Medical Claims Errors - 3 Ways to Fix Them

Medical Billing errors are quite common and the cost of these errors is extremely high. For instance, a write-off as low as 1% can cost an average 300-bed hospital approximately $3 million in lost annual revenue. Therefore, in order to remain financially viable, it has become necessary for healthcare organisations to be proactive in claims management. They need to implement safeguards against billing errors, identify them and take necessary measures to rectify them.

Medical Claims Medical Claims

Here are some of the common medical billing errors that every healthcare provider needs to avoid:

  1. If there is incorrect information in the claim and it wasn’t rectified before submission, the claim will get denied. This is the reason why proofreading claims is very important before submitting it for payment. From the physician’s name, address and phone number to the details about the patient and the insurance company, everything needs to be double checked before submission of claims. You can also call the insurance company and ask for reconsideration if a claim has already been denied or rejected due to data entry mistakes.
  2. Second common mistake is of duplicate billing which usually happens when someone from your office is making a mistake. There are chances your staff hasn’t realized that someone else has already submitted a particular claim before sending it off. To avoid this mistake, it is very important to review files periodically. If the files show that a payment has already been made for a particular service, then there is no need to follow-up with the payer. If there is a mix-up, try and find out the reason behind it from your Medical Billing
  3. Being too late in filing a claim is also a mistake that needs to be avoided. As a provider, you need to be aware that payers impose time limits for claim submission. It includes a 60-90 day limit on initial claims. If the claim gets denied, then there is additional 45 day limit for appealing the claim. To solve this, providers need to create a system in which the billing staff will be receiving automated alerts when medical claims approach their time limit.
To ensure timely payments, many practices choose to outsource billing services to a third party. Reliable billing companies work with expert billers and coders who avoid the above-mentioned mistakes to get their clients paid on time.