Medical billing errors negatively impact healthcare practices in many ways. Some errors reflect actual illegal behavior with severe consequences. Others simply create major operations delays that damage your revenue stream and workflow. Whatever the case, RevWerx is here to help. We can help you spot errors in your billing system through an internal audit. After this, we’ll work with you to determine what type of billing system is optimal for your practice. Our experienced staff is even equipped to facilitate your in-house medical billing implementation process.
We’re excited to help your behavioral health practice thrive through transparent and streamlined billing procedures and practices. Reach out to RevWerx by phone at 833.309.0138 or online to ensure your billing system is efficient and error-free.
Billing Errors That Many Providers Make
Among providers who perform their billing in-house, several common errors exist:
- Poorly executed documentation: Doctors and other providers sometimes complete their paperwork sloppily. This makes it difficult for billing department staff to correctly determine clinical codes for the services patients received. Something as simple as messy handwriting can lead to problems like failure to record procedures patients received in insurance claims.
- Missing patient information: It’s a reality of healthcare that patient intake sessions are often rushed. To some extent, this is unavoidable, but it’s nevertheless in your best interest to make sure patient information is recorded correctly before or at the beginning of an appointment. This helps eliminate billing errors later on.
- Unbundling: This common error occurs when a single clinical code exists for a group of procedures. However, the billing department uses separate codes reflecting the individual procedures instead of the umbrella code. This is illegal since it inflates your practice’s bottom-line falsely.
- Upcoding: This error occurs when a billing team member uses a clinical code reflecting a more costly or complex service than the one the patient received. Upcoding can also happen when a lab or test performed by a technician is coded as if a physician performed it. Like unbundling, this practice is illegal.
- Undercoding: Undercoding errors occur when bills are not generated for all the services or treatments a patient received.
- Duplicate billing: Conversely, duplicate billing errors occur when billing personnel apply a clinical code multiple times for a service or treatment that a patient received only once.
Some Ways in Which Medical Billing Errors Negatively Impact Your Practice
The consequences of medical billing errors can be quite severe and include:
- Lost revenue: Your practice can lose money if services are undercoded and actual work performed by your medical staff is not reflected in insurance claims.
- Delayed revenue: Inefficient, error-ridden billing and rejected claims make correctly projecting cash flow and paying expenses very challenging.
- Rejected claims: Insurance companies can reject claims for a wide variety of reasons, including issues as simple as transposed digits in dates or policy numbers or patient names failing to match what they have on file. Accurate data entry is thus of the utmost importance in healthcare billing.
- Angry patients: A patient who is overbilled due to errors like upcoding or duplicate billing is likely to become angry. Angry patients are less likely to return to your practice and may damage your good reputation by sharing the negative experience with others.
- Audits, Fines, and Other Legal Repercussions: If billing errors reflect illegal activity, you may be audited by the federal government or large insurance companies. Audits can result in loss of practitioner privileges, fines, or other court expenses.
Next Steps for Your Practice
Sometimes billing errors come about because providers simply don’t have the training needed to process patient information throughout the complex billing process, from claims to collection. Other times, a practice’s size or scope of services exceeds its staffing or software resources. In the first case, the provider could benefit from training by a company like RevWerx, specializing in revenue cycle management.
In the second case, the practice could benefit from a third-party billing agency. Such an agency can take over some of the more protracted parts of the process, allowing the practice to focus only on essential steps like utilization review (UR).
UR is the step in which specially trained nurses employed by the practice work with specially trained nurses employed by insurance companies to determine what procedures are medically necessary for each patient.
Partner with RevWerx to Eliminate Billing Errors from Your Practice
Why wait another minute to ensure your medical billing system is efficient and error-free? Call RevWerx at 833.309.0138 or reach out online to begin optimizing your billing department today.