5 Common Mistakes Pediatric Practices Make With Their Medical Billing
Oct 10, 2022
Accurate medical billing is essential to the running of any practice, including those in the pediatric field of medicine. The following errors are common ones that practices make in their billing that can reduce potential collections.
Error #1
Inaccurate Codes
A common mistake that occurs during the billing process is using the wrong codes. This can be problematic not only because the insurance company may reject the claim but also because too many inaccurate codes could get you flagged for an audit to check that you aren’t committing insurance fraud.
Solution
Try outsourcing your medical billing to reduce the risk of inaccurate codes.
Error #2
Codes That Are Too General
Accurate coding isn’t the only criterion for maximizing your collections. Codes also need to be specific. If you’re too general with your coding, you might be leaving money on the table. You might be able to collect more if you’re able to use more specific codes and modifiers.
Solution
Hire a professional medical biller to handle your claims to guarantee more specific codes.
Error #3
Filing Claims Late
Insurance companies may have time limits on how long you can wait to file a claim and still collect. Filing claims late is a common error because doctors are busy with patients. However, missing the deadline could result in also missing out on collections.
Solution
Dedicate one employee to prioritize billing over other tasks.
Error #4
Underbilling Patients
If you’re underbilling your patients, you’re not making as much as you could. Underbilling can occur when staff members aren’t properly trained on medical billing rules and codes.
Solution
Make sure to take the time to fully train anyone handling the claims process.
Error #5
Not Verifying Insurance Frequently Enough
Billing the wrong insurance company can cause claims to be rejected and could result in you missing the deadline with the correct insurance company. It’s essential to check with patients every time they come in that their insurance information is accurate.
Solution
Ask to see patient insurance cards every time they visit.
Outsourcing Your Medical Billing Can Eliminate Mistakes
One way to eliminate billing errors is to outsource your claims filing process. Professional medical billers will be more familiar with accurate and specific codes and are dedicated to billing, so claims are always filed on time.
For informational purposes only.
"My husband and I have a small practice but we were looking for a medical billing company to consult us. We originally started with a local company with some satisfaction. However, our biggest problem was that they wanted us to change our existing EMR to software that they worked with. Quest National Services worked with our existing software so that we didn’t have to make expensive changes to our infrastructure. That saved us a lot of time and headache. I would definitely say that was one of the main reasons for why we switched and why we continue to work with Quest. As a small practice, they helped us without draining our resources."
Adriana C.
