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How to Avoid These Top 7 Billing Mistakes Hospitals Make

It’s no surprise that medical billing mistakes have been a big issue in the hospital realm. In fact, the Department of Health and Human Services stated that approximately 42% of medical bills in 2010 sent to Medicare had errors. The result? A staggering $6.7 billion in costs.

With all that is going on in the medical industry, it is hard to ensure these professionals are healing their patients and attending to these matters. And even if you have office staff who can do medical billing, there is so much they can do, whereas outsourcing experts are more than happy to assist you. With these experts, you won’t have to wonder how to avoid billing mistakes.

Common Mistakes of Medical Billing

There are many common mistakes, which include the following:

  • Wrong ID Number

Incorrectly entering an insurance identification number is easy to do. So, whether you or your office staff enters it wrong, you may have to resubmit it. This may happen if it is denied due to the wrong ID number.

  • Transposing of Digits

It’s also easy to transpose digits. So, a mindless and simple switch of a few numbers may result in claim denial. And as a result, you may encounter severe delays in receiving payments. Digit transposing frequently occurs when entering the patient’s birth date.

  • Claims Sent to the Wrong Insurance Agency

This situation occurs when the individual entering the insurance information does not pay close enough attention or does not obtain a copy of the insurance card.

  • Invalid Procedure or Diagnosis Codes

These codes are updated yearly. So, it is likely that codes for billing will eventually be deleted or changed. If the cold is invalid, you will receive an immediate denial.

  • No Code Linkage

Code linkage includes the matching up of the procedure code with the diagnosis code. With all these codes mentioned thus far, it is easy to get confused and enter the wrong codes. Also, some of these codes may change or be deleted. Additionally, these codes will show the insurance company that the procedures were necessary medically, and the insurance company should pay the patient.

  • Balance Billing

A medical office can get in trouble for incorrect billing, and patients will most likely be extremely irate. Balance billing covers the healthcare costs that are over patients’ coinsurance, deductible, or copayment. It also includes the amount the insurer must pay.

Balance billing is not legal in many cases. So, if the patient is on Medicaid or Medicare and the provider’s agreement with these programs is to accept the negotiated rate of Medicaid or Medicare, the agreement forbids balance billing. Also, balance billing above the negotiated payment is illegal, if a provider and an insurance provider have a negotiated contract for a specific payment structure.

This situation is more difficult when you have some patients who are legally able to have balance billing, and some are illegal to have it. And with medical organizations working hard to heal their patients and maintain smooth operations, who will have time to research insurance agreements and coverage?

  • Duplicate Billing

Duplicates are another common mistake that can be extremely troublesome for medical facilities. For instance, a nurse and a doctor can order the same treatment. Then, the single procedure is billed twice. These sorts of incidences can get the medical facility in trouble with the insurance company, and the patients will quickly become angry.

In Closing

Don’t let any of these unfortunate happens to your medical facility. And instead of worrying about how to avoid billing mistakes, it will behoove you to contact proven experts.

Midland Group includes proven experts who have been serving clients since 1989. Their record speaks for itself. So, for more information, contact Midland Group now!

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