Obviously, it goes without saying that your practice deserves to be paid for the care you provide. That’s especially true when you’re only running a small practice and don’t have the resources or cash flow to recover from delays in reimbursements.  

But incorrect medical coding and billing mistakes can seriously get in the way of that. In today’s healthcare system, even minor errors can lead to:

– Denied claims

– Delayed payments

– Extra work for your physicians

– Unnecessary headaches

Inaccurate coding – something as simple as a wrong digit in a CPT code – can turn an otherwise clean claim into a denied one, which can be pretty problematic. Incorrect coding, like billing the wrong service entirely, only makes things worse. 

And for smaller healthcare providers with tighter margins, denied claims can be a massive hit to your financial stability and means you’ve got more staff dealing with resubmissions rather than treating patients.

Common Coding Mistakes

Larger healthcare organizations usually have dedicated coding departments. On the other hand, small practices tend not to have luxuries like this. They often rely on in-house staff to manage the coding process along with everything else. So that’s where the margin for error gets fairly slim.

One of the more common mistakes we see when working with smaller practices is that the in-house staff have been billing for services that are supposed to be bundled together.

Reporting multiple codes when only one bundled code is appropriate will often get one of those claims rejected. For example, billing a lesion excision and a simple skin repair together without the proper modifier will almost always result in the second service being denied.

Another frequent issue is entering the wrong code altogether, which is definitely easy enough of a mistake to make. The whole claim can go down the drain from something as simple as:

– A mistyped digit

– A dated codebook

– Not applying the latest updates 

And if the billed procedures aren’t properly backed up in the patient’s medical records, it’s game over. Every CPT code should clearly tie to a documented diagnosis. If it’s not charted, insurance won’t count it.

Tips for Accurate Coding

So what can you do? Train your staff to treat every claim like it matters – because it does. Review each diagnosis and procedure carefully before submission. Make sure your documentation lines up with what you’re billing.

In addition, it’s a good habit to start looking at your denied claims each week, regardless of how many there are. That’s not just so you can fix them, but also to see where your process is slipping. 

If, for instance, you notice that rejections keep coming back for the same codes or the same payers, take a closer look at what’s actually going on there. Fix the source. A tighter coding process now means you’ll be saving hours of corrections later.

Finally, make it another habit to implement regular internal audits. Periodically reviewing your claims is a solid way of spotting patterns of errors before they ever become a systemic problem. That’s a far more proactive approach since checking up on your revenue cycle health helps you spot areas where your practice can improve in your documentation and coding process. This also reinforces your practice’s long-term success.

And just keep in mind throughout all of this: the goal isn’t perfection, but awareness. The more you know where things go wrong, the fewer denied claims you’ll have to deal with. Over time, that adds up to smoother operations and stronger revenue cycle management.

Why Outsourcing to PMN Makes Sense

Running a small practice means juggling a lot. Between patient care and administration requirements – not to mention staying compliant – the paperwork alone can really start to pile up. That’s where outsourcing to a company like PMN can really take the weight off your shoulders.

We’ve got over 20 years of experience, and can handle your practices medical billing and coding for practices across many different specialties. We’ll take over the full administrative load so you and your team can focus on providing healthcare services – not decoding payer requirements or appealing denied claims.

Our expert medical coders make sure all your claims are compliant and ready to go out the door correctly the first time. That leads to faster reimbursements and fewer rejections. 

Are you interested in hearing more about the range of services we provide here at PMN? If you’d like to have a conversation with us in person, don’t hesitate to schedule an appointment at our office in Laguna Hills, Orange County, California. Alternatively, you can get in touch by calling us for a quick chat.

Final Thoughts

Coding is obviously a bit more than just paperwork since it’s the backbone of what actually keeps your practice running. So whenever coding errors start to pile up, they impact everything – from your cash flow to your ability to provide quality patient care.

So rather than trying to handle coding in-house with your limited staff numbers, consider handing it off to the experts. If it’s all getting just a bit too much to manage, outsourcing to a company like PMN can help lighten the load while keeping your claims clean and your revenue flowing.

In the end, a healthy billing system supports a healthy practice. And that makes it easier to care for the people walking through your door.

FAQs

What Are The Most Common Coding Mistakes That Cause Denials?

Entering the wrong CPT or ICD code is a big one. So is billing services separately that should be bundled. Without the right modifiers or documentation, insurers often reject those claims. Staying current and checking your codes before submission can prevent a lot of these issues.

How Can Outsourcing Billing Help My Practice?

Outsourcing connects you with experienced billing professionals who know how to submit clean claims. They:

– Reduce coding errors

– Speed up payments

– Free up your team to focus on patients

As a result, you’ll have fewer denials and more time for the care side of your business.