A reliable and steady revenue stream is requisite for running an efficient home health and hospice agency. If your billing errors are not optimized for success then it’s difficult to achieve reliable and steady revenue.
Whether they incur denials, delayed payments, lost productivity, or client complaints; billing errors can inflict detrimental effects on your revenue cycle management.
Eliminating billing errors is integral for your bottom line, so you have to narrow down common billing mistakes that your agency is prone to make and craft strategies to prevent repercussions.
Certain home health and hospice billing complaints are costly and they may lead to severe financial crises and even loss of significant revenue if not addressed efficiently.
Here are several billing and coding errors along with their coping strategies.
Common Medical Billing and Collection Mistakes
1. Insurance Verification Failure
The primary reason for claim denials is insurance malfunctions. The overreliance on routine may cause a failure to verify stems. For instance, when patients visit the practice frequently the staff may assume that their coverage plan or insurance provider hasn’t changed, resultantly they don’t check the eligibility.
As insurance information is prone to change at any time, the Implementation of a verification step into the billing process is quite mandatory. This implies that you have to check all four potential reasons for all insurance-related claim denials.
- Services not authorized.
- Coverage terminated or otherwise ineligible on date of service.
- Maximum benefits reached.
- Services not covered by the plan.
By implementing these steps into your home health and hospice billing and collection workflow, billing companies verify the patient’s insurance at every visit. In this way, you can minimize the policy-related issues that may lead to claim denials.
2. Disorganized and Scattered Claim Fillings
Accurate coding and billing lie at the heart of efficient claims. A single unchecked and empty section is all it takes for a claim denial. In most cases, even the fundamental field like date of birth, time of accident, or gender are left blank.
Timely claim fillings are also critical for smooth RCM. Deadlines play a pivotal role in claim acceptance or rejections. The overdue claim fillings adversely affect the cash flow and resultantly profit diminishes.
An efficient system for claim fillings, billing, and collections is the easiest way to prevent claim denial mishaps. The automated system of billing companies considerably reduces the tardy filling and reduced cash flow possibilities.
3. Lack of Specifications
Insurance companies often deny claims that are truncated (unnecessarily shortened) or not coded with a high specificity level. The trained coder is well aware that each and every diagnosis is required to be coded with the absolute highest level.
With the ever-changing requirements for billing today, staying on top of the new codes, rules, and documentation is truly a full-time job. The best approach is to outsource coding to a home health and hospice billing collection company, so your staff can focus on other responsibilities.
4. Miscoding and Typing Error
When your staff is heavily involved in coding along with other responsibilities it’s common to make general billing errors. These errors can be in the form of a duplicate charge, incorrect date, unbundled code, or miskeyed patient name.
Even honestly accidental mistakes can lead to a derail insurance claim. The upcoding and under coding mistakes are illegal and they may lead to heavy fines or criminal persecution.
5. Lack of Follow-Ups
In case you haven’t noticed your home health and hospice agency is leaving a lot of money on the table by not following denied claims. Your staff can be overwhelmed with tasks and they may stop consistently following outstanding payment denial claims.
To Wrap Things up!
Home Health & Hospice billing and collection is a complex area that can create big problems for healthcare providers.
Managing billing and collections is not an easy task. It requires a lot of knowledge, skill, patience, and determination.
Outsourcing billing and collection has proven to help home healthy and hospice practices in maximizing revenue by lowering claim denial rates.
Our experts at Dominion Revenue Solutions make use of the best policies and systems to aid your agency in increasing the clean claim ratio and maximizing RCM.
If you’d like to inquire about working together, and how you can stop making these mistakes, click here.
