What are the most common billing errors that impact patient satisfaction, and how can you avoid them?

1 Wrong patient information

One of the most basic but frequent billing errors is entering or using wrong patient information, such as name, address, insurance, or diagnosis codes. This can lead to denied claims, delayed payments, or incorrect statements. To prevent this error, you should verify and update patient information at every point of contact, from registration to discharge. You should also use electronic health records (EHRs) and automated verification tools to reduce manual errors and ensure data consistency.

2 Duplicate or missing charges

Another common billing error is charging patients twice for the same service or procedure, or omitting a charge that should have been included. This can result in overbilling or underbilling, which can affect your cash flow and compliance. To avoid this error, you should implement a charge capture system that tracks and records all the services and items provided to each patient. You should also review and reconcile your charges regularly to identify and correct any discrepancies.

3 Incorrect modifiers or codes

Modifiers and codes are used to describe the type, level, and complexity of the services and procedures performed by healthcare providers. However, if they are used incorrectly, they can cause billing errors that can lead to underpayment, overpayment, or rejection of claims. To prevent this error, you should ensure that your staff are trained and updated on the latest coding and billing guidelines and regulations. You should also use coding software and claim scrubbers to check and validate your codes and modifiers before submitting your claims.

4 Lack of documentation or authorization

Documentation and authorization are essential for supporting and justifying your claims and charges. Without them, you may face denials, audits, or penalties. Documentation refers to the medical records, notes, and reports that show the medical necessity and appropriateness of the services and procedures provided to the patient. Authorization refers to the approval or consent from the payer or the patient for the services and procedures that require prior authorization or are not covered by the insurance plan. To avoid this error, you should document and code your services and procedures accurately and thoroughly, and obtain and verify authorization for any services and procedures that need it.

5 Poor communication or transparency

Communication and transparency are key factors for enhancing patient satisfaction and loyalty. Patients want to understand their bills and their financial responsibilities, and they want to receive clear and timely information and assistance from their providers. However, if you fail to communicate or disclose important information, such as fees, discounts, payment options, or policies, you may create confusion, frustration, or distrust among your patients. To avoid this error, you should provide your patients with upfront estimates, detailed statements, and easy-to-access channels for questions and complaints. You should also educate your patients about their insurance benefits and coverage, and offer them flexible and convenient payment methods.

6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?