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    4 Medical Billing Errors Preventing a Healthy Patient-Provider Relationship

    Posted by Carl Mays on Thu, Dec 19, 2019 @ 02:00 PM

    4 Medical Billing Errors Preventing a Healthy Patient-Provider RelationshipDo you know that “surveys consistently demonstrate that patients prioritize both the interpersonal attributes of their providers and their individual relationships with providers above all else?” This is the statement made by Kurt Strange, an expert in family and health systems in one of the articles published in Harvard Business Review.

    This video from Advent Health Florida further elaborates on this:



    A healthy patient-provider relationship that develops in the office can quickly be affected negatively if after the treatment the patient receives a medical bill that contains errors.To avoid this from happening, it is important that physicians and staff keep in mind the following common errors in medical bills that can hurt a good office-developed relationship.

    1. Medical Code Mismatch

    Any mismatch with your codes can cause rejection or denial of your patient’s medical claim. Healthcare in America reveals just how much these medical billing errors cost:

    “Most patient billing errors happen due to technology or a staff member entering an incorrect diagnostic code onto the bill. This becomes more common on bills that total more than $10,000 or more. According to credit agency Equifax, those bills often come with errors totaling more than $1300.”

    With a discrepancy amounting to more than $1300, there is no wonder your patient becomes dissatisfied. Thus, it is essential that your medical billers enter the right codes. Otherwise, be prepared to face the fury of your patient or the patient’s relatives.

    2. Duplicate Medical Billing

    As of July 2, 2018, all CMS-1500 hard copy claims should not have any duplicate ICD-10-CM diagnosis code within item 21. This is the directive issued by Medicare. Thus, any claims containing duplicate diagnosis codes will be returned as unprocessed by the Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME).

    With this being implemented, the frequency of duplicate medical billing is expected to decrease, if not eliminated. The outcome is a more satisfying patient experience.

    3. Upcoding

    In 2018, Prime Healthcare Services was charged $65 million to settle a federal whistleblower lawsuit that accused the fast-growing California hospital chain of engineering a wide-ranging Medicare fraud scheme. Included in this lawsuit is the issue of upcoding, a medical billing error wherein services are added to the patient’s medical bill even if these services are not executed.

    Upcoding may happen for two reasons: accidentally or intentionally. Whatever reason it may be, any patient who sees unnecessary treatments included in their medical bill will most definitely direct anger towards your billing staff.

    Therefore, always perform due diligence before issuing a medical bill. Double check the codes you have entered.

    4. Incorrect Entry of Patient Information

    Sometimes, it’s the small things that can be so annoying, such as a misspelled last name or incorrect policy ID number. These could have been easily checked to avoid any claim rejection or denial.

    So, be extra careful and meticulously check all the information you’ve entered into your system. Not only will this save your practice time and money, but it will also free you from heaps of frustration due to increasing patient complaints.


    Billing errors should hurt the provider-patient relationship. Ensure patients are well treated during and after check-in. Do so by handling their medical bills more efficiently through a skilled and reliable medical billing company. Learn more tips and advice related to medical billing and claims processing. Subscribe to our blog, today.

    About ClaimCare

    ClaimCare has more than 29 years of medical billing experience. We have an established 100% USA based medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to clients.

    ClaimCare has a proven track record of increasing client collections by 10 to 20 percent.

    Healthcare Tech Outlook named ClaimCare as one of the nation’s"Top 10 Medical Billing Companies" in 2019. For more information, contact sales@claimcare.net, or phone toll-free at (855) 376-7631, or visit the ClaimCare Medical Billing Company website.





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