5 Medical Billing and Coding Tips

Medical billing errors are very common in the United States. Doctors begin a medical practice but usually have no business background, so they’re not accustomed to some of the technicalities that are imperative for you and your staff to understand in order to achieve the revenues you deserve.

On top of that, the government is constantly making changes to how diagnoses and medical services are coded. These changes can cause errors due to the lack of full staff knowledge of the latest codes and rules.

When forms are improperly coded, it can result in a practice receiving costly fines. These fines are in place to prevent doctors from getting paid for services they didn’t perform (or didn’t need to perform for that patient), but the incorrect codes are often keyed-in innocently by administrative staff who just didn’t know which codes to use.

Below are five key tips to help your practice with your medical billing:

Tip 1: Have Front-End Staff First Verify Insurance Benefits

Many medical billing errors can be avoided if the front-end staff take the important step of updating patient information every time a patient receives care. This is also the best time to verify insurance benefits in order to ensure that the insurance-provider information is current and accurate.

Things may have changed since the last time the patient was in your clinic. Train your front-end staff to verify all coverage dates, benefits, co-payments, authorizations, and other information that can affect medical billing.

Tip 2: Correctly Input and Double-Check Patient Information

Even the smallest errors in patient information, such as a typo, can lead to a rejection by the insurance company. If the patient’s last name is Greene but it’s misspelled as Green, or if Johnston is misspelled as Johnson, you could be penalized or – at the least – you will not be paid as soon as you want.

Create a system whereby a “second set of eyes” double-checks every form before it is submitted, proofreading everything carefully from the spelling of the patient’s name to the insurance policy number.

Practices often have multiple patients with the same name (or a very similar name), and staff must be encouraged to double-check all information to ensure that the correct information is being entered and submitted.

Tip 3: Double-Check Diagnosis Codes and Procedure Codes

The insurance company will look at a wrong diagnosis or procedure code and deem it unauthorized or unnecessary, which will make them reject the claim. The coding books are also updated yearly, so make sure your front-end staff and billing staff members have easy access to the current codes.

You might think that providing ongoing training and purchasing the newest coding books are expensive. However, medical billing errors will cost you much more in the long run.

Tip 4: Write Clearly or Use Technology to Your Advantage

Doctors work quickly, so their handwriting is often not very legible. If you cannot write clearly enough for your billing staff to understand the letters and numbers you have written, why not type the information to your staff via a handheld device?

By utilizing a smartphone or electronic tablet, you can help reduce the errors in communication with your staff. This way, your administrative staff members are much more likely to key-in correct information, so you have much less likelihood of your claims being rejected.

Tip 5: Avoid Duplicate Billing by Doing Double Checks

Performing internal audits will ensure you do not submit the same bill twice. Sometimes a bill may be submitted for a canceled or modified procedure, and a chart audit usually catches these errors.

ProMD Medical Billing is happy to help with your billing assessment needs so you can maximize profits and increase patient satisfaction. To learn more about how ProMD can make your practice run like a well-oiled machine, call 866-960-9558 or fill out our online form to request a billing assessment.

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