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Is Your Medical Office Part of the $68 Billion in Medical Coding Errors?

May 23, 2017

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Since at least 2011, mainstream media has made a point of noting the high instance of errors in medical claims submitted to insurance companies. According to the Medical Billing Advocates of America, errors have only been growing since that point. The Integrated Healthcare Executive reports that these errors have cost the medical industry over $68 billion in a single year. $6.7 billion of these payments are incorrectly coded, resulting in many improper Medicare claims.

The most common culprits include a lack of office staff training, including training in electronic medical record systems (EMRs). Many small offices with errors in medical bills risk losing the entire payment under certain circumstances. Medical bills with mistakes can also lead to miscommunication with patients – when the insurance company refuses to pay, doctors often find themselves at odds with the patient when it comes to procuring payment.

Is Certification the Answer?

Many medical offices are trying to get around the problem of bad training by requiring new hires to have certification in medical billing before consideration for a job will even be given. However, this solution has a number of disadvantages.

The quality of a new employee may not always coincide with the certification that he or she receives. While certification is a testament to some basic skills, it is impossible to test those skills in the pressured environment of a medical office. Employees also need a certain passion to their work that will definitely come through in their ability to keep records accurate. Even with the automation of the modern EMR, bad inputs from employees still lead to bad records.

Related Article: How to Handle Denied Medical Billing Claims

Certification is also good only for a certain period of time. As standards are updated, certifications that are obtained months and years ago become increasingly irrelevant. If you are an employer who is looking to sponsor the continued education of your employees, updating the certification of your employees can quickly become an expensive pursuit.

Is Third Party Vendor an Option?

Instead of relying on individual employees or repeating certification processes, outsourcing your medical billing out to an established, vetted third party billing service is the best option. First of all, you will have an entire team of specialists working on your claims on a daily basis – for the same price as you would hire a single in-house billing generalist. These specialists will have more experience dealing with different denials and unique situations. There will also be a much more robust system of checks and balances – you will have more people looking over your entire revenue cycle for errors.

Outsourced medical billing process itself is also a cleaner system that has been tailored specifically to your medical office. As codes expand, small medical offices may spend days or weeks updating their systems. An experienced medical billing company gives you updated codes in real-time as they are generated from the standard, ensuring that your practice continues to generate income even as the landscape around it changes.

Your in-house staff also gains the ability to focus on the core competencies of your office instead of halfway participating in your billing process because there is no one else to do the work. As a doctor, your reputation is built on your customer service. Let your staff be your staff, and let medical billing company take care of the finances.

Do not be one of the offices that send out three of every four records with an error. There is no reason to be a part of the $68 billion shortfalls that is currently plaguing the medical industry. Take advantage of the technology that M-Scribe provides and enhance the efficiency of your office while collecting a much greater share of the money that you have worked hard to earn.


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