Overbilling issues arise from time to time in health care, and sometimes, they occur due to an oversight or a lack of knowledge, rather than malice. However, when your health care practice repeatedly overbills patients, Medicare or other programs, it may lead to significant legal trouble.
According to Medical Economics, the results of a 2013 study reveal how common medical overbilling has become across America.
The study revealed that more than 490,000 health care providers billed Medicare for at least 11 standard patient visits in 2015. Of those 490,000 providers, 1,250 of them used the wrong codes to bill for those visits, using a code that referred to a far more intensive – and expensive – treatment. Another 1,825 of the providers reviewed had billed Medicare for the most expensive type of office visit available for almost 90% of all patient visits.
There are a number of measures you might take as the owner of a health care practice to reduce overbilling in your clinic. For starters, consider hiring an individual or team that is going to be responsible for overseeing all bills before they leave your practice. This person or team should have extensive knowledge in proper billing and coding procedures and be current on all regulatory requirements.
You may, too, want to conduct internal monitoring to help enhance accuracy in billing. Training your administrative staff thoroughly about your expectations when it comes to billing may, too, help eliminate problems before they arise.
Overbilling issues may mean big trouble for your health care practice. However, the vast majority of billing errors are avoidable.