| Medical Billing Articles (updated Frequently)
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| The 9 Biggest Mistakes Every Medical Billing Office Should Avoid |
| By: David Duncan |
The following information is crucial to the success of any
medical billing office. Doctors simply do not pay enough
attention to the admission/information gathering process.
Receiving maximum reimbursement for your procedures is
important; however one mistake in any of the following nine
areas could result in NO payment whatsoever!
The biggest mistake I have experienced in over 15 years as the
owner of a successful medical billing service, is the almost
blind assumption by some physicians that their office manager
,"walks on water" and that billing staffers work hard and truly
care about the practice. Assume the contrary or at a minimum
look upon your staff with guarded optimism and you'll make a lot
more money!
The second biggest mistake made by physicians is not taking a
closer look at exactly what is being written off and why!
1. Always get a copy of the front and back of the patient's
insurance card even if they're an existing patient. Never assume
on follow-up visits that the patient is still covered under the
same insurance plan. Make it a policy to assume they've changed
insurances. Patients change insurance coverage all the time.
Copying the insurance card will save you thousands of dollars
per year and ultimately save, not cost your staff valuable time.
Tracking patients down for missing information after the claim
has already been filed is one of the most tedious and
time-consuming tasks facing your billing office. Every time an
initial claim goes out incorrectly you run the risk of a not
being paid.
2. Verify benefits! Patients go in and out of coverage all the
time. Their plans, in terms of deductibles and co-pays change
all the time. Obviously the preauthorization process is quite
time-consuming. It is not necessary to verify benefits in every
circumstance such as follow-up care but I would recommend that
you develop a reasonable policy and establish a timeframe for
your verification of benefits process.
3. Post your e-mail address throughout your office. You probably
won't have time to respond personally. But Read Them All! Have
your IP professional program your e-mail client with a nicely
crafted auto response. You'll be amazed at the valuable insight
gained from reading the e-mails not to mention the positive
impact it will have on your staff by ," keeping them on their
toes."
4. Always obtain a second form of ID such as a driver's license
from the patient. This information is very important especially
if later on you experience collection problems. It's always best
to assume that you will have future collection issues.
5. Always ask for the patient's work telephone number, cellular
phone, pager and a relative's telephone number. This should be
built into the encounter form. If the patient leaves it blank
your staff should ask for additional phone numbers. This will
also play a crucial role in the collection process later on. I
cannot emphasize this fact enough. Plan for future collection
and revenue related problems.
6. Always obtain authorization when necessary! Lack of
authorization is probably the most commonly missed element in
the billing process and it's a real income killer as well.
Insurance companies deliberately make it difficult on your
staff. Contact your provider service representative if you feel
the carriers are taking advantage of the situation. Insurance
companies are particularly notorious for denying," procedures"
when performed on the same day as a consult or office visit.
Many carriers expect a separate authorization number for
procedures/injections performed on the same day as the office
visit. Make sure your staff is familiar with which carriers
require separate authorizations for procedures performed on the
same day as the office visit.
7. Collect co-pays and deductibles at the time of service.
8. Secure sign Advanced Beneficiary Notice where indicated
9. Is the injury related to work or other type of accident? Many
patients seeking medical services especially in the area of
orthopedics and pain management have multiple injuries and are
being treated for their injuries simultaneously. It is not
uncommon for physicians to treat one part of the body which is
work related and another from an automobile accident which is a
completely separate situation. Your encounter form should have
adequate fields for accident details.
I have yet to see a physician's medical billing office get this
correct 100% of the time. I have a pain management practice that
saved over $100,000 last year just by properly implementing step
six.
Written by David Duncan President and founder of Medi-Bill Inc.
www.usemedibill.com
About the author:
David J. Duncan President and CEO
Mr. Duncan is a graduate of Florida Atlantic University with a
B.A in Finance and is the original founder of Medi-Bill Inc. He
also has an extensive law enforcement background and is a former
police officer with the City of Fort Lauderdale. Mr. Duncan's
reputation for honesty and integrity is well known throughout
the medical community. During his career, Mr. Duncan has
provided billing, financial and pract
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| Keywords: Medical Claim claim, billing office, same day, office, any medical billing, medical billing office, medical, successful medical billing, Medical Claim, medical billing |
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