What are the problems that can happen with medical billing? As the medical and health care expenses are rising by the day, it is very essential to plan ahead for unexpected health care bills. If the clients are not careful they may end up paying huge medical bills out of their pockets. The very purpose of taking medical insurance is to avoid such burden of unexpected medical expenses which can be devastating and may totally upset all personal / family plans.
Some of the common problems that you may encounter during the healthcare / medical billing are,
- Overdue payments
- Denied claims
- Not good communication within the provider group
- Errors in claims
- Inaccurate coding
Medical bills have to be paid either by the patient, or by a third party payers, which is could be a private insurance company, a private managed care company, or a government insurance program such as Medicare. Whenever a claim is denied by the insurance company the billing company must find out the exact reason why it happened. The claim should be thoroughly checked to determine if any coding or other error has occurred.
Quite often, a portion of the care (co-payment or deductible) is to be paid by the patient, and the remaining amount gets billed to the insurance or managed care company. If the patients cannot pay the amount at one stretch, he or she can request for credit so that payment can be done over a period of time. Is interest charged for this extended credit? Well, it depends on the individual state credit laws.
A statement called the explanation of benefits (EOB) is received from the insurance company from where the payment is received and it has all details of the payment. All received payments must be endorsed with a rubber stamp. The physician or health care provider must be contacted and doubts clarified if there is any doubt about the diagnosis or service performed.