A vital component of every practice is medical billing. Complications may hinder cash flow, result in rejected claims, and lead to financial problems even when they are a top priority. Utilizing medical billing management software is intended to lower the likelihood of billing problems. Enrollment in a medical plan is one of them.
Medical billing services are causing considerable problems for medical billing companies all around the world. Almost all healthcare systems experience issues with bill issuance, tracking, and payment.
While some problems are caused by the patients, others are caused by the medical facilities or hospital billing outsourcing companies. They need the most advanced and efficient payment and management solutions for medical billing.
Top 7 Medical Billing Issues and How to Address Them
Here are seven common problems with medical billing systems and how to fix them!
1. Limited Information
A common mistake is leaving out crucial details on a claim, like the patient’s birthday or the nature of the injury. Even if there is no inaccurate data and the patient is covered, a blank field could lead to an insurance company denial.
You must make sure that your claims don’t have any blank fields or missing data before submitting them. It is your best opportunity to find errors before they force you to go through a time-consuming rejection and resubmission process.
2. Inaccurate Patient Identification Data
When entering patient data into your medical billing system, even minor issues could result in mistakes. Every clinician is aware that insurance companies frequently reject claims for insignificant errors like typing a patient’s name incorrectly or changing their birth date.
There are two approaches to handling this situation. Double-checking each entry to ensure its accuracy is the first step. The next step is to choose medical billing management software that will automatically add the patient’s verified data to the bill.
Consider that prior to their initial evaluation session, you ask patients to enter their information and validate it with you. It is doubtful that this issue may cause a payment delay in such a case.
3. Inappropriate coding
Incorrect medical claims coding is one of the most prevalent and time-consuming mistakes made by physical therapy companies. Among the many causes of incorrect claim coding are:
- Making use of outdated coding guides
- Charges that fall under the same process code should be managed separately.
- Incorrect and excessive pricing
- Conflicting codes
- Missing codes
The answer is to choose a medical practice management system with updated coding automation that complies with the most recent coding standards. Software that allows for just the codes specific to each medical insurance carrier can reduce billing time and remove the chance of error.
4. Repetitive Billing
Occasionally, a staff member will design a patient’s bill, and another staff member will prepare it without realizing it has already been designed. A double bill in this situation would mean additional costs for both the patient and the incensed client. Duplicate errors are frequent in spreadsheet administration and manual billing.
Automation is the answer since it can issue a bill automatically and spot duplication if someone tries to make a second bill for the same services and treatments. Medical billing staff training properly might also aid in minimizing this issue.
5. Inadequate Documentation
Each insurer needs specific paperwork in order to process claims payments. Without it, they might reject your claim and send it back to you; in that case, you’d have to provide the necessary paperwork and resubmit your claim.
Ideally, the supporting documentation for a claim should be easy to provide using your medical billing management software.
6. Expenses Not Included
A patient’s insurance coverage may change for a variety of reasons, such as a change in employment. A maximum number of reimbursed physical therapy sessions or treatments may also apply, after which the patient would be liable for paying.
If an insurance company is charged incorrectly, it could cause expensive delays and make it harder to collect money from the patient or their new carrier. At each visit, it is important to confirm the patient’s insurance coverage. While ensuring that their benefits have not expired, you must confirm the patient’s insurance coverage.
7. Lack of recommendation or approval
Several medical plans demand that patients receive their primary care physician’s approval or patient services’ consent before beginning physical therapy.
Once more, you must confirm with the patient and make sure that everyone on your team is familiar with the carrier’s restrictions and specifications. You can work with the patient to get a referral if one is needed before submitting a claim.
