Accurate medical coding is necessary for claim reimbursement and plays a critical role throughout the whole claim cycle. Inaccurate coding can have a negative impact on the practice in a number of ways, including by causing missing income opportunities, potential overpayments, and charges of abusing reimbursement guidelines. Incorrect coding can also cause personnel issues due to the increased quantity of follow-up required for claim denials. The most difficult task is knowing the various codes from the many code sets that are updated on regular basis.
Top Challenges in medical billing and coding for mental health practices:
- The pain of takebacks
- Incorrect application.
- Operating in a state of denials.
- Revenue integrity can close the gaps.
Patients with mental health issues receive invoices from insurers for services like counselling, psychological evaluations, and medical management. The largest problem with mental health billing is that it frequently happens that a patient’s requirements are greater than what the insurer would pay for in terms of services.
Financial & Clerical Challenges:
Many organizations that outsource medical billing encounter administrative and financial difficulties. Several regulatory initiatives address the current need for cost reduction and quicker medical billing services. They are:
- Data Collection: Patient registration & Claim preparation.
- Claims Transmission: Coding edits & Diagnosis Entry.
- Claims Management: ERA Download & Payment posting (electronic/paper)
- A/R Follow-up: Secondary Claims, denial management & appeals.
- Reporting: Report creation & Analysis for practice recommendation.
- Describe the need for treatment and provide a clinical justification.
- Incomplete, non-concise, inaccurate data, including the face-to-face consultation.
- Missing legible, dated and signed document.
- Improper maintained and unavailable data for review.
- Inappropriate medical coding for billing purpose.
Common Medical Billing Errors:
- Incorrect Patient Information leads to denial of claim by insurance.
- Double billing for single treatment on the same bill.
- Double billing for single treatment on a different bill.
- Incorrect treatment code leads to more expensive charges.
- An in-network provider uses an out-of-network lab for testing.
Medical Coding Pitfalls:
- Fraud and negligence
- Erroneous codes in claims that are submitted
- Pre-approvals: The changes in insurance can cause the claim to be denied, leaving you with uncollected payments. Similarly, if you treat a patient before getting that pre-approval, the insurance provider won’t pay for the required care. This can eventually result in a patient needing assistance to pay for those treatments, missing appointments and losing out on revenue opportunities. Individuals who are in need of mental or behavioural health care are probably going to frequently attend planned visits and services.
- Coding Bills Correctly: Coding errors can cause significant delays in claim approval or even prevent the claim from being approved at all. If a patient has many disorders, mental and behavioural health coding may be more specific. Most of the time, conventional billing software is not made for mental and behavioural health practises. This could make submitting your claim to the system more difficult.
- Insurance filing preferences: Most insurers now-a-days use a digital billing model. However, this does not mean that every agency will go by the similar filing method.
The staff may feel compelled to keep up with an ever-changing set of preferences and if you file incorrectly, you may struggle to collect payment from that insurance company.
Outsource medical billing and coding services:
Outsourcing can be the best medical billing solution for revenue cycles leaks. By outsourcing billing to the professionals, you can save a lot of time and money and, as a result, boost your revenue steadily and visibly. It helps in:
- Billing operations is handled off-site.
- Electronic handling of data.
- Data entry, prior authorization, submitting & follow-up on claims with health insurance companies, the billing company handles all of that.
- Easy process with the help of an EHR software.
- Redundancy of data is avoided hence accuracy of patient data is improved.
Partner with Info Hub Consultancy Services :
ICS is one of the top medical billing and coding companies in India providing their best services across specialties. Healthcare facilities, doctors, health organizations, and groups can all benefit from Info Hub Consultancy Services (ICS) medical billing solutions. Our revenue management cycle contributes to a decrease in operating costs and an increase in overall revenue. We are one of the leading medical billing outsourcing services provider for all the healthcare organizations, physicians and medical practices.
Allow us to take care of the challenging medical billing and coding procedures so you don’t have to! Also, we can effectively handle your needs for prior authorization and insurance verification. Use your time and assets wisely. As a member of your medical billing team, we can help produce lasting improvement in addition to just finishing the work.
Our services include –
- Medical Billing
- Medical Coding
- Credentialing Services
- RCM Consultation Services
- A/R Follow-Up