The American Medical Association has estimated that medical practices and hospitals lose 11% of their total revenue on average each year because of underpayments. Here are a few errors you might be making in your medical billing and coding process.

Duplicate Billing

As the name suggests, this error occurs when certain services or procedures or services are billed more than once, resulting in a duplicate bill.

This can happen if two separate staff members include the usage of a particular medication or procedure, without knowing that it has already been accounted for. Often, hospitals end up billing medication at time of prescription as well as when it is administered, making for two separate charges for the same thing.

Upcoding

If the medical bill is altered to show an inaccurate and improper adjustment, it results in upcoding. For instance, if the bill represents a more severe diagnosis or a more expensive treatment plan than the actual one, the billing is calculated according to the changes made.

Making alterations that misrepresent the actual information is illegal and causes inflation of the billing system.

Unbundling

Unbundling is when separate categories are made for certain charges that would otherwise be listed together. This again misrepresents the data and can make the bill appear to be a lot higher as all the different categories are charged separately art different rates.

For instance, if various medical tests are billed separately despite falling under the same code, it counts as an unbundling error.

Lack of Medical Necessity

Failure to obtain sufficient information about the diagnosis and treatment plan of the patient can also result in a grave billing error. Not having the right information can lead to a wrong medical diagnosis code being used in the bill, making for an inaccurate billing.

Incorrect Patient Information

Incorrect patient information such as spelling errors or typos in the patient’s name can also cause medical claims to be denied. Minor inaccuracies and errors in patient information can have a huge impact on billing and delay the process considerably.

This is why it’s imperative that data collection is done thoroughly and is double-checked to ensure there aren’t any inaccuracies. This includes the patient’s demographic information, diagnosis, treatment plan, and medical insurance information.

Failure to Verify Insurance

If the patient will be relying on insurance to pay their bills, their coverage needs to be verified. Insurance policies tend to fluctuate, and to ensure accurate billing and coding, the patient’s eligibility status and benefits must be inspected.

Want to improve your medical billing process and avoid costly coding errors? Get in touch with A&B Accounting and Business Solutions, LLC.

As a leading medical billing solutions provider in South Florida, our team of certified experts will guide you through effective billing strategies for your practice.

Contact us today to discuss your medical billing needs and learn about our professional accounting services in detail!