If there has been an incident and you need to file a claim, it is important that you do so promptly and correctly. Making an error in the filling process could keep you from the benefits you deserve.

By taking note of the most common errors or having a checklist of these nearby when filing, you can make sure to avoid most, if not all rejections or denials.

Common Input Errors:

Probably the most common of these errors involve information that is included or excluded in the claim.

These include:

• Incorrect patient information (name, gender, date of birth, insurance information, etc.).
• Incorrect insurance provider information (address, contact information and policy numbers).
• Mismatched diagnostic and treatment codes.
• Incorrect or switching of codes (CPT, point of service and other codes that are mixed up).
• Codes that have excess or missing digits.
• Missing codes for all or some of the services performed.

Wonder Worth Solutions combines years of firsthand, medical practice management experience with IT expertise to deliver exceptional medical billing solutions that can be customized to suit your specific needs.

Other Avoidable Errors

Apart from the actual information being entered into claims, there are certain erroneous actions which also cause rejections or denials, and must therefore be avoided.

These actions include:

1. Taking Too Long to File: One of the most important things to do after there is an incident is file the claim promptly. After you have contacted your insurance company to let them know about the incident, they will come out to survey the damage, then let you know how to file your claim. There is a specific window of when the claim can be filed. You need to work swiftly, making sure you gather the required documents and submit the claim within that window. If you wait too long, you might have your claim denied and may not even be eligible to an appeal.
2. Upcoding: This involves entering codes into a patient’s bill for services which were not given, or entering codes which are higher in cost and complexity than the services given. This is often done to inflate the total amount to be paid by the patient. This is illegal and can lead to fines and even criminal prosecution.
3. Downcoding: This is the opposite of upcoding, whereby some codes are left out of the bill or purposefully under-coded to minimize a patient’s cost or to avoid audits. While it may have the opposite effect of upcoding, it is still illegal and can also lead to legal repercussions.
4. Not Including All Required Documentation: Part of filing a claim is showing exactly why you need benefits in the first place. You must have proper documentation for the source of the damage and the amount of damage it caused you.

For example, if there was a fire in your home that destroyed most of your kitchen appliances, you need to be able to show what caused the fire and that it was not your fault. You will then need to provide a list of appliances that were damaged and approximately what their value was. If you fail to give them the documentation they request, your claim could be denied, at which point you might need to appeal the denial and hope it is approved the second time.

5. Duplicate Billing: This occurs when a patient is billed for the same service more than once. This often occurs out of negligence.
6. Failure to Verify Patient’s Insurance Coverage: Sometimes a patient’s health insurance coverage will change without the patient’s knowledge. It is a must therefore to verify insurance coverage directly from the provider.

Simplify your billing and maximize the results and revenue with us. Request a free demo for more information http://localhost/main-site-update/live-demo/