In medical billing, improper payments an area of concern for almost all healthcare practices, clinics, hospitals etc for ages now. In fact, according to a recent report, where CMS has reported spending around $ 1.1 trillion on coverage for 145 million people across America, where they end up wasting about $ 95 billion precisely due to improper payments and improper billing. It is reported that around 3-10 percent of total health spending is wasting due to improper billing. A billing mistake or a fraud in the billing process can happen for many various reasons like:
- incorrect billing
- even upcoding claims
- unaware of recent and changing HME billing regulations
- un-updated software
All these can be the reasons for your HME billing errors where you can further be charged with Medicare fraud or abuse for your practices and even delayed reimbursements, bad ROI and legal consequences. Moreover, to reduce the billing errors and mistakes the Congress has even mandated severe punishment for false claims.
This is why having a strong complete HIPAA compliance standard becomes important for a practice that can ensure complete operational transparency with lesser billing and coding errors and frauds.
A billing and coding errors have numerous negative impacts on your practice. The primary concern of healthcare practices is regarding the increase in the denial rate. This is why careful measures should be taken to avoid billing mistakes.
Ways to prevent HME billing mistakes:
Maintain an updated and proper documentation process – accurate records and information help the treatment process as well as practices to earn faster reimbursements.
Be careful of upcoding or undercoding – upcoding is when a code is entered into a patient’s bill for services that were not received or undercoding is when codes are left out of a patient’s bill; in both the case's issues like reimbursement as well as illegal can be a problem which is why proper and careful measure has to be taken.
Proper claims management – inexperienced billers and coders due to excessive administrative pressure often miss out on the deadline and end up delaying claims. Being overwhelmed with the number of claims they’re handling they even miss out on the most recent changes within the industry; thus leading to billing errors and mistakes.
Avoid duplicate billing - another HME billing error is duplicate billing which is when a bill is done twice.
Ensure billing transparency - transparency in a billing process helps in identifying the root causes of billing errors and improving on them.
With more than 12 years of experience in dealing with a broad range of medical billing services, Sunknowledge Services Inc has seen just about every kind of HME billing error an organization makes. Thus, making us an efficient RCM solution where our experts ensure of maintaining a 99.9% accuracy rate in the billing and coding process. With cleaner and timely claims submission, our experts further help in 80 % operational cost reduction and the highest productivity metrics in the industry. With excellent industry references across the industry, we today are the operational partner of the top 3 leading HME names in the industry.
So, if you are struggling and in need of an expert HME billing solution, let Sunknowledge Services Inc be your go-to source for error-free billing solutions. For more information, get in touch with our experts.