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Efficient Techniques to Resolve Billing Errors | physician Revenue group

by Alma Bartram
medical billing audit

Accurate medical billing is essential to ensure that the practitioners are paid correctly for their services. However, wrong input of billing details and mismatched codes make billing complex which further leads to monetary loss and claim denials. Implementing preventive measures is important to reduce billing errors and boost the effectiveness of the billing process.

Top Ways to Prevent Medical Billing Errors

According to a report published in 2010, 42% of claims had incorrect coding, and 19% lack to fulfill the required medical documentation. This is how medical billing errors cause the loss of thousand-dollar revenue each year.

It can be difficult to maintain the medical records of several patients at a time besides analyzing them for inaccuracies. Therefore, if you’re still looking at how to avoid billing errors, medical billing audit is the answer. Here are the top suggestions for preventing medical billing mistakes so that hospitals can swiftly receive their payment.

Check for Mismatched Patient Information

Minor inaccuracies in the patient’s record and insurance details cause claim denial. It is important to recheck patient data, including the policy number and group number to ensure its validity.

Double Check the Information

The insurer checks the procedure codes of every diagnosis performed for patients to correctly reimburse the medical claims. The following situations would result in claims being rejected:

  • Insurer makes wrong assumptions
  • Uses incorrect codes
  •  Initiates treatment without deciding its necessity  
  • Carries out the procedure without authorization

Ensure that billing staff receives appropriate training in coding tasks.  It is paramount for medical practices to use the latest rules of healthcare compliance to avoid committing expensive billing errors.

Create Accurate Electronic Health Records

An unclear prescription written by a medical professional may lead to claims denial. If the billing staff passes the claims that are challenging to read, they may face legitimate inquiries. The use of billing systems like EHR helps medical billers to rectify claim problems with automation and regular review. Just ensure that the billing staff is efficient in handling the billing errors using EHR.

Avoid Upcoding

While filling patient invoices it is important to align codes with their designated treatment. Improper input of medical codes results in upcoding which will further lead to claim rejection. This happens when the biller can’t comprehend the doctor’s instructions and place inaccurate diagnosis and treatment codes.

Such types of billing errors in patient invoices can ruin your time and money. Despite getting insurance money you may need to pay an additional fee for ignoring healthcare legislation. Upcoding not only causes claim denials but also subjects your practice to an audit or a fine.

Employ the Most Recent Medical Billing Strategies

It is not easy for medical billers to govern the most recent billing rules and regulations because they keep changing. Practitioners shall keep their practice according to the change in billing guidelines by accessing the most recent billing manuals. Moreover, getting trained billing staff helps them to stay updated with the prevailing billing techniques. You shall understand that claims can be processed effectively, quickly, and without revenue loss if current procedures are used.

Avoid Billing Duplication

This happens when a patient receives multiple bills for a single treatment. This is a common error but it can increase the likelihood of claims rejection, which might lead to payment delays and disrepute in the healthcare industry. Reduce errors with billing audits to avoid billing duplication.

Verify Benefits and Coverage Ahead of Time

Insurance companies have a variety of coverage policies for the given medical services. Furthermore, the specifications of the billing policy can alter at any time. A practice cannot rely solely on their most recent data input for a patient, even if they are a regular customer. If the patient’s policy limit, terms of service, or insurance provider has changed, this could result in inaccuracies.

Your practice must check the patient’s eligibility each time services are provided in order to avoid claims rejection. Verify and share facts about insurance terms, copayment options, and healthcare benefits. A complete list of such details is necessary for correct patient billing.

Employ A Qualified Medical Biller

Medical billers are a trustworthy resource to establish a stable and efficient system for handling insurance claims to guarantee stability in the practice finances.

Medical billers always face challenges, such as claim rejection and lower-than-expected reimbursement. But when the billing is handled next to revenue cycle management, the possibility of medical billing mistakes and loss of revenue increases.

Hiring a qualified medical biller helps prevent mistakes made by incompetent medical billers. Thousands of medical codes, diagnoses, and outpatient procedures can be tracked by a team of medical billers, helping to lower the number of denied claims.


For correct payments and to keep medical practices financially stable, effective methods for error-free medical billing are crucial. Follow the above-mentioned tips to reduce billing errors and improve revenue cycle management. Such efforts can enhance the integrity and efficacy of the healthcare sector as a whole.  More posts>>>>>> POS Billing Software

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