Common Medical Billing Mistakes
Only when insurance claims get held up or denied, do the billing staffs try to trace out what went wrong. And then they realize that there has been some thing they have overlooked, a mistake that should have been corrected during the medical billing process itself.
With the high cost of health care in the USA medical billing errors have often created situations that make some unfortunate client get wrong bills and makes him pay up more than he needs to. If in such situations if the client does not have the necessary insurance documents in order, his condition becomes pitiable.
Tracking of billing mistakes is not always easy even for the billing professionals and is an assured impossibility for the naïve client/patient with not much technical knowledge about it. Quite often we have come across many a people wondering as to why a simple surgery did cost them a fortune.
It is for the health care professionals to avoid such common billing mistakes which often amounts to just carelessness and could be caused by a flaw in the internal communication process. Here is a list of the most common billing mistakes that often becomes the cause for a delay or denial of the insurance claim / bill reimbursement.
Wrong patient identification number
Wrong ICD-9-CM code with out fourth / fifth digits when required
Wrong date of service
Wrong rates charged
Procedure of claim not fully furnished by the other party
No match between the ICD-9-CM code and CPT code
Physician's ID not available
Billing for more Operating room time than used
Type of service code not mentioned
Billed for cancelled services / tests
Amount totalling mistakes
Treatment/service provided was not validated
Service/treatment given in an invalid centre/place of service
Service not a medical necessity
Place of service code not mentioned
Some of the suggestions given to reduce medical billings in physician offices include, having an auditor who is well schooled in medical policy and terminology. Errors should be corrected immediately when found out and care must be taken to remember not to repeat the same mistakes again. It is always right to report an error to the government authorities even though one can be fined for it.
About the author:
The author of this article is Ricci Mathew of Outsource Strategies International (OSI), a US based company that offers services in M edical Coding, and Medical Transcription.