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Healthcare organizations require thoughtful consideration of their data-input processes to avoid common, detrimental billing errors.

When dealing with everything from personal daily planning to career management, the devil is often in the details. This certainly holds true for the medical billing process, in which attention to detail can significantly help a healthcare organization save costs due to small mistakes. According to medical writer Avery Hurt, certain key strategies can help physicians and organizations sidestep revenue loss attributed to seemingly minute oversights.

For instance, Hurt suggests that healthcare organizations use the correct modifiers when submitting claims, considering that both not using modifiers and using the wrong modifiers can lead to claims denials. Healthcare consultant Karen Lake from Alabama-based Pearce, Bevill, Leesburg, Moore, P.C., notes that using an incorrect modifier is one of the most common billing errors. Lake encourages physicians and healthcare organizations to make sure that their staff are thoroughly trained to avoid easily avoidable oversights. What’s more, Lake urges physicians and organizations to direct training toward their most frequently employed diagnoses and procedures rather than waste time training staff how to properly apply codes that aren’t even relevant to their healthcare organization.

Another strategy that Lake encourages physicians and healthcare organizations to heed may seem obvious, but it is surprisingly an issue; they must bill the correct payer. For example, consider a patient who thinks they are on Medicare when they have a policy with Blue Cross. The patient hands in a Medicare card to the front desk, and upon entering the patient’s information, office staff submits the claim, but it is rejected. Lake notes that healthcare organizations can easily steer clear of such errors if they simply verify insurance upon checking in patients.

Lake emphasizes that failing to include even one required field can lead to a denied claim, adding that double-checking the inclusion of all necessary information is an easy task that inputters should never skip. Inputters should ensure that all required information is filled in accurately. As Lake points out, everything from name spellings to phone numbers needs to be error-free. According to Kenneth Hertz, FACMPE, a principal consultant at Medical Group Management Association,  maintaining an isolated space specified for taking insurance information is ideal, as this will minimize distractions and allow for dedicated concentration during data input.

Brennan Cantrell, a commercial health insurance strategist for the American Academy of Family Physicians, points out that electronic health records are an excellent tool for healthcare organizations seeking to analyze errors as a tactic for lessening the number of billing mistakes. One strategy might be to look for patterns in errors. For instance, perhaps a healthcare organization is consistently producing clinical coding mistakes. Pinpointing patterns can, Cantrell notes, allow organizations to prioritize where training is most needed. Cantrell also points out the importance of obtaining prior authorizations when they are imperative for procedures and prescriptions. In a perfect world, notes Cantrell, organizations would have a staff member whose job is specifically dedicated to handling prior authorizations, as they present a humongous administrative burden.

Ultimately, healthcare organizations require thoughtful consideration of their data-input processes to avoid minute oversights ballooning into potentially detrimental careless errors. Implementing a few simple data-input strategies goes a long way in preserving revenue.