Mistakes Every Medical Billing Office Should Avoid

Professional medical billing services will find the following information very important in helping their overall success.

Unfortunately, many doctors are not very good at gathering important information that is needed for the billing process. It is always important that the medical office be able to receive the largest payment possible for services rendered. Making any of the following mistakes, however, could lead to the medical office receiving no payment at all.

One of the most common mistakes made by physicians is assuming that the people that are responsible for administration of the medical billing process for their office will not make mistakes and genuinely care about the success of their medical practice. While there are many skilled professionals out there, it is in the doctor’s best interest to be cautious about the level of trust they place in their medical billing service.

Another common mistake made by doctors is failing to carefully examine those bills that are written off and the reason payment will not be received.

1. You should have a current copy of the front and back of every patient’s insurance card. Even if a patient is coming in to follow up on a previous visit you can not assume that there insurance information is still current. It should be standard office practice to ask a patient if their insurance has changed at every visit. Having a copy of the current insurance card can save you lots of money over the course of the year in both saved employee hours and rejected insurance claims. It can be very difficult to track down patients and get the correct insurance information after the claim has been rejected by the old insurance company. You run the risk of not receiving payment when a claim with the incorrect insurance information gets processed.
    
2. Remember that patients routinely lose and acquire new medical insurance, so always verify that they have insurance at the time of the visit. With each new plan there are changes to the required co-pays and deductibles, as well as preauthorization requirements for certain procedures. Checking to see whether the patient has insurance should happen on a scheduled basis in your medical office.
    
3. Doctors should have an e-mail address for patients to send correspondence posted throughout their office. While it may not be practical to personally respond to each message, it is important to see what your patients have to say. You can have your office computer wizard program an automatic response that gets sent to patients upon receipt of an e-mail. You are sure to gain lots of valuable insights from reading your patients thoughts, as well as allow your patients a discreet way to tell you about the professionalism of your staff. Knowing that patients have this avenue to give you feedback is sure to improve the work ethic of the members of your office staff.
    
4. Always to be sure to get a copy of a piece of identification other than the insurance card for new patients, preferable a picture ID. You may find this documentation very helpful down the road if you experience problems getting the insurance company to pay the claim. You always want to have the tools available to resolve claims problems down the line.
    
5. Be sure you have a reliable way to contact the patient, including work number, cell phone number, pager, and the phone number of a relative. This information should be collected on the patient profile form. Your staff should follow up and request that any blank contact information be filled in. You always need to be prepared should you encounter collection problems down the road. This information will be very valuable in resolving those problems.
    
6. Do not neglect to obtain any necessary pre-authorization's. The majority of rejected insurance claims can be attributed to lack of prior authorization prior to the procedure. The insurance company is looking for any way to avoid paying the claim. If the insurance company is exploiting the lack of authorization you may need to call the company yourself instead of relying on your staff. Insurance companies will often attempt to deny procedures that take place on the same day as a patient’s office visit, with many asking for a special authorization number to approve the charge. Your staff should be knowledgeable about which insurance companies have procedures that require a special authorization code.
    
7. It is always best to collect any co-pay or deductible due you at the time of the office visit.
    
8. Have an Advanced Beneficiary form securely signed when appropriate.
    
9. Always determine if the patient’s office visit is related to a workplace injury. Many patients will have multiple injuries that are all being treated at the same time, especially in the fields of pain management and orthopedics. Sometimes a doctor will need to treat one problem which is work related and one that is not simultaneously. Be sure to take careful notes in your patient’s records, being careful to detail the various injuries.

While no medical office or medical billing service will get everything right all the time, these steps can help dramatically increase your revenue. Simply getting the proper preauthorization can have a huge impact on your bottom line.

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