Medical billing can be tricky, with lots of room for mistakes. A smooth, super-efficient system is needed to handle medical claims without any big errors. Even small mistakes can cause significant problems for doctors, insurance companies, and patients. Regular billing checks help avoid errors and audits, saving your office from headaches.

What Is a Self-Audit?

If you work with billing, “audit” might sound scary. It’s often linked to checks by payers or in-depth looks at how your office and specialists do their jobs. These audits could happen unexpectedly or after a big mistake. Nobody wants them. Self-audits are a way to prevent these outside audits by making sure everything is running smoothly all year. Healthcare providers can do healthcare audits, or they can choose to outsource to third-party medical billing companies in the USA to handle audit-related tasks. 

Common Errors in Medical Claim Submissions

Understanding why self-checks are necessary means looking at the mistakes that can mess up a doctor’s office. Medical billing involves lots of charts, codes, and messages between people. It’s easy to make a mistake that turns into a big problem. But there are ways to stop a billing mistake before it gets worse. You may have already seen some mistakes, so you’re interested in self-audits. If not, here are three common mistakes in medical billing:

Messed-up codes

Every medical biller knows how important codes are. Codes like CPT, point of service, and ICD-9-CM are used during claims. Putting in the wrong code, mixing up codes, or not using enough or too many digits can cause significant problems later. These codes are updated yearly, so keeping your manuals current is crucial.

Processing mistakes

When handling many claims in one day, billing specialists might need to catch or enter parts of a claim correctly. Common mistakes include:

• Entering patient or provider information incorrectly.
• Check if the patient’s insurance covers the service.
• Mixing up different claims.

Getting every detail on a claim is essential to go through smoothly.

Security issues

A big worry in medical billing is a security breach. If there are gaps in your electronic security, sensitive patient information could be at risk, leading to significant problems and lawsuits. A major security breach could force a doctor’s office to shut down. Regular self-checks can help keep the office’s electronic systems safe from bugs and hackers.

These are just a few examples of medical billing that can go wrong. Even with lots of training, even careful specialists can make mistakes that mess up billing later on. It’s much better to stop billing issues before they happen than to fix them afterward. Self-audits are a great way to protect an office from billing mistakes and problems with claims and processing.

What are the Benefits Of Self Auditing?

Self-auditing, like checking your work regularly, might seem like a hassle for your team. However, taking a little time each year to review your processes is much easier than dealing with an extensive audit from someone else or fixing a grave mistake later. Big mistakes in billing can cause chaos, make your office look bad, and even cause problems for patients. Instead of waiting for something terrible to happen, it’s better to do regular audits and checkups on your work to catch problems early.

How to Do a Self-Audits

Keeping track of medical billing can be easier if you do regular self-audits. Knowing the best ways to look at your billing records and fix any problems can make this process quick and easy. The main goal of self-auditing is to help your company. Follow these three steps to make the most out of your self-checkup:

Check your systems

Pick a group of patient records from the last six months for your team to review. Look for missing information, incomplete documents, or mistakes in coding. Make sure everyone doing the checkup uses the same methods. Give them a list of things to look for with each record.

Find any problems

If you have coders available, get them to help with the checkup. Otherwise, you might need to hire someone from outside. Tell coders to be on the lookout for possible problems. If they spot anything suspicious, they should immediately tell a manager for review and action. Assign a manager to deal with any potential issues.

Fix the issues

If the checkup uncovers any mistakes or concerns in your billing system, take time to investigate and fix them. This is your chance to catch any problems before they become bigger for your company. Consider if upgrading your system could help prevent problems in the future. Self-audits are also suitable for evaluating performance, assessing, and introducing new technology.

Make Use of Billing Software to Maximize Productivity

Self-review aims to fix and improve how you do things. Be careful to spot even the most minor mistakes. By watching out for common errors, your team can prevent most medical billing mistakes before sending claims for payment. Your office needs to move claims through the system quickly and accurately. To stay on top of things, check if you need to improve critical areas like communication, teamwork, or using the latest billing and coding technology.