Medical billing is meant to be a system that is smooth and timely, making sure all bills are paid on time and the revenue stream is adequate, allowing medical facilities to operate as normal. And while this is the case most of the time, issues can occur and medical overpayments can happen. The problem with this is that you start to look bad in the eyes of your patients who begin to question their trust in you, your facility, and your system as a medical professional.
Because medical billing overpayments are something you can’t sweep under the rug or push aside, it’s important to not only refund the difference but also figure out why it’s happening. Here’s a look at four common causes of medical billing overpayments.
An Issue with the Benefits
Many patients have medical insurance coverage and while that is certainly helpful from a financial point of view, it can cause issues with billing and paperwork. It’s quite common for there to be a mistake made when coordinating benefits. Each provider has its plan with its details, rules, limits, and restrictions. These can also change over time, so the billing department of your healthcare facility must take care when running claims through the system.
The Medical Billing System Isn’t Adequate
This is also a great opportunity to take a closer look at the medical billing technology and systems you are using and ask yourself if they are good enough? Technology advances at a rapid rate, and before you know it, your software is not only outdated but obsolete. If that becomes the case, then accurate medical billing will be much more difficult to achieve.
Using the Wrong Medical Billing Codes
When it comes to the most common mistake made, inaccurate medical billing codes are often the culprit. A simple misunderstanding, reading the chart wrong, or keying in the wrong code can lead to the mistake. These mistakes while easy enough to make, can be time-consuming to find.
The Staff Aren’t Comfortable with the Billing System
Perhaps you have new hires in place or staff that were never fully or adequately trained in the medical billing system. These systems tend to be quite complex so without knowledge and experience, it’s easy to see how human error can occur. Staff may think they are following the correct steps, but they aren’t.
Have a Medical Claims Audit Conducted
These are just a few of the many issues that can go wrong and cause medical billing overpayments. This is exactly why it can be worth it to have a medical claims audit conducted to ensure such things as medical claim pricing accuracy, collections, overpayment analysis, and more. This is how you ensure things move forward in an organized and accurate manner.
Mistakes Can Happen but They Need to Be Limited
The fact is that mistakes can happen, things don’t always run perfectly but when it comes to medical billing healthcare practices need to aim high and do everything in their power to ensure billing overpayments aren’t occurring.