Most Common Factors that Slow Down Imaging Center Billing Services?
Medical billers and coders are crucial to the healthcare industry. By carefully documenting patients’ treatments and procedures they keep Imaging Center Billing Services on track. They carefully submit medical bills to the insurer, who then pay claims. When medical billers or coders make errors it may result in denials, delay in the reimbursement process, loss of huge revenue, affect patient care, etc.
No doubt, errors are bound to happen even in a professional environment- especially when dealing with thousands of medical codes. But keeping in mind the most common mistakes can help you to avoid such errors in the future. Because these types of mistakes not only impact your business efficiency but also negatively impact your business overall reputation.
However, medical claims can be denied due to several reasons and many of them are due to wrong coding and inaccurate claims submitted which is the foremost reason for claim denials. Below listed are the 6 common medical billing and coding errors that need to be prevented for the smooth operation of RCM.
1. Poor or Missing Documentation-
In Imaging Center Billing Services it’s the major reason for claim denial. Sometimes a healthcare care service provider does not give enough information about the procedures and enters illegible information. A claim request may be submitted incorrectly unless the coder or biller directly contacts the healthcare service provider. It can also happen due to the employee’s mistakes.
2. Incorrect Patient’s Information-
Missing or incorrect necessary patient information is one of the common reasons for claim denial. This may include missing patient name, home address, job descriptions, multiple phone numbers, birth date, sex, etc, which cause serious problems. But you can easily rectify these problems if you double-check each claim before submitting it to the payer.
3. Failing to Verify Patient Insurance Coverage-
From case to case patient’s health insurance can vary drastically. Sometimes without a patient knowing, insurance coverage can change. Failing to verify the patient’s healthcare insurance coverage can lead to surprise medical bills. Which is one of the least welcome events in a patient’s life. If a patient will blame you for not verifying the healthcare coverage beforehand it can make your practice look bad or negatively impact your business reputation. This is one of the most essential steps so don’t skip it to keep your Imaging Center Billing Services running smoothly.
4. Coding Errors-
In the Imaging Center Billing Services medical coding acts as a backbone. Unfortunately, wrong coding is one of the biggest problems in the medical billing process that results in heavy penalties, fines, and even in serious cases in prison. However, the most common coding errors are; upcoding, under coding, unbundling, mismatched codes, NCCI edits not checked, unlisted codes, and use of inappropriate modifiers. It is very important to send the claim only once. So rechecking or going back to make changes before sending a medical claim to the insurance company is good to avoid denials.
5. Failure to keep up with Insurance payers-
If a claim request has been incorrectly submitted, it may result in errors. When processed, the insurance company rejects or denies that claim and does not pay the bill as written. However, a medical claim may be denied if the insurance company determines the charge or procedure is not payable. It negatively impacts the patient-provider relationship (I.e., using a high-tier prescription that is not covered or an out-of-network provider). Denial can be appealed but it can take much time, effort, and maybe expensive.
6. Lack of Staff Training-
Lack of proper training and education is also one of the big reasons to claim denial. Medical codes are eliminating, changing, and modifying quarterly or monthly basis. If your billing staff is not staying updated on constantly changing billing and coding regulations it can result in errors and denials. When you implement new billing technology into the medical billing process make sure that your staff knows how to use these tools. You can also provide training that helps to improve their efficiency and reduce the chance of errors.
Key Takeaways:
Thank you so much for reading this article. I hope this article helps you to rectify and know common billing mistakes. In case you want any kind of information about Imaging Center Billing Services contact Medcare MSO. Our professional billers and coders will be happy to help you 24/7 and make your collection process smooth. We have a 95% success rate in overturning denials and collect 35% more for our clients, on average.
