When physicians treating substance abuse are taking care of patients, they also have to make sure that accurate billing and coding is done so that the services that’ve been provided are accurately reflected. Given the complexities of substance abuse billing, however, mistakes can often arise that result in delays in payment. Keeping these mistakes to a minimum will help your practice to run as efficiently as it can. These are some of the substance abuse billing errors you’ll want to prevent in your practice.
Not Getting Patient Eligibility Verified
With regards to substance abuse, how much coverage a patient has is dependent upon whatever their health insurance plan is, as well as the location where they purchased those benefits. When you don’t verify patient eligibility and coverage, it can result in claim denials in the substance abuse billing field.
Insurance coverage is something that can change often, for reasons such as a changing address or plan revisions. Staying on top of these changes ensures that a patient’s insurance coverage is always confirmed before treatment. It also helps the patient know what their financial responsibilities will be.
Incorrect or Insufficient Documentation
In the field of substance abuse billing, errors in documentation can have serious consequences with regards to legal compliance as well as patient care. If the documentation you provide doesn’t support whatever services you have billed, you’ll be denied any reimbursement. If you want to justify the interventions you’re providing, you’ll need to have the right papers to back up your reasoning. Failing to explain why a medical procedure is necessary means that insurers will likely not approve payment for the procedure.
Claim Filing is Done Too Late
When you’re submitting insurance claims for your substance abuse billing facility, it’s important to get those claims submitted in a timely manner. Failing to do so could result in your claims being either denied or rejected. This, in turn, could result in your providers experiencing a loss in revenue. Disruption of cash flow can have a large impact on your ability to offer care to your patients, and it can be harder to pay your own staff members as well.
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