In today’s healthcare market, even small billing mistakes can make a significant difference in a physician’s income. Physician practices lose thousands of dollars annually due to neglected errors that cause payment delays or denials. Familiarity with the following common errors is essential to having healthy cash flow and efficient physician billing systems.
Incomplete or Inaccurate Patient Information
One of the easiest and most prevalent physician practice billing problems is incorrect patient information. A minor typo on the insurance ID, birthday, or policy number can lead to rejection of claims. Too often, personnel hurry to complete intake forms or do not bother to verify information given by patients.
Utilize verification software to verify patient information prior to the visit. Having one staff member responsible for ensuring demographic and insurance data at check-in saves rework dollars down the line.
Missing or Inaccurate Coding
Proper coding is the basis of physician billing. Nevertheless, many practices continue to grapple with employing old or incorrect codes. Differing documentation between clinicians and billing personnel also causes mismatched codes, resulting in denials.
Invest in frequent coding audits and regular staff training. Implement coding software that remains current with payer rule updates. Having a physician billing company with certified coders through outsourcing guarantees accuracy and compliance for all of your claims.
Failure to Submit Claims on Time
Late filing of claims is a quiet revenue slayer. Most payers have tight filing deadlines, typically between 30 and 90 days after the date of service. Missing those windows can make it hard for claims to get approved.
Use a system that tracks each claim’s status from creation to submission. Set internal deadlines shorter than payer limits to stay ahead. Practices that outsource physician billing to revenue cycle management experts like RCM Workshop benefit from dedicated teams who submit claims on time and track claims daily, reducing turnaround time and avoiding lost revenue.
Inadequate Denial Management
Most practices err in handling denials as permanent denials. Most denials can, in fact, be appealed and recovered if properly and promptly handled. Ignoring them translates into missed revenue and reduced reimbursement in the long run.
Have an open denial management process. Recognize denial patterns, address underlying causes, and resubmit claims in a timely manner. Outsourced billers like RCM Workshop most often offer analytics to point out repeat issues so you can repair them in the first place.
Poor Communication
There is usually a gap between the clinical and billing aspects of a practice that creates avoidable errors. Incomplete encounter forms, missing notes, or miscommunication regarding procedures done can slow down claims or result in underbilling.
Promote teamwork among providers and billing personnel. Share the notes and billing information in real time using integrated practice management software. Outsourcing can also help fill this gap. Outside groups usually work directly with internal personnel to ensure proper and complete information exchange.
Failure to Follow Up on Aging Claims
Unfollowed aging claims are a frequent cause of revenue leak. Practices lack staff or time to follow up on unpaid claims on a consistent basis. Allocate certain personnel to review accounts receivable routinely. Establish AR day benchmarks and monitor them on a monthly basis. A specialized physician billing firm, such as RCM Workshop, can manage consistent AR follow-up to receive payments promptly and have fewer write-offs.
It’s time to start looking into outsourced physician billing services and consider industry-leading partners like RCM Workshop. With our expert support for compliance monitoring, accurate billing, timely claim submission, trained professionals, and proactive follow-up, your practice can minimize the time spent making corrections.
