviews are combined with targeted education, coding accuracy improves. However, it’s important to continue doing coding reviews and continue educating providers to ensure the improvement in coding accuracy doesn’t decline. Continuous reviews and education ensure that providers maintain improved coding accuracy. Since structured coding reviews can help improve accuracy, it may help minimize the risk of an audit for your medical practice as well. 

Outsourcing Your Medical Billing and Coding 

Since medical billing and coding can be some complex and medical deal with a lot of day-to-day demands when running a medical practice, outsourcing the billing and coding is often an excellent option. However, it’s important to work with companies that have an in-depth understanding of the medical specialty to ensure accurate documentation and reimbursement. 

If your medical practice decides to outsource billing and coding, it’s important to go with a company that has an in-depth knowledge of HCPCS, ICD-10, and CPT codes. Our professionals can analyze lab results, medical records, other test results, and doctor’s notes to determine the best codes to get your practice maximum reimbursement. Some of the services offered by the best companies include: 

  • Using the proper diagnosis codes for hematuria, various types of kidney disease, kidney stones, and other kidney problems
  • Assigning the correct codes for inpatient procedures 
  • Choosing the right E/M codes
  • Validation of ICD-10 codes
  • Ensuring that appropriate modifiers are added 
  • Monthly, weekly, and daily reports
  • Regular reviews and claims denial analysis 

Continually focusing on improvement, education, and accuracy is essential if you’re going to save both time and money for your medical practice. If you want to optimize appropriate reimbursements and mitigate the risk of audits and penalties, you may want to begin outsourcing your billing and coding. M-Scribe offers billing and coding services that allow you to focus on the day-to-day business of running your medical practice. Contact M-Scribe today to find out how we can serve your medical practice.


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