Medical billing errors are inconvenient and costly. According to the Medical Group Management Association (MGMA), billing errors can cost medical practices on average up to 5% of their annual revenue. Denial rates due to errors in billing and coding can be as high as 20%- 30%. Finally, a study published in the Journal of the American Medical Association (JAMA) Internal Medicine, approximately 90% of medical billing errors are preventable. Here we will discuss some of the most common errors and how to successfully prevent them.
Incorrect Patient Information
Simple mistakes such as a slight misspelling of the patient’s name, incorrect date of birth, or outdated insurance information can lead to claim denials or delays in reimbursement. Staff must confirm correct patient information at each appointment to make sure these errors don’t occur. Many EHR Systems, like CGM APRIMA, feature a patient portal, allowing patients to update their information, reducing the chance of incorrect information.
Patient Eligibility
Patient eligibility is a common reason for claim denials but is easy to fix. Verify patient eligibility at each appointment. EHR Systems like CGM APRIMA validate patient eligibility to keep you on track here.
Billing for Services That Are Bundled
When multiple services are bundled together, there is a higher chance of error in coding, such as using incorrect codes or failing to properly identify each service within the bundle. It is important to be familiar with correct coding and modifiers for these situations.
Global Periods
A global period is the period of time between a scheduled procedure and the follow-up appointments that are bundled into the cost. But, sometimes, the follow-up appointments are accidentally billed when they shouldn’t be. It is important to doublecheck these appointments to avoid overcharging.
Human Error
Sometimes the cause of billing mistakes is simple human error. For example, manually entering in codes can often result in mistakes. EHR Systems like CGM APRIMA offer OCR scanning to help reduce these errors.
With some staff training and the right EHR System, you can help reduce common billing errors, and avoid costly mistakes.
TILT Healthcare is proud to be a CGM APRIMA provider. We can help you reduce common billing mistakes while increasing efficiency in your practice.
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