Why Physicians Need To Prioritize Billing and Coding Errors?
In
the process of mitigating the risk of loss of revenue, solo practitioners (mainly
physicians) end up spending more time with the management tasks such as medical
billing and coding. The result is they are unable to take in more patients. In
many practices, the physician is the sole person responsible for choosing the
correct codes to compete for the notes as part of the documentation process for
a visit.
The
burden of medical
coding and billing for the services rendered by the physician while
caring for the patients often results in incorrect coding and billing, drowning
the practice. Unfortunately, many fail to realize such issues' damage to the
facility until it's too late.
Why
Physicians Need To Avoid Billing & Coding Errors?
The
medical coding errors can potentially cost the practice thousands of dollars
lost in revenue. Also, high denial rates compromise patient care, and there are
more serious issues that a physician can face when they fail to prioritize the
billing and coding process.
Some
issues can arise when medical billing and coding errors are not avoided in
practice are as follows:
Getting
Scrutinized For Fraud
Often
a history of incorrect coding by a physician where upcoding happens even by
mistake, the practice can come under intense scrutiny. The scrutiny done by the
governing body is for medical fraud and abuse, and the practice can face severe
penalties and fines. The extent of which can be closing the practice or being
blacklisted.
Medical
abuse or fraud is associated with claims that have been falsified either
deliberately or by mistake, resulting in the practice's monetary gain. When
wrong claims are made even unintentionally for an extended period and for many
patients, it will be considered medical abuse and fraud. Submitting any
incorrect claims to the insurance agencies, including Medicare and Medicaid,
violates the Federal Civil False
Claims Act (FCA).
Claims
Refused By Insurance Companies
As
mentioned earlier, wrong coding and billing can result in claims getting
rejected, denied, or receiving partial payment. Often insurance companies state
that any claim that is denied cannot be repaid. Majority of the time, the denials
result from missing information, inadequate coverage reporting, or other
documentation errors.
However,
reimbursement can happen with rejected claims, but the claim needs to be
corrected and then resubmitted to the insurance company.
Both
claims denied and rejected are often the result of untrained staff. With the
ICD-10 codes being quite confusing, the medical billing becomes a challenge
creating a long and short-term revenue issue.
Any
physician must keep its revenue flowing and stop the denials and rejections to
ensure the practice thrives. So, the more you have correct billing and coding
in place a practice will notice the patterns where the errors are occurring,
which they need to correct.
However,
correcting and staying at the top of the changing rules and regulations
regarding billing and coding is essential.
Some
Common Mistakes Made In Coding and Billing
When
you are a physician practicing in a small or independent facility, often these
are some of the common errors that can happen that cause claims to be rejected
or denied. You need to ensure that these mistakes are avoided.
•
Incorrect documentation
•
Hurried intake
•
Missed information about
the patient and the coverage
•
Unbundling
•
Upcoding or under-coding
•
Duplicate billing
•
Overuse or wrong use of
modifiers
•
Improper coding
The
Importance of Medical Coding In Billing
Medical
coding is the process in your practice where the services you offer to a
patient as a physician becomes billable revenue. Since each service offered has
its corresponding Current Procedural Terminology (CPT) and codes related to the
Healthcare Common Procedure Coding System, they must be appropriately
mentioned.
The
physician needs to submit proper CPT and the codes for the claims of the
services to Medicare, Medicaid, and other insurance companies for payment.
Failure to quote the correct codes will cause denial delay or partial payment
of the reimbursement amount. This can lead to the practice of building up a
cache of delayed or denied reimbursement with loads of paperwork. The situation
can quickly become stressful for you, but there is an immense loss of revenue
in practice. Eventually, it might lead to you having to close the service.
Any
miscoding for a procedure can create a difference in payment between $10 and
$10,000. However, it is not only the loss of money, but the loss of reputation
can also happen due to incorrect medical billing and coding.
How
To Ensure You Get Paid For Your Work?
As
a physician, we know you are swamped with patients and treating them. This
gives you very little time to take care of the medical billing and the coding
process without compromising your time with the patients. Many things need to
be taken care of when it comes to correct medical billing and coding. Also,
keeping a staff looking after the billing procedure can be expensive as a small
practice. The answer to all these woes is to hire an experienced third-party
billing and coding company like 24/7 Medical Billing Services.
The
company has dedicated staff to oversee all the coding and billing. They also
uphold the knowledge of the latest changes in the system. Furthermore, they
have revenue cycle management that can ensure you are never bleeding money and
the claims are always full proof. They also have the option to scale the system
as your practice grows.
Contact
24/7 Medical Billing Services today to ensure comprehensive revenue collection
for your practice.
About
24/7 Medical Billing Services:
We
are a medical billing company that offers ‘24/7
Medical Billing Services’ and support physicians, hospitals, medical
institutions and group practices with our end to end medical billing solutions.
We help you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow physicians to attract
additional revenue and reduce administrative burden or losses.
Contact:
24/7
Medical Billing Services
Tel:
+1 888-502-0537
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