Avoid these Medical Billing Mistakes for a Successful Revenue Cycle

  • May 12, 2017

  • Effective revenue management ensures that healthcare providers can focus on giving quality care to patients. However, providers often struggle to bill effectively. Below are the most common errors that prevent healthcare providers from billing properly and collecting on money that the practice is owed.


    Gathering incorrect patient information

    The gathering of patient data is the framework upon which claims can be submitted and paid. A simple error such as a misspelled name or an incorrect date of birth will result in a denied claims payment. It should become a habit for administrative staff to double-check the accuracy of information gathered during the initial consultation with the patient.


    Neglecting to check the patient's insurance coverage

    In the last quarter of 2016, the American Hospital Association reports that 43 percent of hospitals in the U.S. have spent more than $10,000 on managing claim denials, while 26 percent have spent more than $25,000.

    Each time a patient schedules an appointment, it is of the utmost importance to validate the patient’s insurance plan and eligibility. The following questions can serve as a guideline for administrative staff when evaluating eligibility:

    • What is the patient’s responsibility regarding the cost of the visit?
    • Does the patient have valid insurance that is accepted by your practice?
    • Does the patient have additional insurance?
    • Is all patient registration information correct?

    Not advising patients of their payment responsibility

    The amount of high-deductible insurance plans has increased greatly in the past five years, which means that patients are taking on a greater burden in payment of their medical bills. Additionally, the cost of collecting payments from patients is higher than that needed to collect from payers, as it requires more time and money. This need for more resources is placing an even greater financial strain on practices that are already struggling to collect payments and bring in owed revenue.

    Clearly inform patients of their financial responsibility and of any balance due, and collect at least a portion of this balance at the time of the visit.


    Manually submitting claims

    The implementation of the new ICD-10 billing code was not as traumatic as anticipated. However, the American Health Information Management Association (AHIMA) has identified several recurring mistakes in submitted claims, and it will take some time for administrative staff to become proficient in the new code as well as the new documentation practices. Billing errors due to manual reporting can result in a significant loss of income and productivity.


    Billing in-house when your staff is overworked

    Administrative processes become less efficient and billing mistakes are more likely to happen when a practice’s workload is high. Keeping up with annual medical code revisions and billing practices may overwhelm your staff.

    Outsourcing billing services decreases labor costs and increases claims payments, and overall revenue for practices, and clinics.

    To learn more about how RevPro Healthcare Solutions medical billing services can help you make more money, limit overhead expenses, and make your practice more efficient, contact us below or call us at 561-578-8400.