Patient billing is critical to the financial health of an independent physician practice. When billing errors are made, revenue can be lost and severe consequences can result. Errors in Medicare and Medicaid billing, for example, are not tolerated and can actually result in the practice not being allowed to bill those entities for several years if negligence is discovered in the billing process.
Financial ramifications of medical billing errors can be substantial. Access Project, a Boston-based healthcare advocacy group has found that up to 80% of all medical bills have errors in them. In addition, Kaiser Health has reported that medical billing errors account for $68 billion in lost healthcare spending.
How can independent physicians reduce their rate of medical billing errors? Fierce Healthcare offers several suggestions, specifically in regard to receiving proper reimbursement for claims:
Ensure that patient data is correct. Verify that names, policy numbers, birthdates, and all pertinent information on the bill are accurate and current. Sometimes even the placement of a different middle name can cause a claim to be rejected.
Use technology. Billing features in electronic health record (EHR) systems can help the independent physician automatically check for errors in billing before the bill goes out. Maintaining accurate patient data in the EHR can further prevent errors in patient information contained in claims. Data in the patient’s EHR only has to be entered once, so the potential for error is significantly reduced and virtually eliminated.
Keep clinical staff informed. Healthcare is changing. Medicare and Medicaid regulations continue to change as well. Independent practices should “conduct regular training about coding and billing updates and other changes.”
Stay aware of the trends that may be occurring. The independent physician should review billing errors on a regular basis, as often as weekly, to determine if there is a pattern. Those errors should be addressed with staff so they can be corrected and not repeated.