How many infusion billers does it take to change a light bulb?
I have no idea, but I can tell you that the number one cause for errors in billing, as I see it, has to do with too many assumptions and way too much carelessness.
Companies place so much emphasis on getting the claims out the door. You know…timely filing. The faster we can get that claim out, the faster we can get our money. While that is true, those claims need to be squeaky-clean. Managers assume that these claims are going out correctly. That’s what they are paying for...right? If someone would just take the time to review the claims first and point out any potential errors, then these companies just might get their money faster.
For example, I have a client that was having some major issues with one of their payers. Their claims continued to be denied stating that the provider was out of network. Everyone (both sides) assumed that the claims were correct. The provider even went to the trouble of submitting full documentation with proof of positive clinical outcomes from the therapy. Usually when these types of errors happen it’s for something so ridiculous (i.e. obvious) that people can not believe the reason. Would you believe that I found that each of the claims were being consistently printed with a lower case “i” after the tax id number? That is all that it took. And for that reason tens of thousands of dollars were being held up.
This is just one silly scenario. And, believe it or not, mistakes like this are out there. Don’t be surprised if you are making them right now. Please relax and focus and take the time to do it right the first time. Computers are great…people are better!
Gary Collins, President
Professional Reimbursement, Inc.
www.teampri.com
800-774-0899