Medical billing is important and complex. It is critical to the health care business in general, and particularly mental health care. When it comes to mental health, diagnosing, treating, and covering patients are rife with errors because of coding errors. This makes claim processing complicated, and this, in turn, results in most claims being denied. So, what are some of the prominent billing errors that you must steer clear of?
- Clerical Errors – One of the main reasons why insurance companies reject claims is due to errors such as erroneous spellings, typos in insurance ID numbers. Mistakes may be made in filling in the name, contact, and address of both the provider and insurance company.
- Outdated Information – Similar to inaccurate information, old or obsolete information is harmful too. It might also cause a delay in the process of getting your claim approved. For claims to be refuted, obsolete data must be discovered; thus, being up-to-date is critical.
- Mistakenly ordered quantities – The charge to the patient may go higher if the data is submitted improperly. Adding a zero to the end of a number increases the cost dramatically. Such mistakes should be avoided at all costs.
- Non-accurate and messy documentation – Doctors who write illegibly are in the majority. A cliché has emerged among the medical community, causing this phrase to be widely used. Although handwritten papers may lead to claims being rejected, this can also result in claims being rejected since handwritten documents are just too untidy to be complete.
- Double billing – Unfortunately, double billing is an age-old behavioral medical billing error that has persisted for thousands of years. There may be two charges, one from the doctor and another from a non-authorized medical worker. In certain cases, the patient may be charged twice both medications that were prescribed and those that were given.
- Under coding – When the therapy given is less costly than the invoicing of the service, this is known as underbilling. Some providers may under code patient expenses to reduce costs or evade any audits. This mistake hurts the physician as well as the patients.
- Incorrect Codes – The codes may be incorrect when a doctor uses an upcoded diagnosis but leaves the patient’s billing code the same. While mismatched codes may result in inflated claims, upcoding can lead to that as well.
- Unbundling – When individuals are charged for their treatments, unbundling is a means of charging for the various services that make up a lower-cost treatment option. This is often interpreted to imply that charges that formerly fell under one category are now being presented as distinct charges.
- Preauthorization – Prior authorization, notification, and precertification are often used interchangeably in the medical billing world to mean that for certain procedures and situations, providers have to obtain prior authorization (or, in some cases, a precertification) from the insurance company in advance before they can be reimbursed for their services. Revenue cycle management processes are essential because verification and authorisation services are crucial. Research indicates that rejection of claims happens when the patient is unable to pay the services invoiced by the healthcare practitioner.
Best Practices to Avoid Billing Errors
- Check the patient’s personal information twice.
Simply verifying and re-verifying your patient’s personal information is arguably one of the simplest methods to prevent medical billing mistakes. Make certain that all of the information they provide is accurate and free of any glaring errors or omissions.
- Check the patient’s insurance information twice
Before you offer your services to your patient, be sure you contact their insurance company. Check to see whether their policy number and coverage are the same as yours and that your billing contact information is up to date.
- Create a policy for collecting billing information.
Create a clear and explicit policy that explains how billing information should be handled and maintained by your employees. You must guarantee that your patients are not charged twice, designate one individual to oversee and manage the billing team.
- Keep track of your claims.
Simply being attentive in your follow-ups with insurance providers may help you prevent mistakes. A claim representative may be able to notify you of mistakes, enabling you to correct them and resubmit a polished claim.
- Create a clear line of communication and coordination
Everyone on your team that works on a claim should understand their roles and responsibilities. They should also be well-organized and coordinated to successfully interact with one another. Keep yourself up to date by subscribing to our newsletter. You must remain current with your claim procedure and avoid entering any outdated information from your paperwork.
- Mental Health Plan coverage
Anxiety, depression, substance disorder, or alcohol abuse, all require a different plan as per the nature of medical service. Offering the right patient plan as per the service offered is critical.
Tall RCM the Best Psychiatry Medical Billing Service
Behavioral health medical billing is hardly a stroll in the park, as you can see from the article. The whole procedure takes a lot of time, work, blood, and sweat. At Tall RCM, we work with concerned practitioners to provide pre-authorization, third-party billing, claims follow-up, and assistance with insurance claims appeals. Our service offerings include in-demand services like Transcranial Magnetic Stimulation (TMS) therapy, Sleep Study, Spravato, as our medical health billing experts can adeptly work on these mental health specialties. You can count on our Psychiatry Medical Billing Services, by our mental health billing experts, and ensure the billing process goes as smooth as possible!