Is your claim rejection rate costing you money? Delayed or incorrect reimbursements from medical aids directly impacts your practice’s cash flow & revenue. The good news is that most coding & billing mistakes causing rejected claims are preventable. If your claims rejection rate is high, focus on fixing these common coding & billing errors: 

1. Poor or missing information 

It’s not uncommon to forget to add important information when creating a billing instruction. You could also forget to add consumables or your handwriting might be illegible. Unless your staff or billing company are able to clarify the billing instructions directly with you, a claim can easily be incorrectly submitted & rejected. 

How to fix it

Use an Electronic Medical Record (EMR) that integrates directly with your practice management software. Because you can send billing instructions electronically directly to your billing company or staff, there is less chance of illegible or incomplete information. An integrated EMR is an effective way to ensure that the claim is submitted correctly & will be paid on time. 

2. Inaccurate procedure & consumable codes 

Forgetting to include procedure & consumable codes for minor treatments is one thing, but if you are not capturing them correctly & in the right order, you run the risk of the entire claim being rejected. 

How to fix it

The right practice management system takes the complexity out of coding. Choose a system that allows you to create & use customised billing templates. This means that codes for common procedures & consumables are organised in their correct format & you are less likely to forget to include them in your claim.

3. Simple errors

Human error when capturing patient information is another common & costly mistake. Misspelling a name or accidentally swapping a digit in a medical aid membership number can mean rejected claims. 

Ensure that your staff verifies the following patient information at every visit: 

• Correct name & spelling, date of birth & medical aid membership 
• Medical aid information such as membership & dependency numbers

How to fix it

There are a few ways to prevent simple errors. First, use a practice management system that is integrated with your clinical notes. This means that the same, accurate patient information is accessed from consultation to billing. 

Secondly, perform a benefit check before a patient’s scheduled appointment. You can then verify whether the patient’s medical aid details you have on file corresponds with the information from the medical aid. It also reduces the risk of rejected claims due to depleted funds or incorrect information.

Do you recognise any of these common coding & billing mistakes or grappling with a high claims rejection rate? Chances are that your practice management system is inadequate for your practice’s needs. Avoid costly coding & billing errors with a practice management system that integrates with your clinical notes. If you need help reducing coding errors at your practice, click here & a skilled Business Consultant will contact you to demonstrate how.