Billers everywhere know all too well what it feels like to get a rejected or denied claim returned to them. What many don’t realize, though, is there are very real, achievable ways to reduce the amount of claim errors they see. The best part is it only takes a little extra time and effort to ensure claims are clean before they’re submitted. But first, it’s important to understand why a claim might be rejected or denied. Below are some of the most common errors medical billers face:
Missing or incomplete information
If enough information isn’t collected at the beginning of an appointment, it can result in incomplete or missing fields on the final claim. Missing information on a claim will cause an immediate error, as will any incomplete or incorrect data. This is a very common error billers see, but it’s also a preventable one.
Invalid insurance coverage
It’s crucial to verify insurance information before a patient’s appointment. This includes checking that both the provider and the coverage have remained the same. Many providers make the mistake of only asking for this information when a new patient arrives, but it’s equally important to check existing patients’ coverage. If this step is overlooked and coverage has changed, a claim could be rejected or denied, resulting in a potentially lengthy appeals process.
Under coding and up coding
These practices are both purposeful and fraudulent. It’s important to note that providers found intentionally undercoding or upcoding could face serious charges. Undercoding is the process of reporting that a procedure was less expensive than it truly was, and upcoding is the opposite—charging more than the procedure is worth. It goes without saying that billers should stay away from these practices, but they do happen from time to time.
These errors are small, common issues that typically occur due to lack of attention to detail. They include but aren’t limited to incorrect patient data, provider details, insurance information, mismatched codes, and duplicate billing. One of the best ways to prevent these problems is by using non-emergency medical transportation billing software.
Reduce billing errors with the right billing software
Humans make mistakes, and too many mistakes can be costly. The right billing software puts you on track to reduce claim errors and improve your efficiency. Every business is different, so the team at iSi Technology offers a host of solutions that cater to different disciplines across the healthcare industry. From medical dispatch software to NY Medicaid Billing solutions, we have something for everyone. Get in touch to schedule a demo today!