How To Avoid Medical Billing Errors


Last month, we dedicated one of our blogs to the unfortunate practice of placing billing errors on medical bills. Of course, there are many times when such errors are done by mistake. On the other hand, there have been numerous instances of bills that carry overcharges and other discrepancies that were done purposely.


With the No Surprises Act having taken effect at the beginning of this year, patients all over the United States should avoid receiving bills with unexpected charges. That doesn’t mean, however, that no error will ever occur again. So what steps can be taken to avoid medical billing errors?


Try to eliminate inadvertent upcoding or undercoding.


Upcoding and undercoding are both illegal. Upcoding is the process of entering codes into a patient’s bill for services that were not received. This is often done in order to inflate the total amount due to a provider. Undercoding is the process of leaving codes off of a patient’s bill. This is often done in order to avoid an audit. Of course, both upcoding and undercoding can be done by accident. Be careful to prevent this mistake from happening.


Make sure to verify changes to a patient’s insurance plan.


Insurance issues are among the most common reasons that patients have their claims denied. This can occur when a patient who visits a medical facility on a regular basis is assumed by staff members to not have had any changes made to his/her insurance plan. It’s important to check on your patient’s eligibility with each visit. This will ensure that there are no insurance-related issues. They may include termination of coverage, services that are not authorized or covered by the plan and maximum benefits having been reached.


Check for mismatches in patient information.


Some medical billing errors are extremely trivial. They should easily be avoided. We’re talking about an error in the spelling of a patient’s name, checking off the wrong gender or inputting the wrong date of birth. These can all be grounds for a rejection of claims.


Double check all information.


The practice of double-checking should be automatic. Naturally, it’s vital that correct procedure codes and diagnoses are inputted on claims in order for insurers to successfully provide reimbursements to patients. Be sure that all members of your billing staff receive proper training in coding. Providers should also use the latest coding books for references on how to avoid committing expensive errors.


Avoid double billing.


Billing for the same service twice is one of the most common errors found on medical bills. Double bills commonly lead to rejected claims. It’s wise to go through bills with a proverbial fine tooth comb to ensure that no charge is duplicated before submitting the bills to an insurer.


At Allegiant Experts, we identify facts, locate errors and illuminate the truth. We also ensure that we keep our clients informed during every step of the process. It’s part of our mandate to always provide our best and most qualified opinion as we strive to meet your needs. For more information about how we help to both dispute and minimize medical billing errors, please don’t hesitate to call us at 407-217-5831. You may also email us at info@allegiantexperts.com.

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