Costly Mistakes Every Medical Billing Department Can Avoid

October 27th, 2022 - Find-A-Code
Categories:   Coding   Compliance  

No business owner likes mistakes. Mistakes cost time and money to fix; they harm a company's reputation; they are bad news all around. Every private practice and healthcare clinic with an in-house billing department knows exactly what we're talking about.

Medical billing is arguably one of the most complex enterprises in all of healthcare administration. Medical coders and billers have tens of thousands of codes to worry about. The billing office has insurance carriers and patients to deal with. And of course, less than stellar EMR software doesn't make life any easier.

Codes, Codes, and More Codes

If you work in medical coding or billing, you know that the very thing that powers your employment can also be the bane of your existence. What is that thing? The medical code. And it's not just one code, it is tens of thousands of codes encapsulated in:

All it takes is one code mistake to gum up the works. Some codes are outright wrong for whatever you are trying to bill for. Other times, you might not realize you could choose a more specific code. At any rate, you live and die by medical codes.

Under-Billing Patients

As long as we are talking about medical codes, we should probably mention the mistake of under-billing patients as a result of not fully understanding the coding system. Under-billing is not particularly unusual when a billing department has a fairly new staff without a lot of experience.

There is a lot to learn about medical billing that isn't taught in school. Much of what billers do in the real world is only learned on the job. So it's a mistake to operate a billing department without at least a few veterans to guide the way as supervisors.

Filing Claims in a Timely Manner

Private practices and clinics that handle medical billing in-house can actually lose money by not filing claims in a timely manner. As you know, claims have deadlines. Fail to meet a deadline and no reimbursement will be forthcoming.

For a busy private practice that has a hard enough time handling daily patient loads, billing may fall by the wayside. A lot of money could be on the line by the time the billing department realizes it has fallen behind.

Not filing in a timely manner is a very costly mistake. It is also one that can be avoided with the right policies in place and the resources to get the job done.

Do Not Forget to Check Insurance

Medical billing exists because we utilize private health insurance to pay medical bills. With that said, it stands to reason that private practices and clinics strive to routinely update their patients' insurance information. Most do, which is why the receptionist asks about your insurance every time you visit.

Though most private practices and clinics routinely check, not all do. This is yet another costly mistake. Continually sending bills to the wrong insurance company creates a logjam that eventually needs to be untangled. And when the billing department is up against deadlines, not getting it untangled fast enough only compounds the problem.

Here at Find-a-Code, there isn't much we can do to help private practices and healthcare clinics avoid making costly mistakes in the medical billing department. What we can do is provide fast, easy, and accurate code lookup through our online database. Medical billing codes are our business. It is what we do. Give our code lookup engine a try and see for yourself. We suspect you will be pleased with the results.


Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.

Latest articles:  (any category)

Artificial Intelligence in Healthcare - A Medical Coder's Perspective
December 26th, 2023 - Aimee Wilcox
We constantly hear how AI is creeping into every aspect of healthcare but what does that mean for medical coders and how can we better understand the language used in the codeset? Will AI take my place or will I learn with it and become an integral part of the process that uses AI to enhance my abilities? 
Specialization: Your Advantage as a Medical Coding Contractor
December 22nd, 2023 - Find-A-Code
Medical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.
ICD-10-CM Coding of Chronic Obstructive Pulmonary Disease (COPD)
December 19th, 2023 - Aimee Wilcox
Chronic respiratory disease is on the top 10 chronic disease list published by the National Institutes of Health (NIH). Although it is a chronic condition, it may be stable for some time and then suddenly become exacerbated and even impacted by another acute respiratory illness, such as bronchitis, RSV, or COVID-19. Understanding the nuances associated with the condition and how to properly assign ICD-10-CM codes is beneficial.
Changes to COVID-19 Vaccines Strike Again
December 12th, 2023 - Aimee Wilcox
According to the FDA, CDC, and other alphabet soup entities, the old COVID-19 vaccines are no longer able to treat the variants experienced today so new vaccines have been given the emergency use authorization to take the place of the old vaccines. No sooner was the updated 2024 CPT codebook published when 50 of the codes in it were deleted, some of which were being newly added for 2024.
Updated ICD-10-CM Codes for Appendicitis
November 14th, 2023 - Aimee Wilcox
With approximately 250,000 cases of acute appendicitis diagnosed annually in the United States, coding updates were made to ensure high-specificity coding could be achieved when reporting these diagnoses. While appendicitis almost equally affects both men and women, the type of appendicitis varies, as dose the risk of infection, sepsis, and perforation.
COVID Vaccine Coding Changes as of November 1, 2023
October 26th, 2023 - Wyn Staheli
COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.
Medicare Guidance Changes for E/M Services
October 11th, 2023 - Wyn Staheli
2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....

Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association