Medical Billing Codes: A Key to Fraud Case

Mistakes in medical coding and billing can negatively affect practice revenue in various ways. They can disrupt your cash flow and take your attention away from your core function of providing high quality care to patients. They can even possibly lead to fraud charges, which will harm your reputation and practice. Making a mistake and actually engaging in fraud are two entirely different things, of course. However, if the mistakes seem habitual and claims are always getting rejected, suspicions may arise.

Health insurance frauds happen when a practice intentionally submits incorrect claims with the intention of getting paid for services that weren’t actually performed. Physicians who bill excessive charges, submit a huge number of claims, and perform unnecessary services may be charged with fraud.

Investigations on fraud charges can take years. They can also cost a lot and result in the revocation of a physician’s license. Hence, it’s prudent for doctors and other healthcare professionals to always be careful when submitting claims. All activities must be well-documented and all rules and regulations should be strictly followed.

The truth is that committing errors and being fraudulent are no different from each other; you may still face charges whether your mistakes were honest or you actually engaged in fraud. Medical coding and billing should be taken seriously, and any errors should be quickly acted upon. At the same time, it is also important to evaluate and correct the factors that are causing these mistakes to happen.

To make sure such errors are minimized and fraud charges are avoided, it will be best if you just outsource medical billing and coding duties. That way, you will have access to trained and experienced professionals as well as a comprehensive range of services. Outsourcing healthcare services is more efficient and will help you save money. When you outsource to a reliable company, you and your staff will be able to focus more on providing quality health care to you patients.

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How Outsourcing Medical Billing Overcomes Medical Billing Pitfalls

Medical billing is a complicated and extremely demanding process and it can be difficult for a practice to deal with all of the tasks involved. The billing function possibly takes up a huge chunk of your support staff’s time—time that could be better spent caring for patients. The good news is that you can choose to outsource this process. By outsourcing medical billing, your team will have more time to deal with other important responsibilities as a healthcare provider while reducing billing mistakes.

Rules and procedures in medical billing are constantly changing. This means that if you won’t outsource medical billing, you will have to consistently spend time and money in acquiring new software and training your staff on the Industry changes. For a practice that needs to take care of a lot of other responsibilities, constantly keeping up with these rules and regulations can be too taxing.

It’s more practical to simply outsource medical billing to a reliable company so you can leave the task to professionals. Medical billers are always on top of things; it is their job to comprehend and implement new rules thoroughly. As long you are confident that you have chosen the right company and professionals, you can trust that these billing rules will be followed.

Because of ICD-10, everyone is worried about getting coding errors and are thus taking much longer to double check their coding. This puts a lot of pressure on a practice’s support team and takes time away from other functions that need attention. More time taken up by coding also means less time for billing. This results to rushing—and that’s when mistakes happen.

Outsourcing medical coding and billing prevents errors from happening. Medical billing companies are focused on getting everything right, and they’re less likely to commit mistakes because this is the core of what they do. They also have ample knowledge and the right equipment to see to it that bills and claims are processed quickly.

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Rectify Your Patients’ Health Information with Document Management System

Administrative costs account for over 25% of the total expenditures of healthcare clinics and hospitals. A large portion of this goes to paperwork involved with billing, coding, records, and insurance. Each patient visit adds to the already voluminous paperwork healthcare providers have to deal with on a daily basis. What’s more is these medical facilities are obligated to maintain all these records for at least 10 years after any patient’s final visit. With the amount of information that practitioners have to manage, how do you ensure your own practice’s reliability, accuracy, and efficiency in keeping patient records?

Many healthcare providers are discovering the benefits of digitizing their patient records and other related paperwork and adopting the appropriate document management system, which, in a lot of ways help reduce the cost of paperwork management and at the same time ensure document processing speed and accuracy.

Cost efficiency is one of the most obvious benefits of document management systems. Facilities that have already switched to digital record keeping systems cut spending substantially in terms of reduced material and equipment costs, reduced storage needs, reduced retrieval fees, and smaller staffing costs. Well-designed document management systems also ensure information security and regulatory compliance. Paper documents are prone to damage due to natural disasters and accidents, ranging from mold to fires, flooding, and other incidents. Physical damage to paper-based documents are usually irreversible rendering patient information non-recoverable. Electronic document and file systems have redundant storage features and highly efficient disaster recovery solutions, making sure that all information stored can be recovered one way or another. Even when a particular server fails, there are digital backups that practitioners can turn to so important information can be recovered when needed.

Document management systems also provide a level of protection no paper-based file system can offer, that is a detailed chain of file custody, wherein timestamps and employee names are recorded on each stage of the document processing. This means extensive protection of patient information confidentiality.

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An Essential Tool for Efficient Practice Management – Medical Billing Software

Practice management will be less stressful and tedious with the help of the right tools. No matter the size of your operation, any medical practice entails a lot of complex processes to keep up with. Streamlining different aspects of your operations should help simplify your practice and allow you to focus on what you do best—which is providing your patients the care they deserve. Discover the many great advantages of practice management solutions by letting electronic medical software and medical billing programs do the work for you:

• With a medical billing software, you can automate many time-consuming aspects of the billing process, ranging from invoicing to claims processing. Electronic medical billing is the future of any medical practice and it is exactly what sets today’s clinics apart from traditional doctor’s offices.

• Transactions are made easier and faster as medical billing services help reduce excessive paperwork traditional medical billing processes require. With your own customizable program, you reduce tedious paperwork without compromising patient records, claims, and billing records.

• Medical billing software programs do require a substantial investment, but the upfront cost is a small price to pay compared with the efficiency that they bring to practices. Overhead expenses are also reduced as they eliminate the need to hire additional employees to take care of the different steps of the billing process that medical billing software can all do with little human intervention. 

• Thanks to advanced technological integration, medical billing programs also allow fast and easy access to all data and patient information a medical practitioner needs. With all essential data kept in a central location, you have access to the information you need anywhere and anytime you need them.

• Finally, medical billing software programs help reduce error margin as there is less manual work involved. The best programs can even be customized to fit your office’s workflow, helping you reduce errors while ensuring all your billing needs are met.

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