Revenue recycle management plays a vital role for hospitals and medical centers. It is a financial process that facilitates the administrative and clinical functions of healthcare organizations. Managing claims processing, payment, and revenue generation are some of its objectives. In that way, telemedicine Lake Worth FI and urgent care Riviera Beach FLcan keep its door open to patients seeking treatment.
However, billing mistakes often occur. Such are results of human errors or management abuse that can affect the institution’s finances and reputation.
No healthcare facility would want to suffer such circumstances. Here are the five common billing mistakes your medical crew should be wary of:
Insurance verification failure
Failure to verify insurance first will lead to denial of a patient’s medical claims.Insurance often changes, especially when services got rendered. And that’s the reason why the staff should double-check the details of insurance, like coverage period and effective dates, before proceeding to the following procedure.
Forgetting clearinghouse reports
As patients flood hospitals, the whole workplace becomes busier. It also affects how employees review and submit clearinghouse reports essential for medical firms. Without it, dealing with problem claims between the provider and insurance payers becomes hard in the long run. Proper planning is crucial to ensure that the report is timely and accurate.
Complex nature of an explanation of benefit (EOB)
Understanding explanation of benefit (EOB) takes time and effort to grasp. Staff should carefully read and interpret an EOB, or else your office will suffer major financial setbacks. One must know the strategies to apply when a payment arrives early and pay the right amount.
Duplicate and wrong billing
Duplicated or wrongful billing happens when patients receive the same bill for the same test, treatment, or produce, even if not performed. It also occurs when a scheduled test or procedure got canceled but still covered by the patient. Most are outcomes brought by human errors, yet if not considered, lead to fraud.
Incomplete/incorrect patient info
Inaccurate patient information is one of the most factors why claims got denied. Misspelled name, wrong birthday, or incorrect diagnosis code leads to payment delays or, at worst, claim denial. Ensuring through double-checking the accuracy of personal and medical details is a must so the patient will receive the maximum benefits covered by the insurance.
Connect with us, AI-Care, for more information through our contact number, (561) 462-1799, email address, [email protected], or contact page.
