In 2020, medical spending reached an all-time high of more than four trillion dollars, which equated to bills equally more than $12,000 per person. From doctor services to prescriptions to home health care and more, it’s an incredible amount of information to keep track of. So it’s not hard to believe that medical billing errors do happen.
That doesn’t mean we have to accept it, though. Even the smallest errors can end up costing you and your customers a lot of money, erode trust, and cause issues that can last for months and even years. That’s why it’s so important to have competent billers and coders, either in your office or as a third-party vendor.
By double-checking each code for an itemized bill, you’ll ensure medical coding errors aren’t passed on to the billing department. Fewer mistakes won’t necessarily keep healthcare costs down, but they will save you and your patients a lot of headaches.
Common Medical Coding and Medical Billing Errors
Let’s take a look at a few of the most common coding and medical billing errors that happen, from the first patient visit to when the final bill is sent out. Some of the most common include:
- Billing for services not rendered
- Failing to bill third-party payers
- Billing multiple times for the same service
- Incorrectly billing patients
- Mishandling or misreporting payments
- Not following up on billing disputes
- Improper coding of services
- Not filing medical claims in a timely manner
- Recording incorrect patient billing information
Billing for services not rendered
This can include services that were not provided or were billed incorrectly.
Failing to bill third-party payers
Sometimes healthcare providers will forget to bill insurance companies or government programs such as Medicare or Medicaid, for services rendered. This can lead to lost revenue and can impact the provider’s bottom line.
Billing multiple times for the same service
This often occurs when a healthcare provider bills for a service twice, either because of an error or because they were not able to collect payment from the patient the first time around. Duplicate billing can lead to overpayments and increased costs for the provider.
Incorrectly billing patients
This can happen when a healthcare provider bills a patient for a service that was not actually provided, or when they bill for a service that is not covered by insurance. This can lead to costly mistakes for the provider and confusion on the part of the patient.
Mishandling or misreporting payments
When payments are made to healthcare providers, it is important to ensure that those payments are properly recorded and reported. If payments are mishandled or misreported, it can lead to lost revenue, inaccurate financial statements, and overcharges for the patient.
Not following up on billing disputes
Sometimes healthcare providers will encounter billing disputes with patients or insurance companies. It is important to follow up on these disputes in order to resolve them as quickly as possible and avoid any potential financial losses.
Improper coding of services
Coding is one of the most important aspects of medical billing, and it is crucial to ensure that all codes are properly used and assigned correctly. If codes are assigned incorrectly, it can lead to lost revenue and incorrect information in the patient’s information.
Not filing medical claims in a timely manner
Insurance carriers and even some states have “timely filing” guidelines when it comes to claims, some as little as 30 days. They also restrict the time allowed to correct any mistakes that may have been made on a claim by the payer or the medical office. This will lead to delayed payments and may even cause a claim to be denied.
Recording incorrect patient billing information
Many errors happen at the start of the relationship by not getting accurate patient information. Anything from the incorrect birthday, mailing address, insurance information, and more can lead to problems down the road when it finally comes around to submitting claims. Take the time at the start of each visit to review this information and to make changes as needed.
Other Common Issues With Medical Coding and Billing
While the above may be attributed to inexperience or just plain sloppy work, there are times when incorrect billing or coding is fraudulent. Upcoding, under-coding, and unbundling are acts that intentionally send improper codes to payers. Certainly, an incorrect code could be a mistake, but these are often intentional.
Upcoding refers to the practice of attaching a more complex (and thus more expensive) code to a procedure. Under-coding is the reverse, applying less expensive codes to services provided. Unbundling is when a healthcare provider enters separate codes for several services that are usually covered under one umbrella code.
These problems can lead to audits, incorrect payments, claim denials, and more. Now, there are times when incorrect codes are entered without intent, but these can usually be attributed to miscommunication. That’s why it’s so important to ensure there’s enough contact between the provider and the medical billing and coding team.
Reduce Medical Billing Errors
MBA Medical Billing Services handles the medical billing and coding services for hundreds of providers, either through consultation, training, or acting as a third-party partner. We handle millions of dollars of accounts receivable every month and our track record is unimpeachable.
Common medical billing errors happen all the time (otherwise they wouldn’t be common) with inexperience or a lack of diligence. When you work with MBA Medical, you’ll be working with experts in healthcare coding and billing costs. Reach out for a free consultation and see how we can help you stay on top of your medical billing and coding.