For every medical specialty, having an accurate and efficient billing process is important to receive maximum reimbursement. For dermatology specifically, maintaining accuracy can be even trickier, due to the specialty requiring both medical and surgical aspects in many instances. If you have a team of coders and billing specialists, it is crucial that they have a thorough understanding of dermatology CPT codes, modifier usage and other factors.
But even if your team is very knowledgeable with billing and coding, mistakes can still happen. Here are some of the most common errors when it comes to billing and what you can do to avoid them:
Mistakes with Insurance Verification
Insurance issues are common causes of claim denials, such as not updating a patient’s insurance provider or eligibility. To avoid this, utilize a verification step into your billing workflow process for each patient visit. This includes checking all the potential causes of insurance-related denial—non-covered services as detailed in the plan, maximum benefits already reached, non-authorized services, termination of coverage and ineligibility. By checking each appointment, you can ensure there are no policy issues that can lead to a denial.
Missing Claim Information
One empty line or unchecked box on a claim can result in a denial, even on common fields like gender, date of birth, etc. Be sure to review for missing items (and have someone else take a look too) before submitting. For electronic claims, check if your program can identify and alert you of missing fields.
Information is Not Specific Enough
Insurance companies will often deny claims that are not specifically coded enough or that are inaccurately shortened. Each diagnosis must be coded to the absolute highest level for that code (the maximum number of digits for the code). If your team is unfamiliar with coding, they may make this type of mistake regularly without realizing it.
Deadlines Not Met
In some cases, payers give two-year “timely filing” windows for individual medical claims, while others only offer 30 days. If not filed within the set time frame, denials for timely filing are among the most difficult to appeal. Maintain a list of your most common payers’ deadlines and incorporate it into the organization of your biller’s “to-do” lists. Unfiled claims should be audited regularly to ensure that none slip through the cracks. A recurring reminder or calendar event can also help with this.
Typos and Coding Errors
Like in everything else, people make mistakes with coding and billing, whether it’s duplicating a charge, misspelling a patient name or putting in the wrong date. Even small errors like these can stop an insurance claim in its tracks. Like with the missing claim info, double-check all the details (or have another set of eyes on it) to ensure everything is accurate.
Perhaps you don’t want to deal with the responsibilities of billing and coding, along with other business burdens? If so, VitalSkin may be the right option for you. Our partnership means access to a full suite of business support, including a billing and coding team. To learn more, schedule a consultation with one of our practice management experts today!