Common Medical Billing Errors And How Software Fixes Them

Published on: 24 March 2023 Last Updated on: 11 September 2024

An authentic stream of revenue is needed for your medical practice to be efficient and profitable. However, you may need optimized billing efforts to avoid some challenges. Some medical billing problems you may encounter include client complaints and delayed payments. Bear in mind that these problems are capable of hurting your medical practice. Your primary task should be getting rid of those medical billing errors by fixing them.

Billing errors are now common, but there are ways to fix them. Various software has been developed to help with practice management and reduce the chances of running into a medical billing problem. This software provides a medical billing solution that makes practice easy and smooth. This article will focus on the common medical billing errors you might face in your medical practice and tell you how software fixes those errors.

Medical billing: Explained

Medical billing is important in the healthcare industry. It involves the processing and submitting of healthcare claims to insurance companies so that medical services offered to patients by providers can be reimbursed. Medical billing is a complicated process with many steps, like claims submission, denial management, coding payment posting, and charge capture. Medical billing ensures that healthcare providers get their payment timely and accurately for services provided, which is vital for financial stability.

An understanding of billing regulations and medical coding is needed for medical billing to be effective. Effecting billing also requires the potential to find your way around complex insurance systems. Excellent problem-solving and communication skills are must-haves for medical billers. This will help them resolve issues that might arise in the billing process. Electronic medical records (EMRs), electronic health records (EHRs), and electronic billing systems have risen. These systems have reduced errors and streamlined the billing processes.

In essence, medical billing is challenging and complex; the task requires expertise and specialized knowledge. Medical billing is a vital role that must be addressed in the healthcare industry. Healthcare providers must receive reimbursement for services rendered n a timely and accurate manner. Despite the priority given to this medical billing process, various issues are bound to occur. These issues can make cash flow slow, claims can be denied, and financial difficulties may arise.

Medical billing errors

Let us explore the most common medical billing errors.

1. Data entry errors

This billing error is prevalent. It occurs when incorrect information is entered into the billing system. Some errors may include procedure codes, insurance information, and patient demographics. Data entry errors increase administrative costs, delayed payments, and claim denials. To prevent this error, healthcare providers should conduct regular audits to ensure accuracy and implement a double-entry system.

2. Coding errors

When a medical service is assigned a wrong procedure code or the code is not specific, a coding error occurs. Coding errors lead to fraud allegations, delayed payments, and claim denials. With proper training of staff in medical coding, this error can be prevented. Healthcare providers should also ensure that they update their coding manuals regularly.

3. Upcoding and down coding

Upcoding occurs when a healthcare provider bills for an expensive service than what was provided. Downloading occurs when a healthcare provider bills for a service that is less expensive than the provided one. Upcoding and down coding are fraudulent activities that can result in and attract legal actions and fines. Billing practices must be based on detailed and accurate documentation to prevent this error.

4. Duplicate billing

Billing for the same service multiple times is duplicate billing, which occurs accidentally. Duplicate billing happens when a claim is resubmitted due to a technical error or intentionally as a fraudulent practice. Note that duplicate billing leads to legal actions, delayed payments, and claim denials. Implement a system to track and reconcile all claims to prevent duplicate billings.

5. Coordination of benefits errors

This occurs when two or more insurance companies are responsible for a medical service payment, and a disagreement arises about who is responsible for the payment. Coordination of benefits errors can lead to increased administrative costs, delayed payments, and claim denials. Healthcare providers must ensure that their patient’s insurance information is updated and accurate.

6. Out-of-network errors

Errors like this occur when the healthcare provider bills for services an out-of-network insurance provider provides. This comes up when a patient receives medical services from a provider outside their outlined insurance network. Out-of-network errors lead to increased administrative costs, delayed payments, and claim denials. Educate patients about insurance coverage and be sure that they obtain prior authorization for out-of-network services.

How to fix them with software?

Here are some ways software can be used to fix medical billing errors and improve the financial health of a healthcare practice.

1. Automated claims management

Automated claims management software is one of the best strategies to stop medical billing mistakes. Before submission to insurance companies, this software may automatically examine claims for mistakes and inconsistencies. Automated claims management software decreases the likelihood of claim denials and delayed payments, which may check for coding mistakes, duplicate billing, and other frequent problems. Eliminating the need for manual claims review and resubmission can save healthcare providers time and money.

2. Electronic health records

EHRs can improve medical billing efficiency by automating certain aspects of the process. For example, EHRs can automatically generate billing codes based on the services provided, reducing the risk of errors related to manual coding. The advancements in EHR software development have been pivotal in enabling these automations and ensuring the accuracy of medical billing and coding. EHRs can also facilitate submitting claims to insurance providers, reducing the time and resources needed to complete this task. Patient outcomes can be improved by healthcare providers by providing them with a complete picture of their patient’s medical histories. By having access to comprehensive medical records, healthcare providers can make more informed decisions about patient care and avoid mistakes related to incorrect or incomplete information.

3. Real-time eligibility verification

Real-time eligibility verification software can help healthcare providers improve their revenue cycle management by reducing the time and resources needed to verify insurance information. By automating checking patient eligibility and coverage parameters, healthcare providers can free up staff resources and focus on delivering high-quality patient care. The software can also improve the accuracy of insurance information by reducing the risk of errors related to manual data entry. By automatically verifying insurance information in real-time, healthcare providers can ensure they have the most up-to-date and accurate information before providing medical services.

4. Automated payment posting

Automated payment posting software can help healthcare providers improve their revenue cycle management by reducing the time and resources needed to process payments. By automating the posting of payments from insurance companies, healthcare providers can free up staff resources and focus on delivering high-quality care to their patients.

Automated payment posting software can also improve payment processing accuracy by reducing the risk of errors related to manual data entry. By automatically matching payments to the corresponding claims, healthcare providers can ensure that payments are processed accurately and promptly.

5. Data analytics

Data analytics tools can help healthcare providers track key performance indicators (KPIs) related to their revenue cycle, such as days in accounts receivable, collection rates, and net revenue. By monitoring these metrics, healthcare providers can identify areas of their revenue cycle that need improvement and implement strategies to optimize their financial performance. These tools help healthcare providers identify opportunities to streamline their operations and reduce costs. For example, by analyzing supply usage and waste data, healthcare providers can identify areas where they can reduce waste and save money.

6. Automated denial management

This software can help healthcare providers identify patterns in claim denials, allowing them to improve their billing processes to prevent future denials. By streamlining the appeals process and reducing the number of denied claims, healthcare providers can improve their revenue cycle management and ultimately increase their bottom line. Automated denial management software can provide real-time insights into claim status and help healthcare providers prioritize which claims to focus on. This can be especially helpful for practices that handle large claims or have limited staff resources. It is a valuable tool for healthcare providers looking to improve their revenue cycle management and reduce the time and resources spent on manual appeal procedures.

7. Patient payment portals

Patient payment portals can also improve patient satisfaction by offering a convenient and secure way to pay medical bills. Patients can access their payment history, view outstanding balances, and set up payment plans through the portal. This level of transparency and control can help reduce patient anxiety and promote trust between patients and healthcare providers.

It also saves healthcare providers time and resources by automating payment processing and reducing the need for staff to handle payment transactions manually. This can allow healthcare providers to focus on delivering high-quality care and improving patient outcomes rather than on administrative tasks.

Conclusion

Medical billing errors are a significant problem that can lead to financial loss and legal action for healthcare providers and patients. Healthcare providers can improve their revenue cycle management by implementing effective strategies to prevent these errors and ensure high-quality patient care. Software programs help streamline billing practices to provide better care to patients. Try using software to fix your medical billing errors to experience swift medical billing processes.

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Abdul Aziz Mondol

Abdul Aziz Mondol is a professional blogger who is having a colossal interest in writing blogs and other jones of calligraphies. In terms of his professional commitments, he loves to share content related to business, finance, technology, and the gaming niche.

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4 Essential Ways Of How To Make Your Feet Stronger

The human feet are a masterpiece of engineering and a work of art that enables you to stand for long hours, walk for long distances, hop, skip and jump and follow the activities that your heart wants to follow. Just like a sound foundation ensures that a building stands upright forever; having strong feet ensure a longer, happier, and healthier life. However, we often tend to take our feet for granted. Even the best of athletes focus upon building muscles legs, arms, calves, abs, and the rest of the body; but hardly anyone pays attention to the feet. We seem to forget the fact that our feet are involved in almost every activity we do. They provide us the support and balance in almost all our bodily movements. Lack of strength in our feet is therefore bound to compromise our ability to do any physical activity; be it walking, running, jump, high-intensity sporting event, or even standing! The Science Behind the Structure of the Feet Before we embark upon knowing the ways about how to ensure that your feet stronger, it is important to understand the three most important aspects that dictate how strong or weak your feet are. These are - 1.The Soles Most of us who wear shoes all day long have very soft and tender feet soles. You would have noticed that those who spend time barefooted, have thicker soles. This makes them stronger and firmer and they are able to withstand superficial injuries as well as normal wear and tear quite easily. 2. The Joints, Muscles, And Tendrils Of The Feet The human foot is a very complex structure. It is made of 33 joints, 26 bones, and almost 100 ligaments! They all are designed to function in a manner that the foot can take the weight of the entire body and spread it evenly to maintain balance in all types of movement. Strong feet not only help an efficient movement but also help in improving the posture. They also help in avoiding spinal injuries by efficiently maintaining our balance, thus cushioning the effect of any jerks. 3. Arches in the Feet The arches in our feet help in an efficient rolling action, which maintains the balance during movement. Sometimes the arches are not well developed, giving rise to a situation commonly known as flat feet. When someone is flat-footed, it is difficult to maintain good rolling action which in turn leads to a lower range of action consequently lowering strength as well as speed. How to Make Your Feet Stronger Most of us are blessed with well-shaped feet that can take the rigors of our daily life and all the activities we undertake, but often we tend to neglect our feet and suffer the consequences by way of loss of strength as well as suffer from early aging symptoms. It is but natural that if the feet are weak, a person's mobility will be restricted and he will do fewer activities. This would have an adverse effect on overall health. On the other hand, if a person is active, some of the drawbacks of being flat-footed can be overcome. Here are some of the ways of how to make your feet stronger - Exercises By consciously spending some time doing the following specific exercises is the best way to make your feet stronger – Caterpillar Type Movement – (Benefit- Strengthens the arches) Lie down on your back, draw your knees and place the feet flat on the floor about 8 inches away from each other. Then lift the arches of both the feet and simultaneously pull your toes backward toward the heels. Keep this position for a few seconds and bring back the arches and toe to their original position. Then do the reverse- arches up and heels toward the toes. Repeat this set three to five times. Windshield Wiper Movement – (Benefit- Strengthens the entire foot and improves ankle stability) In continuation with the caterpillar type movement exercise listed above, lift the toes, keeping the feet flexed while only the heels are touching the floor. Then slowly roll your feet to the ground and lift the heels keeping only your toes are on the ground. Repeat 8-10 times. Wing and Sickle Movement - (Benefit - Strengthens the ankles and promotes correct posture) Continue lying down as above and roll your feet inward along the inner edge in line with the toe, then roll outwards in line with a small finger. Do this 3-5 times. The Round Knot Movement - (Benefit - Stretches the ligaments and aids foot alignment) Sit upright on the floor and extend your legs in front. Bend the left knee towards yourself and interlace the fingertips of the right hand with the left toes. Inch them forward and backward giving the foot a stretch. Repeat 6-8 times. Then do the same with the other foot. Toughening up Your Feet There are many other ways of how to make your feet stronger. Stand More Often – Our daily life is mostly based on sitting. Be it office or home, we spend the day sitting. Consciously standing more often would help strengthen and stretch the muscles of the feet. Jogging/Walking on the Sand – If you have access to a sandy beach, try walking or running gently on the sand. This would increase the flexibility and strength in your feet and exercise the arch. Read also: Why Jumping on Trampolines is More Beneficial than Running or Jogging? Walking Barefoot– Crazy as it may appear, walking on smooth rocks can do wonders for your feet' strength. Walking barefoot on grass is equally effective as it toughens up the feet soles and makes the feet stronger. Using Shoes With Insoles Insoles were traditionally used for making short people appear taller. These days however they are scientifically designed for multiple functions and assist in skiing, biking, golf, etc. Using best insoles for flat feet ensures not only physical comfort but also improves efficiency and performance in all your multifarious activities. Even those who suffer from other ailments like Morton’s Neuroma and plantar fasciitis can benefit by using the best insoles for flat feet and carry out all activities normally. Go On, Focus On Your Feet! If you want to enhance your control, balance, and power, it is important to start focusing on strengthening your feet. It will also make you agile with better control of movement. Following these simple tips in your daily routine can put you on the way to balanced, more powerful, and stronger feet in a matter of a few days! Read also: Get up and Workout! Things to Consider

Medicare Pros and Cons: Everything You Need to Know before Enrolling

Given that more than 40 million Americans benefit from what Medicare has to offer, there are many ways for older adults to stay healthy. Those with disabilities or who might be on the edge of the income limits should know the Medicare pros and cons before enrolling. There are plenty of reasons to choose Medicare or something else, so you need to know what suits your lifestyle. Here are some of the most common pros and cons that people bring up when they're struggling with this decision. Pro: Coverage for the Uncovered: One of the reasons that Medicare is such a powerful coverage tool is that it has offered coverage to millions of people who didn't have it. With this program, elder adults are covered and protected from medical catastrophes. With only half a million seniors uninsured from year to year now, it's made it so that almost no one over 65 has to live without protection. Because Medicare is for those who need it and have little means, it helps keep more Americans protected than ever. Without it, elderly Americans would be forced to pay for medical treatment they couldn't afford. Older people tend to need the most medical care, and so it's vital that they have affordable and manageable care. Since elderly Americans are often retired, they don't have the means to keep up with rising medical costs. People with disabilities get help under Medicare to pay for the challenging costs of care. Without this aid, they would be dependant on caretakers and stuck with few options for care. Con: There Are Massive Costs to Cover It: Put all the costs of Medicare together and you'll find that it costs nearly half a trillion dollars. While this might be a hard figure to quantify, it ends up being 15 percent of all of our federal spending. It's only going to continue to grow in the future. While there are several items in the federal budget that we don't question the cost of, this is one we have to consider in a realistic sense. The costs of medical care are constantly climbing ever higher and leading to insurmountable bills for the average American. Without any intervention by the federal government, the cost of healthcare and the cost of providing programs like Medicare will take a big cut out of taxes. Without Medicare, we would have a much bigger tax base. However, we would have people who are constantly sick and in need of care, clinics that are filled to the brim, and elderly people who had no way to care for themselves. While we could do some work to ensure that the money we have is spent more wisely, for now, we can imagine this money going to education or social justice. While it could help with programs to eliminate poverty, ultimately, more than half of bankruptcies are due to high medical bills. Pro: Get More with Medicare Advantage: For people who need more medical care than the average person, there are ways to supplement Medicare. Those people who find that they're at the limits of their Medicare coverage can sign up for the Medicare Advantage plan. Enrollment in this program is constantly growing and should be a powerful way for people to cover those massive increases in medical fees. Paying for private insurance is difficult if you're in the tax bracket eligible for Medicare. It's also redundant given that so much of what's covered by the standard medical plan is wrapped up in Original Medicare. However, with the help of Medicare Advantage, there is now a place for a third component that offers what many healthcare recipients need. The way this works is that insurance companies provide benefits related to what's missing from Medicare through a contract with the government. They offer them at competitive rates that are affordable to the average Medicare recipient. People taking advantage of these plans get everything they expect from Part A and Part B of Medicare but then get more dental and vision benefits. This extension provides some of what's missing in most of the other parts of this program. Con: Bad Health Is Expensive: If you're in poor health, you have an intimate view into just how expensive healthcare is. Even if you've got great insurance, you've seen the prices that come on the bill before you get your care deducted. You could be paying double or triple what a healthy person pays every year, even with healthcare. While you need to have great healthcare, you need to do what you can to stay healthy. Talk to your doctor about preventative care. You're never too old to take action to lower your healthcare costs and your need for supplemental care. There are many free preventative care programs that come standard with most Medicare plans. However, you need to take action to make sure you follow your doctors' recommendations and stay on top of your health. Many people who incur high bills with Medicare suffer from problems that preventative medicine could assist with. Even though this program costs very little from month to month, you need to manage your costs as they'll add up on a limited budget. If you're tight on money, Medicare supplements may be out of reach. This makes it all the more vital to staying on the good side of health. Medicare Pros and Cons Are Individual: Because everyone has their own healthcare needs and requirements, Medicare pros and cons vary from person to person. You need to get to know what you need and what you might need in the future before you decide on Medicare or any other insurance policy. As more people suffer more chronic health issues, check out our guide to watch the trend. Read Also: Finding The Right Hospital Complete Pregnancy Guide For Mumma’s To Be

Ways to Stay Fit and Healthy in Your Senior Years

As you get up there in age it can be even more important to stay active and healthy. The key to a longer life is to keep active and not be sedentary all the time. Eating healthy can be a huge contributor as well. There are simple things you can do to help achieve this that are actually fun too. Clean Eating It all starts with your diet. You don’t need to be on some special fade diet. However, you do need to watch what you eat. One of the first things you should do is take in more liquids. Some seniors may have to force themselves to drink more water than usual. Planning out your meals ahead of time can really help you stay healthy. Most people end up in the fast food trap because they lack planning. When it’s dinner time they simply drive to the nearest drive-thru restaurant. Avoid this and do some meal planning. In the long run, it’s not only healthier it’s cheaper. Our last healthy eating tip is to reduce the amount of sugar intake. Sure, it can be easy to pull out the ice cream at night and have a bowl or two. But sugar turns into fat and can lead to an increase in health dangers. Instead of that sugary snack replace it with fruit or even a sugar-free snack. Protein is very important for the body as it gives you the energy and will help you feel fuller throughout the day. Lots of seniors overlook how much protein they take in. Cut down on the carbs and plan out a diet that is higher in protein. Some of the foods with the highest protein are eggs, chicken, turkey, cottage cheese, steak, beans, and nuts. Exercising Getting on an exercise routine can be hard. Our suggestion is to make it fun and social. Does your community have a walking group? If so this can be a great way to get outside and make a new friend while doing it. Some seniors enjoy golf. Some might think riding in a golf cart isn’t much on an exercise but that’s not true. You can’t ride everywhere on a golf course and although it’s not constant you are walking and often times up and down hills. Golf can be an enjoyable game that takes out the fact that you are actually exercising. Swimming is hands down one of the best exercises you can do. It essentially works the majority of your muscles and gets your heart rate up. The best part about swimming is you can go at your own pace. Get tired? No problem get out and lay in the sun for a bit. When you are rested up to go back in the water for a few more laps. Take the grandkids to the park. What kids don’t love going to the park? Grab a basketball or a soccer ball and take the grandkids out. Sure, you might not be running around playing soccer with them the entire time but you can play some. The point is you need to get out of the house and gets some miles under those legs. You don’t have to overdo it but just work on being more active and have some fun doing it. Read Also : More Than Just A Fad: The Benefits Of Going Gluten-Free Health Benefits Drinking Less Soda Health Benefits Of The Amber Teething Necklace

Common Medical Billing Errors And How Software Fixes Them

Medical billing: Explained