Tackling Commonly Encountered Medical Billing Claims Submission Errors

November 26, 2012 11:23 am

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Revenue cycle management is many-layered and a non-proficient medical billing company may easily lose its way within its maze, unless they hold the right map which may guide it unfailingly through its many pitfalls.  Incidentally, such a map has to be devised by the medical billing company itself; the key ingredients for which are:

1.  Medical billing and medical coding expertise of its own personnel.

2.  Their study of the many reports (Denial, A/R etc) generated by their EMR/Medical Billing software and their proficiency in generating such reports.

3.  Proactive measures undertaken by the company to keep itself updated with the latest medical billing and medical coding guidelines.

Unfortunately, the usual run-of-the-mill medical billing company is usually found to be lacking in all of the above, and hence their modus operandi at best can be described as an ad-hoc submission and follow-up of claims, with no regards to finding patterns to optimize future submission of claims.  But BillingParadise strives to stand out from this motley assortment of underachievers.   Our claims submission , A/R follow-up, and denial management protocols have been derived scientifically based on all of the above.  We don’t leave it to lady luck to decide whether you get reimbursed appropriately or at all for your services.

For example, one of the medical billing errors commonly encountered in many a claims submission cycle, has almost disappeared from our annals of claims submission history.  This is the error:  10416.

The above is encountered when the DOS overlaps a hospice election period of a patient.  Medicare mandates that the SNF provide all care relating to any terminal diagnosis, and thus won’t recognize the services of another non-hospice provider. This, unless the care is being provided for a non-terminal condition the patient may have.

Thus BillingParadise, which believes in honing its medical billing skills to a fine edge, will leave no stone unturned in making sure you get the maximal reimbursements for your claims.  Call us at 1-888-571-9069 for a telephonic rendezvous.

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