Most patients will look at their medical bill, add their credit card to your practice’s online portal, and never think about their bill until they see it on their bank statement. However, errors can slip past medical providers and insurance companies, and patients are the last people you want to second-guess your services and professionalism.
This brief article highlights how medical billing discrepancies negatively affect your healthcare practice and patients and how to improve your billing process to reduce mistakes and improve your reputation.
Medical billing discrepancies include:
These can result from simply inputting the wrong service code or using outdated codes during billing. However, they can also come from negligent or poor business practices to charge patients or insurance companies more money for a typically inexpensive service.
Either way, these billing discrepancies can cause patients to lose faith in your practice, leave negative reviews online, and possibly pursue legal action. While one billing discrepancy from a single patient won’t shut down your healthcare practice or impact your revenue cycle, one mistake can reveal an inefficient billing process that can spiral into mayhem.
Medical billing discrepancies aren’t isolated to the bill sent to patients after treatment is provided. Insurance companies can deny medical bills with discrepancies that make the provided treatment unclear, vague, or appear outside the patient’s coverage, even if it is. This can affect your practice in various ways, impacting your revenue and ability to provide essential healthcare services.
Medical billing discrepancies can impact your patient’s finances, credit scores, and peace of mind. In cases where they cannot afford their next round of medical services, patients are less likely to continue their treatment, which can harm their health. Considering that most people have full-time jobs and insufficient time to engage in back-and-forth interactions with insurance companies and healthcare providers to resolve billing errors, this situation can lead to unpaid claims and treatment delays.
It’s important to note that the No Surprises Act protects patients from surprise medical bills exceeding $400 beyond their Good Faith Estimate, higher charges for emergency care from out-of-network providers, and increased charges for care received from out-of-network providers at in-network facilities.
Even small mistakes in the patient’s details can cause problems with insurance claims. To prevent these errors, make sure to update the patient’s information in the electronic health record (EHR) during each follow-up appointment. Additionally, the rules for medical billing and coding are always changing. Even if you have staff in your office handling billing, keeping up with the latest changes can be challenging but necessary to avoid discrepancies.
Before submitting claims, it’s essential to ensure everything is in order. Check that you’ve accounted for the right amount of billable hours, obtained signatures from clinicians or supervisors, and followed state and national guidelines. If the workload is becoming too much, consider partnering with a medical billing company that can follow up on and appeal denied claims due to errors.
These dedicated teams will monitor claim submissions, identify errors, and make necessary corrections. They can also work with and educate your medical staff to ensure that the initial coding process is smooth and that claims are processed correctly from the start.
Read about: The Benefits Of Outsourcing Your Medical Billing
If you want to know more about reducing and eliminating billing discrepancies, contact Hansei Solutions. Our medical billing team can ensure billing discrepancies are caught before they’re sent for payment, safeguarding your time and resources toward treating patients and providing the highest levels of care. If you’re unsure if your practice has an inefficient billing process, one of our RCM team can review your practice and provide a free demonstration of our solutions. Don’t let billing discrepancies hold down your business. Call today and partner with professionals dedicated to helping you grow and improve your practice.
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