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2 Steps To Take To Avoid Medical Billing Errors

If you have been noticing that more and more errors seem to be cropping up in your medical billing practice, here are two important steps you can take to avoid medical billing errors in the future and ensure that your practice runs more smoothly.

#1 Requires That Insurance Always Be Verified

One of the biggest mistakes that many medical practices make is not being thorough enough with insurance information. If you have incorrect insurance information, the claim is sure to be denied.

You need to make sure that your front desk staff always verifies medical insurance information, even if it is a patient that they have seen before. Have your staff ask for and copy the medical card on file for all patients when they come in. If it is a returning patient, train your front office staff to then ask to see their medical card and use it to verify the information in your system to make sure that it is correct.

Next, make sure that you have a management software program that allows your staff to electronically check all insurance before an appointment. The right type of software can even verify if that patient's care is fully covered and what they will have to pay. If the burden of paying the bill falls more on the patient, be sure to have your medical staff call and let the patient know, so that there are no billing surprised later or when they show up for their appointment.

#2 Double Check Patient Information

The next big error that can result in claims being denies are errors in patient information. This will take a uniform change on the part of your staff. When patients check in, you need to make sure that you always have the staff verify the spelling of the patient's name as well as their policy number.

When the patient goes back to see you, it is important that your practice have a clear system for marking down the diagnosis code that goes with the procedures or treatment that the patient received while in your care. You may want to develop some internal forms that correspond to the typical type of procedures that you perform so that you can check or circle the right diagnosis code.

Finally, ensure that your nurses or billing employees then review the chart and make sure that the notes and the code match up. If they don't, have a simple procedure in place to notify the attending doctor so they can check the chart and verify the right procedure.

This is important because the wrong diagnosis codes can result in a claim getting denied. For example, a male would not come in for a pap smear, nor a female for a prostate exam. Although these are extreme examples, insurance companies are trained to identify and spot codes and procedures that don't make sense and deny them, so make sure you have a seamless system in place that allows you to correctly convey the right diagnosis code to billing. 

For more information, contact a company like Premium Medical Billing Inc.


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