When dealing with everything from personal daily planning to career management, the devil is often in the details. Certain key strategies can help physicians and organizations sidestep revenue loss attributed to billing errors.
For instance, Hurt suggests that healthcare organizations use the correct modifiers when submitting claims, considering that both not using modifiers and using the wrong modifiers can lead to claims denials. Healthcare consultant Karen Lake from Alabama-based Pearce, Bevill, Leesburg, Moore, P.C. notes that using an incorrect modifier is one of the most common billing errors. Lake encourages physicians and healthcare organizations to make sure that their staff are thoroughly trained to avoid easily avoidable oversights.
Another strategy that Lake encourages physicians and healthcare organizations to heed may seem obvious, but it is surprisingly an issue; they must bill the correct payer. For example, consider a patient who thinks they are on Medicare when they have a policy with Blue Cross. The patient hands in a Medicare card to the front desk. Upon entering the patient’s information, office staff submits the claim, but it is rejected. Insurance verification avoids this issue.
Lake emphasizes that failing to include even one required field can lead to a denied claim, adding that double-checking the inclusion of all necessary information is an easy task that inputters should never skip. Inputters should ensure that all required information is filled in and accurate. According to Kenneth Hertz, FACMPE, principal consultant at Medical Group Management Association, maintaining an isolated space specified for taking insurance information is ideal, as this will minimize distractions and allow for dedicated concentration during data input.
EHRs are an excellent tool for healthcare organizations seeking to analyze errors as a tactic for lessening the number of billing mistakes. One strategy might be to look for patterns in errors. For instance, perhaps a healthcare organization is consistently producing clinical coding mistakes. Pinpointing patterns can allow organizations to prioritize where training is most needed.
Ultimately, healthcare organizations require thoughtful consideration of their data-input processes to avoid minute oversights ballooning into potentially detrimental careless errors. Implementing a few simple data-input strategies goes a long way in preserving revenue.