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Avoid these 3 common medical billing mistakes

On Behalf of | May 21, 2022 | Uncategorized

Medical billing and coding are complex, and while you deserve compensation for any medical care you provide, you need to be careful when it comes to billing patients to avoid running afoul of the law. Billing errors arise from many different circumstances, but they have the potential to land you in hot water and cost your practice quite a bit of time and money.

Per the American Medical Association, many billing errors result from similar circumstances. For this reason, it may help you to recognize where others have erred so that you may avoid making similar mistakes yourself. Some of the most common medical billing errors are as follows.

1. Upcoding

Upcoming occurs when a health care provider submits codes to Medicare, Medicaid or a private insurance company for treatments that are more severe, intensive or comprehensive than those actually provided.

2. Unbundling

Another common medical billing error, unbundling involves a health care provider using multiple codes to refer to a single procedure when there is a single code available to use for this purpose. Sometimes, unbundling occurs by mistake. However, some providers do this on purpose so that they may bill higher amounts and take in more money.

3. Overusing modifier 22

Sometimes, a patient might need more work than originally planned. In this scenario, you might use modifier 22 when billing, which indicates that the procedure performed wound up being more complex than initially thought. However, you have to supply additional documentation when you use this particular modifier.

As the owner of a clinic or health care practice, you may have administrators creating and sending your bills for you. However, it is still your responsibility to make sure the bills your office sends are accurate.