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6 Medical Billing Mistakes that Harm the Healthcare Revenue Cycle

Posted By Giovanna Stahl

Medical billing is such a vast and convoluted process that many healthcare providers have begun outsourcing medical billing companies for extra support. Hiring professional billers to act as an extension of your team is one of the many medical billing solutions that has improved the quality of the overall healthcare experience. Any inefficiencies may be avoided by working with dedicated medical billers to assist healthcare facilities and reduce errors significantly.  

ECLAT Health Solutions provides the offshore medical billing solutions you need to maintain a healthy revenue cycle as our team is highly trained to help you navigate the healthcare industry efficiently. We focus on providing our clients with the most accurate and affordable billing solutions possible. Here are some of the factors that cause the medical billing process to be so intricate.  

1. Slow Accounts Receivable (A/R) Follow-Ups

Accounts receivable or A/R is when an organization owes a designated amount of fees in regards to medical treatments and services their patient received. The payer, patients, and guarantors may make these payments, which are measured as A/R. Every healthcare organization has to ensure these bills get paid accurately and on time. Having a slow turnaround time for A/R follow-ups causes the reimbursement process for denied claims to be inefficient.

2. Insufficient Documentation

One of the main medical billing errors that cause the process to be so complex is insufficient documentation. When a single detail is missing or if there isn’t enough information, this prevents health care providers from adequately billing for the provided services. Other details that can affect the billing process is illegible documentation, spelling errors, incorrect date and so on. Once these errors occur, claims can quickly be denied making the billing process much longer than it needs to be.

3. Inaccurate Records

When it comes to medical billing, accurate documentation of patient records are very important. The claims and medical records associated have to align with the rules for Medicare coverage, coding, and billing. Medical records allow billers to see what the procedures and treatment a physician carried out during the visit. Whether the service provided was billed improperly or the services were medically necessary, records have to be signed by a variety of specialists before being passed onto the billing process. If they are not signed appropriately, they will be deemed inaccurate.

4. Physicians Aren’t Included in Patient Network

Patients often receive surprise medical bills after they have visited the hospital. This is due to the complexity of the network system that controls which physicians are covered under certain insurance plans. For example, often times the hospital is within the network of places their insurance will cover, but the doctor treating the patient is out of the patient’s insurance network. The insurance company will pay for the hospital bill but the patient will have to pay out-of-pocket for the doctor’s treatment portion of the bill, which is a fact that they often find out after they have received the medical bill. When this occurs, patients aren’t able to pay their bills in full, which may lead to bad debt.

5. Bad Debt

Bad debt occurs when bills are sent to patients for the services and treatments they received at their healthcare facility and they are not paid in full. As this is a frequent occurrence, it can be only be fixed with consistently accurate medical coding documentation.

6. Claims & Denials

Most medical billers have a specific standard when it comes to submitting claims and denials. However, there are still payers that may not have a standard of submitting these claims. Hiring experienced medical billers will allow your claims and denials to be processed and appealed close to the date the service took place. Collecting these in a timely manner will allow a steady cash flow.

ECLAT Health Solutions: Offshore Medical Billing Services

The offshore medical billing process is an obscure system of coding, guidelines, and procedures to ensure that claims are paid. Many companies have started outsourcing medical coding to secondary locations to improve efficiency. ECLAT Health Solutions is available to offer coding support to our clients so they can navigate the current entanglement of medical billing to make the entire healthcare billing process easier for patients and providers. 

Contact us at 703-665-4499 to receive more information on all of our healthcare support services!

Tags: Revenue Cycle Management