Friday, April 8, 2016

When Was The Last Time You Had A Medical Billing Audit?

By Carlos Lopez

Money is always a problem in healthcare. There never seems to be enough of it to go around. The healthcare industry is in a big change right now and many people feel like it's an unfair system and one that needs to change. There is a problem when a doctor cannot schedule in patients because of a contract not showing up in the insurer's database. When mistakes happen in healthcare, it costs the healthcare company thousands of dollars. It often disturbs the medical biller because it is a painful process. When a doctor receives a mess up, patients begin to wonder. What would happen if your patients received letters in the mail saying that their appointments were cancelled because the physician no longer accepted their medical insurance? What if this was incorrect because of a faulty computer system? What would you do?

Doctors today are often afraid to take certain insurances because the companies often deny their claims. This is a big problem happening in America today. In 2007, many physicians received denial letters from insurance companies. If a doctor used codes 99303 and 99333, their claim was often denied. The main reason was because Medicaid deleted these codes. Problems like these still occur. If you don't keep up with the medical coding industry, you will often get claim denials and not know why. Most of the time, you are unaware that a change even occurred.

Doctors often fail to fill out forms correctly because they forget. Insurance companies often don't remind doctors that their claim is about to expire unless they fill out the form correctly. This is why having a good medical biller on your side is important these days.

The United States has a large amount of an aging population. Many people are simply living longer and require more healthcare. In 2005, there was a 7% increase in healthcare costs. In 2015, this costs rose even more to 4 trillion dollars. Insurance alone costs the US government billions of dollars each year. It is expected that healthcare costs will only rise. In order to make sure that your claims get paid, you need to have your own internal medical billing audits. It is important that you do this at least once a month to go over any bills that you may have missed. If a claim was rejected, was it sent back corrected or is it still laying around in the office somewhere?

Internal audits help the healthcare company to see that they can benefit from the new ICD-10 codes. It should not feel like a nightmare every single time that you mail out your claim. If you have someone that works well with you, then it shouldn't be a problem. It is estimated that 17% of all coders today are not qualified enough to do your billing. It can feel like a nightmare. It can be a completely bad situation that doesn't work well. Getting an outsourced company to do your billing often works best for doctors that want to focus more on their patients and less on their billing.

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