As a nurse practitioner, therapist, or chiropractor, it is important to be aware of the potential medical billing mistakes that can cost you money. These errors are easy to make but can have significant financial repercussions if not addressed promptly and correctly.
Here are five common medical billing mistakes that should be avoided in order to save time and money for your practice.
1. Not Knowing Your Insurance Company’s Rules
It is essential to know the specific rules of each insurance company with which you do business. This includes understanding their reimbursement policies as well as their coding requirements so that all claims submitted are accurate and up-to-date with current codes and regulations. For example, it is essential to understand the rules for filing out-of-network claims versus in-network claims with your insurance provider; some providers may require preauthorization or other documentation before allowing reimbursement for out-of-network services.
2. Incorrect Coding
It is also important to be familiar with the various coding systems used by insurance companies, such as ICD-10 and CPT codes, which are used to accurately describe medical procedures and conditions. Inaccurate coding will cause delays in reimbursements or denials due to incorrect information being sent on the claim forms resulting in rejected claims by insurers. Therefore, it is important to ensure accuracy when submitting codes for procedures performed during patient visits so they match what was actually done during the visit itself.
3. Poor Documentation Practices
Poor documentation practices can lead to inaccurate diagnoses or procedure descriptions which could result in denied claims from insurance companies due to lack of sufficient evidence provided on the claim form. For instance, a practitioner may not provide the patient's name and the date of service on their claim form, or they may not include enough information about the diagnosis and/or treatment code(s). Furthermore, they may simply write “check-up” or “follow-up visit” instead of specifying the exact procedure performed, such as physical therapy or chiropractic care. It is important for practitioners to document the diagnosis and/or treatment code(s) accurately and provide detailed information regarding all services performed during each patient visit. This should include details such as the patient's name, date of service, type of service rendered (such as physical therapy or chiropractic care), amount charged for the service(s), any additional medical materials used (such as splints or braces), any medications administered to the patient, and any other relevant information related to the visit.
4. Failure To Follow Up On Reimbursements
When insurance companies do not process claims promptly, it is important to follow up on each claim to ensure that the necessary documentation has been received and the reimbursement has been processed. One example of how to do this could be by calling the insurance provider directly to inquire about the status of the claim. The practitioner should have their patient's information, as well as any relevant details about the service rendered (e.g., date, type of service provided), billing codes used and amount charged for the service(s). During the call, it is important to confirm that the insurer received all necessary documentation regarding the claim. If they did not receive all necessary paperwork or if they need additional information in order to process payment, then it should be made available as soon as possible.
5. Neglecting To Check For Duplicate Billing
It is easy to inadvertently double bill for a procedure or treatment when submitting multiple claims for one patient visit. Therefore, it is important to check all claims submitted for accuracy prior to submission in order to avoid any unnecessary duplication of billing. One example of how to check for duplicate billing includes verifying that the patient's name, service date, and type of service provided are all accurate and match up with what was actually performed during the visit.
Getting paid by insurance companies for the services you provide can be a challenge. There are many moving parts and it's easy to make mistakes that cost you money. In this blog post, we've identified five common billing mistakes that can cost you money. If you're struggling with getting reimbursed by insurance companies, or if you'd like to avoid making these mistakes in the future, schedule a consultation with us. We can help you get on track and ensure that you receive the payments you deserve. Contact us today.