As a medical practice, it is your duty to minimize any processing or coding errors in your billing, the reason it is recommended to hire reliable medical billing solutions professional services company. While you may deliberately not make a billing mistake, you could still be held liable by law and penalized.
Billing mistakes are quite common than you may think. According to ABC News, medical bills that total more than $10,000 are likely to contain $1,300 in error. The reason is the complicated nature of medical billing. Managing and tracking these processes and the codes could be daunting.
Here are a few billing mistakes that medical practices are guilty of:
Upcoding
Upcoding is when a patient is charged for a treatment that is much more expensive than the one they received. A common example is a patient being charged for a branded pharmaceutical product when the treatment entailed the use of a generic medicine.
Court considers this illegal and deems it as fraud if the patient decides to take the health care provider to court.
Unbundling
This happens when a patient is charged with two or more separate treatments at full cost. When the treatments were somehow complementary and the patient should have been billed at a package rate.
This usually happens when a patient has to undergo a series of tests in order to determine their ailments, and all the tests were in connection to each other.
Duplicate Medical Billing
Court considers duplicate medical billing, when there are multiple individuals involved in the billing process.
This mainly happens when a patient has to visit the clinic multiple times, and is billed on the first visit as well as the subsequent visit.
The patients often end up paying for the bill, as they think that the bills refer to different treatments, or are per visit costs. This is again fraud in the eyes of the law.
Balance Medical Billing Solutions
Negotiations between insurance companies and medical practices are nothing new. Insurance companies try their best to lower medical bills when they are supposed to cover policy holders. However, if the insurance company is liable to pay for the full medical cost, the medical practice has no right to bill the patient for any amount.
Medical practices sometimes send their patients with a balance bill, claiming that a certain amount of the bill was not covered by their insurance company. This is outright fraud, whether done by mistake or not. Patients often think that their insurance coverage was limited and end up paying the balance.
Incorrect Information
Any inconsistency in the patient information could lead to a denial of insurance for the patient; this could be as simple as a typo in the name. There are various forms that a patient as well as the medical practice need to fill. Therefore it is imperative that all parties remain vigilant when filing any sort of information.
The best way to steer clear of these mistakes is to hire professional medical billing services.
A&B Solutions provide affordable medical billing solutions to small and medium sized medical practices.
A&B Solutions helped many clients over the past few years and are known for our commitment to professionalism and friendly business support. For more details call 954-596-9966.