One of the top challenges medical practices experience is the abundance of denied or rejected medical claims. The primary role of a medical billing partner is to ensure that the provider is reimbursed for the services. However, errors, either human or electronic, can occur which sometimes are unavoidable. These errors can turn out to be significantly costly and can impact your overall revenue cycle. Since the medical billing process involves two essential elements, namely health and money, it is imperative to keep the errors to an absolute minimum.
Mismatched or Missing Medical Codes
International Classification of Diseases (ICD) can be traced on patient’s hospital records, doctor’s records, and death certificates. These codes are vital. Once your practice submits bills for insurance reimbursement, these ICD codes have to match the CPT code – assigned to every service offered by a practitioner. If these codes fail to match, the bill is likely to be denied.
Incorrect or Missing Patient Information
If one field is left blank or filled in incorrectly, the claim will be denied. The provider’s responsibility is to fill in these pieces of information. Some of the data includes sex, name, DOB, ID number, social security number, contact info, address, policy number, etc. If you fail to provide this information, the patient won’t be billed, and that means your practice loses money.
A Duplicate Claim for Service
A duplicate claim is one that’s been submitted more than once by the same provider, single encounter, same service, same beneficiary, and with the same date. It often occurs when someone at the provider’s office fails to check whether the service has been reported or paid for when submitting a claim. It is a prevailing problem for both payers and billers and can cause rejection or delay of claim processing.
Let Us Help!
Whether your practice depends on in-house medical billing or through a medical billing company, you still need to keep your medical billing management optimized at all times. Automation of processes and staff training can reduce human errors while scheduled chart audits can deal with electronic challenges. Of course, to ensure that your medical billing process is top-of-the-line, it’s crucial to work with Advanced Reimbursement Solutions so that you can let us help you enhance your medical reimbursement needs and minimize reimbursement denials. Contact us today to speak with one of our staff members in Wilmington or Phoenix!