CAN THIS FIGURE BE REDUCED?
by Contributor
(Apr. 3, 2018) — According to reports from several leading medical billing companies, roughly 80% of all medical bills in the U.S. contain at least one minor error. In addition, these mistakes result in about $70 million worth of unnecessary spending by doctors and patients each year. This statistic may come as a surprise to the owners and managers of medical practices that spend hefty sums on clearinghouse services to ensure such errors don’t go unnoticed. With so much emphasis on claims and billing, how is it possible that such a high error rate would still be present in such an advanced industry?
Improper Use of Medical Billing Software
Technologies have the power to improve processes or worsen them, depending on how they’re used. Many medical practices are now relying so heavily on software that they fail to exercise their own discretion when submitting claims. Although software-based systems have come a long way and are certainly useful, the technology still isn’t at a “set-it-and-forget-it” level, so it’s important for practices to know how to fix medical billing errors manually rather than relying fully on algorithms.
Lack of Human Expertise
When the complexity of a tool exceeds the capabilities of the user, you’re going to inevitably wind up with mistakes, and that appears to be what’s happening in the field of medical billing. You have clerical desk workers who aren’t necessarily software specialists, and yet often there isn’t a serious attempt to ensure they’re fully trained in the interfaces they’re using on a daily basis. One way to solve this problem is to choose a more user-friendly medical practice management (MPM) platform and/or invest in hands-on training courses for key employees.
Can We Turn the Tables Around?
Ideally, it would be nice to see a total shift in the rate of mistakes found on medical bills, with the goal being an error frequency of no more than 20%. Still, even if that were to happen, we’d still only have an 80% overall accuracy rate, which seems anything but acceptable in the medical industry. One could argue that healthcare professionals are adjusting during this transitional period where apps and programs have essentially replaced the role of manual recordkeeping and accounting. Thus, it’s imperative for every practice to make a concerted effort towards maintaining consistently accurate billing systems.
Bonus Tips for Reducing Medical Billing Errors
If you manage a medical practice, chances are you’re surprised and somewhat upset about the aforementioned statistics and the current state of affairs in medical billing. Other than using the right tools and making sure your staff is trained, here are a few things you can do to keep errors minimal:
- double-check every claim before submitting it, even if you’re using a digital submission platform
- track employee performance and address shortcomings
- emphasize the importance of accuracy and thoroughness
- invest in quality training courses and software
Aside from the above, you may also want to consider enlisting the assistance of a clearinghouse if you’re submitting a high volume of claims on a regular basis.