Six of the Most Common Billing Mistakes in Outpatient Therapy Clinics

 

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6 Common Clinics Billing Mistakes And How To Avoid Them

Your therapists may be providing top quality care, but it’s the efficiency of your billing operations that will determine success.

Here is a look at the most common billing mistakes being made in outpatient therapy clinics today.

Human error is wreaking havoc on your clinic
A misspelled name, an O when it should be 0 for the ID number, or a wrong date of birth are just a few of the common data entry errors made by front desk staff. These mishaps may be minor, but they lead to rejected claims and delayed payments.

Your therapists aren’t assigning the ICD-10 codes
It’s up to the therapist to assess the patient and assign the right ICD-10 code. Yet he or she may not realize or feel comfortable changing the physician’s initial diagnosis to provide a more detailed classification. Without the correct code, however, the claim may get denied.

Your documentation is too general
Without defensible documentation, claims can get rejected or worse, your clinic could face fines or be forced to pay back money. Getting therapists provide complete and accurate documentation is an ongoing challenge. It needs to be enforced with training and therapy software that provides guardrails to ensure compliance.

Not checking insurance benefits
It should never happen that a patient receives a surprise bill because the care wasn’t covered. Clinic staff need to be trained to always check the patient’s eligibility before the first appointment, and use therapy software that does it automatically.

Referrals and authorizations are falling through the cracks
Time and again, claims are rejected due to a lack of physician referral or payer authorization. Without automatic verification in the therapy system, clinics have to rely on busy staff to stay on top of the details.

You have zero insight into trends
Clinic management often doesn’t realize that there is a billing issue until it’s too late. Instead of relying on the billing team to alert them, executive dashboards with daily views of clinic operations can keep them involved and aware of what’s happening before problems escalate.

Do any of these mistakes sound familiar to you?
Many of these billing headaches can be solved through a combination of training, best practices, and therapy management software. Find out what steps you can take to correct these mistakes once and for all, and get back in the black.

To learn how Optima therapy for clinics can help you reduce denials and increase reimbursement, contact us today.