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Problems Due to Coding Errors

Posted by mgsionline on April 4th, 2013

Healthcare Providers and Facilities realize that their medical billing and coding methodology have some serious issues only when claims get denied on a large scale. The biggest problem with inaccurate coding is that it can result in a chain of events where the claims get denied, billing amount is not paid and sometimes the Provider is penalized for fraudulent coding. Of greater concern, the percentage of coding errors are expected to rise even more with the ICD-9 to ICD-10 transition. Let’s see the consequences of poor medical insurance billing and coding and the possible solutions: 

Denial of Claims: It is the first outcome of inaccurate coding, which urges Healthcare Providers and Facilities to take instantaneous measures. CPT codes must stay in line with the procedures and services performed by physicians. It is highly essential that medical coders use the recently updated CPT codes failing which can result in the denial of claims. Wrong diagnosis code usage and exclusion of important modifiers also contribute to claim denials. To avoid these consequences, Healthcare Providers and Facilities are advised to outsource medical billing to a reputed medical billing company.

Back to Square One: Analyzing the root cause of a coding error is the most tiresome process. To pick medical billing and coding errors, the billing staff has to start back from square one. Even a small mistake can have a huge impact on the end result. Therefore, finding this minor error will consume a huge amount of time affecting the normal workflow.

The Wrong Provider gets Paid: It is very important that medical coders pay attention while entering the physician’s information and/or number, especially when they Code for more than one Provider. Even if one digit changes, then someone else will reap the benefits from what you have sown. An outsourced medical billing company’s dedicated coding team can do this job perfectly and also bring some level of automation to avoid such errors.

Penalty Charge: Double billing, incorrect coding, up-coding, down-coding and unbundling are some of the fraudulent activities that happen in the healthcare domain time and again. Whether they are done intentionally or unintentionally, Healthcare Providers and Facilities are sure to get penalized under the Government’s 1986 False Claims Act (FCA). Fines may be charged from $5,500 to $11,000 per claim. Why get penalized when there is an option to outsource medical billing and coding?

About MGSI:

When it comes to medical insurance billing and coding, MGSI is at its best! This medical billing company in Florida has been providing unrivalled medical billing and coding services to its clients for more than 20 years. Take a look at this company profile and services by logging on to www.mgsionline.com

 

Also See: Medical Billing, Healthcare Providers, Coding Errors, Outsource Medical, Medical, Coding, Billing

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