Up to 80% of all medical bills contain mistakes.
This alarming figure was deduced by the Access Project, a Boston-based health care advocacy group, and is close to what many health experts have been saying in recent years. Furthermore, Kaiser Health reported that $68 billion in lost healthcare spending can be attributed to medical billing mistakes.
Mistakes result in loss of reimbursement so the practice loses revenue. Secondly, and a potentially costlier problem, is that when it comes to Medicare billing, the federal government and Office of Inspector have “zero tolerance” for any inadvertent errors, fraud or abuse. A practice can be prevented from billing Medicare or Medicaid services for years if it is found negligent.
David Womack, president and CEO of Practice Management Institute, notes the risks are not just financial, as consequences of medical billing errors can even result in harm to a patient. A failure to bill correctly may affect a patient’s treatment due to an incorrect diagnostic code that could lead to improper patient care at another practice.
“Companies offering professional certification in medical coding, third-party billing, office management and compliance are helping set a higher standard in employment by providing up-to-date education and testing that assures each applicant’s complete understanding,” he says. “The result being that physicians can focus their attention solely to patient care, translating to a better experience for the patient, all while ensuring the practice continues to be successful.”
Jim Leonard, director of healthcare business development at GRM Document Management, a records-retention and management service, says problems with billing are less an issue of errors than attempting to file a claim with unverified information.