$125 Billion Lost on Medical Billing Errors

by Applied Medical Systems

Billing Errors Everywhere!

It is estimated that $125 billion is left on the table by doctors in the U.S. every year. This money is either lost or ignored because of poor medical billing practices. Medical billing errors are so prevalent, in fact, that around 80% of medical bills are estimated to contain errors. As medical professionals and providers, your ultimate goal is to provide exceptional healthcare to the people in your communities. However, with numbers like these it is becoming an increasingly larger concern to make sure that your practice is getting adequately compensated. After all, without proper billing and revenue cycle management, it can be hard to keep your practice in business long enough to serve your community. In addition, healthcare reform and new ICD-10 codes, will likely lead to even more medical billing errors and problems in the future of U.S. healthcare.

As a physician, your education in undergraduate, medical school and residency might have focused heavily on medical procedures or medical treatment research. There probably was not too much emphasis on billing and coding processes. Insurance companies also make it even more of a difficult process by having strict guidelines and regulations for medical billing claims.

Insurance companies’ strict guidelines for these medical billing claims cause a hiccup in the medical practice revenue cycle. Physicians are finding themselves waiting months for reimbursements if the billing claims process goes smoothly. If your claim gets rejected it could be even longer for you to get paid for the services you are providing.

Some of the most common billing errors:

1. Incorrect Patient Info- Misspellings or incorrect information on patients insurance IDs or paperwork can cause major problems in medical billing. Medical paperwork and insurance information can touch so many different hands throughout the treatment process. Any mistake can stay on the information all the way through the claim process.

2. Not Up-to-Date on Regulations- Medical billing rules and regulations are changing on a regular basis. This requires constant updating of software and Electronic Health Records (EHR) systems. Training staff and developing new procedures are also needed to stay on top of constant changes within the healthcare industry. Many billing errors occur when outdated software and billing codes are used to process claims.

3. Non-Corresponding Treatment and Diagnosis Codes- If treatment and diagnosis codes are not corresponding properly, insurance companies are often times likely to reject claims. This is a common mistake in medical billing. Imagine what will happen after the ICD-10 codes are introduced.

With ICD-10 codes increasing the number of billing codes by 10s of thousands this is expected to increase the amount of billing errors. The shear number of new codes is overwhelming, and having to learn how and when to use each of the new codes will be a daunting process.

Let AMS help weed out billing errors.

Medical billing errors are common and your practice could be losing revenue. Medical billing and coding companies, like Applied Medical Systems, can provide the expertise you need to stay on top of changes in the medical billing landscape. We can provide practice management solutions, services and consultations that allow you to focus on patient care. For more information, contact us at our Durham, NC office.