Top Five Most Usual Errors of Medical Billing & Coding

Are the claims submitted by the department of your medical billing is accurate? Provided the medical coding system’s complexities, it is not surprising that errors and mistakes are made.

Regrettably, even errors of small extent can lead to claim denials and payment delays.

In regard to being expensive for your hospital, these kinds of errors can also have a worse impact on your relationship with sufferers. Ignoring the common errors of medical billing and coding will assist to mitigate your error rate and keep your sufferers happy.

Top 5 errors usually made by hospital medical billers.

The errors might also occur if physicians do not give accurate diagnosis information.

  1. Upcoding

It occurs when sufferers are billed for more complicated processes than they really received or bills are submitted for such services that were never conducted.

The errors of upcoding can occur if the worker of billing department makes a mistake when entering diagnosis and treatment codes or if the worker is confused by the information given by the physician.

  1. Less Data

Unsuccessful to give information to payers to support claims results in denials or delays. For example, issues can occur if the workers of billing department do not link a diagnosis code to the CPT (Current Procedural Terminology) or Healthcare Common Procedure Coding System (HCPCS) code or do not add a 4th or 5th digit to the diagnosis code.

  1. The mistakes in Telemedicine Coding

The technology of healthcare makes providing quality care to patients in several locations much convenient, but it also complicates the procedure of billing.

Modifiers’ wrong use for telehealth services results in common payment delays.

  1. Wrong Procedure Codes

The fingers’ simple slip can outcome in the wrong entry of a procedure code. Information might also have been wrongly documented on encounter forms or other supporting documentation. If claims are often returned to your hospital because of wrong procedure codes, your workers might not be following the newest coding rules.

  1. Missing or Wrong Information

Omissions or errors are a usual cause of claim denials and can be stopped by double-checking all fields simply before the submission of a claim. Wrong or missing patient names, birth dates, addresses, insurance data, sex, dates of treatment and onset can all cause issues.

However, it might not happen that frequent, sometimes information is entered in the incorrect patient’s record accidently. If the workers of billing only enter the information as given and do not investigate mismatches in diagnoses and treatments, a claim denial will follow. Sadly, in busy departments of billing, these issues can be simply overlooked.

Leave A Comment?