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Tag Archives: Medical Coding & Billing

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How to Save Your Medical Practice from Coding and Billing Errors?

Medical Coding and Billing errors are potential dampeners – hefty amount of money may be lost due to mistakes in billing and coding, causing physician groups, clinics, and practices to lose revenue – not to mention legal penalties and hassles. Using correct coding and billing and thus avoiding the unwanted repercussions are of paramount importance in health care facilities.

Role of Medical Coding and Billing in Medical Industry

Medical coding and billing are considered significant and closely related aspects of contemporary health care industry; they play crucial roles in the Revenue Cycle of medical practices. Both processes are directly associated with the vital reimbursement cycle that ensures payment to care providers toward services offered. The success and financial wellness of a medical practice greatly depends on effective and error-free Medical Coding and Billing processes.

Common Mistakes that Crop Up in Coding and Billing Processes

It is imperative that medical practices perform their coding and billing functions at the highest accuracy level possible. Coding and billing errors often not only lead to loss of revenue but also impact in other ways. Following are certain common mistakes that could cause unwanted consequences:

  • Incorrect Insurance Information: This would lead to delay in patient care, as patient’s insurance data cannot be properly verified prior to treatment, and result in delayed payment to the practice, if patient has been treated without verifying insurance information
  • Improper documentation of services: claims could be denied or delayed if services provided are not documented appropriately
  • Using Outdated Codes: Failure to update and adhere to latest CPT or ICD codes, or failure to use modifiers as and when required, may impact the payment
  • Overcharging the patients: Patients’ wrath needs to be faced when incorrect billing and coding practices lead them to believe they have been overcharged

Billing Errors that must be avoided

  • Upcoding
  • Duplicate Billing
  • Missing or incorrect written information
  • Inflated O R charges
  • No plan for handling denials
  • Insufficient staff to handle billing and coding tasks

How to Avoid Coding and Billing Errors

Delayed payments and denials are often caused by simple errors and lack of applying caution on the part of coding and billing staff. By following certain steps diligently, billing and coding errors may be eliminated.

  • Using proper medical coding and billing: Correct billing and coding ensures smooth claims processing
  • Verification of every medical billing claim: Each claim needs to be double-checked
  • Understanding individual medical specialties: Employing only certified coders and training and educating them on regular basis helps reducing mistakes in coding and billing
  • Constant monitoring of changes in legal regulations: Regular monitoring and taking subsequent steps to ensure adherence with health care laws and regulations and compliance with HIPAA and Medicare helps accomplish control

Sound procedures and policies must be followed, coding and billing plan needs to address periodic reviews, and reviews must be conducted to ensure correct medical coding and billing practices in health care facilities.