Steer Clear of these Medical Billing Mistakes for a Successful Healthcare Revenue Cycle

Medical Billing Mistakes Can Cost You Money September 29, 2016

Efficient revenue cycle management ensures that healthcare providers can focus on what matters most: giving quality care to their patients. However, providers often struggle to bill effectively. Below are the most common errors committed by practices and clinics that prevent them from billing properly and collecting on money that the practice is owed.

Collecting incorrect patient information

The collection of patient data is the foundation upon which claims can be submitted and paid. Errors such as a misspelled name or an incorrect date of birth will result in a denied claims payment. Administrative staff should make a habit of double-checking the accuracy of information collected during the initial interactions with the patient.

Failure to check the patient’s insurance coverage

In the first quarter of 2016, the American Hospital Association reports that 43 percent of hospitals in the U.S. have spent more than $10,000 on managing claim denials, while 26 percent have spent more than $25,000.

It is important to evaluate the patient’s insurance plan and eligibility each time they schedule an appointment. The following questions can serve as a guideline for administrative staff when evaluating eligibility:

    • Does the patient have valid insurance that is accepted by your practice?
    • Does the patient have additional insurance?
    • Is all patient registration information correct?
    • How many visits is the patient allowed?
  • What is the patient’s responsibility regarding the cost of the visit?

Not informing patients of their payment responsibility

Within the past decade, the amount of high-deductible insurance plans has increased exponentially. This means that patients are taking on a greater financial burden in the payment of medical bills. Additionally, the cost of collecting payments from patients is higher than that needed to collect from payers, as it requires more time and money. This need for more resources is placing an even greater financial strain on hospitals and practices that are already struggling to collect payments and bring in owed revenue.

In order to ensure that patients are fully aware of their financial responsibility, clearly inform them of the balance due, and collect at least a portion of this balance at the time of the visit.

Manually submitting claims

The implementation of the new ICD-10 billing code proved to be less traumatic than anticipated. However, the American Health Information Management Association (AHIMA) has identified several recurring mistakes in submitted claims, and it will take some time for administrative staff to become proficient in the new code as well as the new documentation practices. Billing errors due to manual reporting can result in a significant loss of income and productivity.

Billing in-house when your staff is overworked

When a practice’s workload is high, administrative processes become less efficient and billing mistakes can be easily made. Keeping up with annual medical code revisions and billing practices add extra expectations that may overwhelm your staff.

Outsourcing billing services increases claims payments, decreases labor costs as well as resources allocated towards in-house billing, and overall increases revenue for hospitals, practices, and clinics.

To learn more about how outsourced medical billing services can help you make more money, limit overhead expenses, and make your practice more efficient, contact us online or call us at 480-999-0180.

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