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5 Common Mistakes Physicians Commit with the Family Practice Billing

August 2, 2016 | 1:34 pm
Published by | Krunal Popat

A family practice treats patients of all types and often involves multiple fields of medicine. In a perfect world, a medical billing company that works for a practice will have all the proper knowledge of diagnosis and the right procedure codes that are used by the doctor. This will ensure that insurance companies as well as the patient is billed in the correct manner. This also means that the family practice billing will be accurate so that maximum reimbursement for the services rendered is possible.

While 100% is no guarantee, there are five basic mistakes that many family practice billing services make which if they can be avoided would increase the amount of revenue that is generated.

Basic Inaccuracies in Filling Out the Form: It can be pretty easy to make mistakes when filling out the forms, particularly with physicians having a number of things on their plate during the day. Even the smallest inaccuracy like wrong spelling of patient’s name can lead to claims being denied and having to re-file the claim. To reduce inaccuracies, follow a basic checklist each time and have the form seen by another pair of eyes to ensure that it is accurate.

Not Verifying Insurance of Patient: This may be the most common one as patients may have coverage that has changed or has been terminated which means they are not eligible for the services you provide. Too many doctors assume that a patient has the same insurance since when they first entered their office and never bother to ask or check if it is still the same. Be sure to verify the insurance every time to avoid this issue.

Not Billing Enough: It’s surprising just how many family practice billing workers are not aware of the proper billing rules for services that NPPs or Non-Physician Practitioners perform. By not understanding the incident to billing rules along with the shared visit regulations that are laid out by the physician, it is quite possible that these services will not be properly billed with means a loss that might amount to 85% of the total fee. This is the type of loss that no practice can afford to make.

Negligent Audit: The chart audit is designed to track all parts that make up a claim so that everything is billed properly. Unfortunately, it’s fairly common for errors to be made when a test or procedure that was scheduled did not occur, but the billing went forward anyway. This exposes the physician to fraud even if the mistake was an honest one. This is especially true if the services are billed separately and not bundled together.

Improper Codes: Another mistake that many doctors make is not putting the right code on the form. Or, they do put the right code, but it is so badly written that the staff misinterprets it and changes the code to something else. Not having the right code leads to rejection and re-filing of claims. This can be especially problematic if the code books are not updated regularly. In addition, billing under the wrong code for the purposes of getting a better reimbursement lays the groundwork for fraud.

In order to get the right family practice billing, you may want to use the services of a medical billing company to avoid these five common mistakes.