Five Ideas for Fixing Common Billing Errors

Medical billing errors not only waste a lot of time, but will delay payments and raise red flags. While that’s the bad news, the good news is that many of these billing errors can be avoided. Here are five ideas for fixing common billing errors.

Confirm patient information.

Incorrect patient information is one of the most common billing errors and the most easily remedied. Minor errors in a patient’s name or birthdate can have a huge impact and will result in a claim being denied. Every patient visit should include patient information verification to avoid wasted time and denied claims.

Verify benefits.

With a returning patient it can be easy to input old benefit information and assume it’s still valid. So much can change between visits so it’s crucial to check with each patient every visit and confirm coverage, co-payments and other important insurance data.

Keep up on coding.

Coding diagnoses changes every year. To avoid confusion and claim rejection, keep up on these changes and make sure your staff is using the most recent coding book. While it’s important that your entire billing staff is properly trained, have a staff member specifically assigned to coding and checking for potential errors. To help aid this process, ensure all of the physician’s documentation supports the coding as well.

Understand the insurance policy requirements.

Each insurance policy is different and specifies the process for billing medical services for reimbursement. Failing to comply with the required procedure is a red flag that greatly increases the possibility of rejection. Since each policy is unique, it is essential that submission details are thoroughly reviewed before making a claim. It is also a good idea to have a specific team member serve as the claims person with obligation of staying informed of billing issues.

Don’t miss deadlines.

Most insurance companies require that claims are submitted within a certain number of days after the service. These limits vary, but in every case the deadline is officially reached when the insurance carrier receives a claim. If you submit a claim with incorrect information, the claim will be denied. It’s possible to fix the error and resubmit with the correct information, but there is now a risk it will be denied for late filing. For obvious reasons, it’s crucial to file in a timely manner.

Medical billing errors are expensive mistakes that result in lost revenue and profit. The key to fixing these issues is understanding each insurance policy, keeping up to date with changes, being extra cautious with data entry, and properly training your staff. Take the time to organize quality-control policies and make sure your staff recognizes the steps they need to take to keep your practice’s billing as seamless and as accurate as possible. If you have any ideas for fixing billing errors, let us know on our Facebook page.

Posted by
  • As a speaker at the first ad hoc meeting of rheumatology practice managers gathered in a single small room at its infancy a decade ago, I’m amazed to see how NORM has blossomed into a high energy organization of depth and professional meetings with parallel break-out symposia between plenary sessions. NORM has truly come of age. This is where the “business” of rheumatology gets learned. The ”guildmanship” for rheumatology practice management is now strong.- Paul H. Caldron, DO, FACP, FACR, MBA, Arizona Arthritis and Rheumatology Associates
  • In a time of demanding changes in the management of medical practices in the US, NORM has been a lifesaver to the community of Rheumatology practices.  NORM has allowed our practice to stay ahead of the many demands of CMS and others payors and has ensured that our practice remains cognizant of new issues that arise in HIPPA compliance, human resources and medical billing to name a few. Sending our Practice Manager to NORM's conferences has been cost-effective and beneficial to our practice because she returns to our office with an abundance of information that otherwise would have taken months to compile. Every Rheumatology practice that wishes to stay on top of emerging issues in practice management should consider sending a member of their staff to NORM's conference.- Michael S. Rosen M.D., Chester County Rheumatology PC
  • Thanks to all those wonderful people in the NORM Network who respond to emails, offering their advice, experience, time, and support ... I haven't even been a member a full year yet and I am amazed at the dedication of everyone who responds to helping via emails and the NORM Organization itself! I have barely had a chance to explore the resources and I have yet to really dive into requests for help still I am silently learning so much and do occasionally offer what I can! Thank you all!- Cheryl Piambino, Kenneth E. Bresky, DO

What We Offer

We’re adding value to practices across the nation by creating a thriving community of rheumatology managers and physicians.

Membership Benefits

Become a Member

Annual Conference

Conference Registration

The latest industry developments are at your fingertips.

Subscribe to the Rheumatology Practice Management newsletter for more innovation.