9 most common medical billing errors that might result In claim denial

Errors related to medical coding result in more significant federal penalties, claim denials, loss of revenue, fines, and imprisonment. Private insurers’ and Government audits have revealed numerous unfortunate cases of abusive or fraudulent medical billing practices. Considering the difficulties of the medical coding system it is not unexpected that they made errors.

The seven most common medical coding errors

Every part of your claim has to be precise for easy reimbursement. But you may be making a few of the most common medical coding errors unknowingly or intentionally, including:

Sloppy documentation

When healthcare providers or physicians turn in messy paperwork, it’s problematic for medical billing experts to properly allocate the correct codes and bill patients. Misunderstanding handwriting errors may also add to under coding (another lost revenue stream).

Unbundling

Using different codes for related procedures when a single code for the whole group of procedures is most likely unbundling. This unlawful act inflates your profit and upsurges the total claim amount.

Upcoding

Upcoding occurs when your team uses a billing code for a more expensive or complex service than what was performed. It also comprises tests done by techs being coded as performed by physicians. Meanwhile, more stringent codes call for higher payments; this unlawfully inflates your revenue too.

Under coding

Under coding occurs when patients are not billed for all the services or treatments taken. This distrustful practice may aid a patient to evade a high-cost bill or help your emergency department avoid audits.

Hurried intake/missed information

Entering improper information for patients, providers, and insurance providers is a topmost error. Particularly in emergencies, this info can take a backseat in a troubled moment and cause a concern down the road.

Duplicate billing

This happens when your workforce bills the same patient for the same service numerous times, although it was only performed once.

Overusing the modifier 22-increased procedural services

Using this means the patient’s procedure required more work than average, which would come with a price increase. This needs proper documentation to prove/get approved. Those are quite a few of the most communal medical billing and coding errors. Any of them could be the reason why your rejection or denial rates increase. But they don’t have to be a problem that you have to face forever.

How to avoid medical billing errors?

Here is what you can do to avoid medical billing errors;

Train your team on the most common medical claim denial reasons

• It takes an observant eye to evade most medical billing errors before they leave your department. Here’s a list of denials in medical billing you can avoid with firm due diligence:
• Missing information 
• Duplicate claim or service
• Service already adjudicated
• The limit for filing has expired
• Service not covered by payer

Outsourced emergency department billing and coding

Medical coding is a massive quantity of work for even the most knowledgeable teams to manage. Minor errors here and there have the prospective to result in prominent harm. That’s why many groups outsource emergency department services.

The advantages of outsourcing hospital billing include: 

• Easier adherence to compliance
• Fewer errors
• Better cash flow
• The better focus for your staff
• Enhanced patient satisfaction
• Higher revenue
• Greater consistency
• Lower expenses

You’ll also receive complete services to manage the nuts and bolts of the billing procedure from start to end. Hand off this job to the specialists, and you’ll cut insurance rejections and increase your cash flow

Conclusion

At MedsIT Nexus, we are well aware of the time constraints faced by patients and doctors daily, which is why we offer end-to-end professional billing services to assist in managing bills efficiently and effectively. MedsIT Nexus medical billing and coding services plays a significant role in cutting down operational expenses, which in turn increases revenue. Contact us today!