How to Correct Medical Billing Errors

Medical billing is of utmost importance incharge and reimbursement process. Without correct medical billing, hospitals cannot get reimbursement for insurance claims made by a lot of patients. It is because a lot of people claim to have health insurance but not every claim is true. It is, therefore, the medical biller should not overlook any error in the billing process. Incorrect medical billing can affect the hospital’s revenue cycle. The errors in the medical billing and collection services may be minor but overlooking them is not good for the hospital’s finances. Therefore, it is important to correct billing errors. The following are the ways to avoid or correct billing errors to boost the revenue cycle of the hospital.

Correct Documentation

Documentation in a hospital’s record includes patient information, provider information and correct insurance details. The medical biller must enter correct patient information to keep track of all the medical services and charges. Incorrect details may make it tough to verify the details for reimbursement purposes. Therefore, the medical biller must cross-check the information before documenting it.

Pay Attention to Medical Codes

While billing the medical biller must make sure that the codes are entered properly. Incorrect, mismatched or overlooked medical codes can affect insurance claims. It is because the patient and insurance payer are charged for the treatment as per the medical codes used in the hospital. The medical biller should stay updated with the latest medical codes to generate the correct bill.

Avoid Under-coding/Up-coding

One may think that only insurance claims lead to fraud. But medical bills can also be manipulated to cause fraud. This is where under-coding and up-coding comes in. When the medical biller intentionally eliminates a procedure code from the bill then it is referred to as under-coding. On the other hand, adding false procedure code to the bill is referred to as up-coding. The former helps a patient to save money whereas the latter extracts more money from the patient. The medical biller should avoid such fraudulent practices and charge the patient only for the procedures/treatments that he/she has received.

EOB or Explanation of Benefits is a Must

Other than incorrect documentation, a lack of explanation of benefits can also result in a denied claim. Therefore, the medical biller must attach EOB with an insurance claim to prevent any denial.