Medical Billing Problems and Their Solutions - I-conic Solutions

Medical Billing Problems and Their Solutions

Every physical therapy practice must perform medical billing. Even when something is a priority, issues might arise that slow down your cash flow, cause claims to be denied, and put you in a bad financial situation. The secret is to use practice management software that lowers the likelihood of billing issues. Clients frequently approach us for recommendations for remedies when issues arise. Here are seven typical issues with medical billing and their fixes.

Incorrect Patient Identifier Information

Even a small diversion can result in mistakes when inputting patient data into your medical billing system. Nonetheless, every healthcare professional is aware that insurance companies often reject claims for little inaccuracies like incorrectly spelled patients’ names or dates of birth. There are two approaches to solve this issue and stop it before it starts. The first is to guarantee that each entry you make is accurate by checking it twice. The second is to select practice management software that will automatically fill up the patient bill with their verified information. There is almost no risk of this kind of error delaying a payment if you have patients enter their own information and validate it with you before their first first evaluation appointment.

Missing Information

Another typical error is omitting crucial information from a claim, including the patient’s birthday or the date of the accident. Even if the patient has coverage and there is no erroneous information, a blank field may result in an insurance company denial. The remedy is to check your claims to make sure there are no blank fields or missing information before submitting them. It’s your best chance to discover errors before they result in a drawn-out rejection and resubmission process.

Improper Coding

We are confident in stating that one of the most frequent and time-consuming errors committed by physical therapy firms involves inaccurate coding of medical claims. There are a number of causes for claims being incorrectly coded, including:

  • Using dated coding manuals
  • Charges that should be handled separately but fall under the same procedure code
  • Overcharging and undercharging
  • Incompatible codes
  • Omitted codes
  • Submitting claims using CPT codes that are not approved by your insurance provider

Upbilling and underbilling can happen accidentally as well as through fraud. The answer is to select a medical practice management system with updated coding automation that complies with current coding standards. It is simple to shorten billing time and eliminate errors by using software that can only list codes specific to each medical insurance provider. The likelihood of an error being made by your employees is significantly decreased when they can quickly check up diagnosis codes and procedure codes

Missing Documentation

To settle claims, all insurance companies require documentation. Without it, they might just reject a claim and send it back to you; in that case, you’d have to resubmit the claim with the required supporting documents. Making sure your staff is adequately taught to understand when paperwork is necessary to demonstrate medical necessity is the answer. Your billing software should ideally make it simple for you to submit documents along with a claim.

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