One of the major concerns of the healthcare industry is the medical billing issues that arise from lack of expertise and common errors committed by inexperienced billing staff of the providers. Since the in-house staff of the healthcare practices is already overloaded with patient care and other administrative work, the billing responsibilities get impacted in a negative way, which results in making errors. Add to it, their lack of training and inability to update themselves consistently. All these lapses arise from the reason that most of the providers cannot afford to arrange regular training due to their limited budget. Employing specialist under their payroll is another unwise option in this high-minimum salary phase the industry is passing through. Errors in particular result in rejections and denials causing revenue loss.
This is where reliable medical billing services like GoTelecare come and bridge-in the gaps. The focus remains on ensuring that the provider gets proper reimbursement for the services rendered by them. As discussed, errors, both human and electronic are the key reasons behind unsuccessful claim settlement and/or payment collection. Here’s how GoTelecare addresses some of the most common errors in medical billing:
Unbundling: Unbundling arises when the coder lists different billing codes for charges falling under one-single billing code. This causes inflated bills because the items were supposed to be billed at a package rate.
Coding issues: Our experience coders eliminate the usual coding issues of entering wrong codes. This sounds simple but in reality the confusing ICD, CPT, or HPCS codes; conflicting modifiers to HCPCS or CPT codes, etc. create a lot of problems. Add errors like upcoding to these, which refers to improper changes in a medical billing code. To be precise, upcoding is using the code applicable to a more severe diagnosis or treatment in place of the real, less critical one.
Duplicate Billing: Sometimes multiple bills are generated for the same procedures or services resulting in duplications.
Balance billing: Balance billing is particularly very shocking for the patients as this is an extra bill sent to the patient even after the insurance company has paid the negotiated price with the provider and every charge is already covered under the patient’s policy.
Incomplete diagnosis information: Provider failing to provide the coder with enough information about the diagnosis results in wrong medical diagnosis code being used in the bill. This can lead to denial of the claim.
Wrong patient information: This consists of mostly human errors like typing patient’s name incorrectly, wrong policy ID entered etc.
Mismatched Codes: Mismatches between the treatment and diagnosis codes often form the reason for rejections.
GoTelecare through its seamless revenue cycle management and other medical billing solutions ensures seamless claim settlement and maximum account receivable recovery. Our a la carte medical billing service priced at the lowest in the market suits practice of all sizes making it absolute convenient for the providers.