Medical claims will not get you honor, but less errors will. And, looking at current scenario, making flawless claims are the need of the hour. Although, glitch in medical billing process can be the result of variety of reasons, ranging from apathy to improper training, every one of them can be rectified with some focused efforts. So, we have to put our special focus in dealing with the mistakes on ground level, by spotting and correcting them.
A simple mistake arising from misspelling of name, or by entering wrong demography, date of birth or insurance policy number can cause extra cost to the hospital and a lot of rework too. These small oversights, certainly makes a huge difference in the process to avoid errors. These details are the foundation of correct medical billing processing and root cause of major errors. To avoid these flaws, extra care and attention should be allocated and the concerned staff should be trained for capturing patient’s credentials perfectly. So, from patients details to service insights everything will be correct.
Sometimes, billing errors can happen due to clerical oversights. Medical billing errors can also happen when the coder voluntarily or involuntarily enters the wrong codes to charge a higher sum of money for availed services or charge for services that have not been provided. Error of this kind can harm the reputation of the hospital and cause a lot of anxiety to the patient. The legal repercussions caused by mistaken coding can be rectified at all ends if the staff is vigilant at the time of entering the code and discuss about which service has to billed, if there are any doubts. Also the concerned employee has to be up-to-date with latest codes or modifications.
You know what, if duplicate billing is done by intention then it can be termed as fraud. And, it is often said that duplicate billing happens more frequently than any other error in medical billing.
The overcharging of patients by providing inflated bills not only decreases the chances of repeat visit by the patient but also might be a huge headache for the hospital at the time of audit. Hence, to avoid this blunder extra caution should be taken while computation.
After the treatment, when hospital prepares the claim to send to the insurance companies, one of the following scenarios may arrive: the insurance company may out rightly reject the claim, a part of the claim might be refused, insurer may ask for another supporting document to review the claim again, or lastly, the claim can be processed. The first three situations can be cut out completely by appointing a dedicated claim specialist who inspects every minute detail before submitting the claim to the insurer. Also, proper follow-up can be done in order to process the claim fast.
In spite of your best efforts, if you are still plagued by the menace of billing errors, then it is time to outsource medical billing services for carrying out error free billing to an expert such as OutsourceRCM. We eliminate the chances of mistakes with the combination of knowledge and analysis, accompanied by deeper understanding of medical billing industry.