Medical Billing

Medical Billing

Common Medical Billing and Coding Challenges/Issues

Inadequate patient data is a common medical billing challenge, especially when physicians fail to provide accurate diagnosis details. Incomplete data makes it hard for billing officers to link a given diagnosis to a specific diagnosing code (Green, 2018). Using incorrect modifiers leading to a telemedicine coding error is another common challenge of medical billing. Wrong procedure codes are another challenge that often makes it hard for billing officers to link one’s service to the correct given codes (Shen-Wagner, 2021). Although rare, upcoding, where patients are billed for multiple procedures, is another challenge in medical billing procedures. They often occur through errors of omission or mistakes. Hospitals should minimize medical billing and coding errors to minimize legal expenses and avoid reimbursements.

Impact of Improper Claims Management

Improper claims management often sets the foundation for increased operational costs in the medical facilities, high litigation costs, and hurting the firm’s reputation. The reimbursement procedures often lead to increased costs ranging from the time and personnel used to correct the improperly managed claims (Yaqoob et al., 2021). Patients who feel aggrieved by improper claim management by overbilling them often seek legal redress, thus increasing the litigation costs for the health facilities. Do you need help with your assignment ? Contact us at eminencepapers.com.

How Technology Can Be Helpful When It Comes To Medical Billing And What Tools Are Available

For better healthcare claims management, the adoption of technology minimizes human error. For instance, the adoption of big data in healthcare claims management helps minor billing errors by ensuring timely patient information updates right after admission to the time one claims the bills (Obodoekwe & Haar, 2018). Digitizing healthcare claims management instills confidence in the patients because of data security and privacy while minimizing many people’s access to patients’ information. By ensuring that only the relevant people have access to the patient’s data, codding errors are minimized. Most noteworthy, digitizing claims management in the healthcare system helps streamline claims management while setting a solid foundation for improved efficiency and optimizing the records’ accuracy.

References

Green, M. (2018). Understanding health insurance: A guide to billing and reimbursement. Cengage Learning.

Shen-Wagner, J. (2021). Family medicine billing for point-of-care ultrasound (POCUS). The Journal of the American Board of Family Medicine, 34(4), 856-858.

Obodoekwe, N., & Haar, D. T. V. D. (2018, May). A critical analysis of the application of data mining methods to detect healthcare claim fraud in the medical billing process. In International Symposium on Ubiquitous Networking (pp. 320-330). Springer, Cham.

Yaqoob, I., Salah, K., Jayaraman, R., & Al-Hammadi, Y. (2021). Blockchain for healthcare data management: opportunities, challenges, and future recommendations. Neural Computing and Applications, 1-16.

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Claims management is the art of consolidating, billing, filing, revising, and managing medical claims, an imperative aspect of the healthcare industry. Medical facilities cannot receive due funds if patients are unaware of how much they need to pay. Ensuring provider organizations understand the fundamentals of medical billing and coding can help providers and other staff operate a smooth revenue cycle.

Medical Billing

Tasks:

Explain some of the common medical billing and coding challenges/issues.
Explain the impact of improper claims management.
Describe how technology can be helpful when it comes to medical billing and what tools are available.