As patient consumerization takes further hold, the impact of decisions in medical billing is getting more attention from the public and media. This is especially true in the area of errors in medical billing and coding.
Medical providers will benefit from understanding what frustrates patients and taking steps to reduce errors, as well as working with partners who can help them stay on top of changes in billing requirements and patient expectations.
Patients Are Frustrated With Medical Billing and Coding
A recent medical billing survey of 800 privately and publicly insured individuals who had at least one medical billing error over the previous five years yielded interesting results that reveal the frustration patients have with medical billing and coding outcomes.
The survey found that over two out of every five respondents indicated they were significantly frustrated when trying to address billing errors. Less than a third said they had extreme confidence in their ability to find an error in their bill.
Two of the most prominent challenges identified were people knowing who to contact and finding the right information during the bill collection processes. Financial leaders should know that this is an indication that the patient financial experience is more complicated than it should be and that they should look to make changes.
In cases where patients did find an error, it was most often by comparing charges with estimated costs (32%). 29% identified issues by comparing charges to the explanation of benefits, and another 29% found items on the bill that were different from the care they received. Overall, the primary motivator in correcting a billing error was saving money. Half of the respondents said they reported incorrect charges of at least $200, while those reporting issues of over $500 made up a quarter [1].
Issues With Medical Billing Resolution
Revenue cycle leaders should know that patients are also frustrated by spending time resolving bills. More than four out of 10 respondents reported spending up to a month getting bills corrected and seven out of 10 said they spent more than two hours on resolution.
Know that these challenges are an opportunity to improve the patient financial experience and rethink your approach to medical billing and coding to help maintain a patient experience that keeps you competitive.
Reducing Errors in Medical Billing and Medical Coding
The most direct way to address the patient experience in medical billing is to find ways to reduce your error rates. It will be critical to understand where the bulk of your errors are coming from so you can start with the root cause of your most common issues. You have a few options here [2].
Double Down on Data Accuracy
If you have a significant number of errors coming from patient data issues such as misspelled names or inaccurate policy numbers, cleaning up your data could go a long way in turning things around.
Take an End-to-End Approach
While errors can originate with your medical billing and medical coding staff, it’s important to look at the revenue cycle holistically so you can identify any issues along the line.
This includes front office staff who are responsible for insurance verification and checking eligibility during scheduling and check in. It also involves addressing clinician notes that need to be detailed to help ensure proper medical coding on the back end. Internal audits and review can be helpful in identifying where you have the most potential for improvement.
Know the Trends That Impact You The Most
While denials are a universal issue, everything from patient mix, to region, and even staffing can change your results. For example, with the end of the COVID-19 public health emergency, many hospitals and health systems might see an increase in denials because of issues and confusion around Medicaid enrollment. You also might have challenges around changing code sets or even losing extensive institutional knowledge to staff retirement. Whatever they are, identifying them is critical to finding an optimal starting point and forging a path forward.
Work With Your Staff
If you are looking to reduce medical billing and coding errors to improve the patient financial experience, it’s important to inform your staff why they might need to adjust their performance. This could include additional training on medical coding and getting ahead of new code sets, but also simply explaining that they are an integral part of the patient experience – information that might be new to them as back office workers.
Consider Working With a Partner
While getting medical coding and billing error rates up to a level that supports a healthy patient financial experience might be new to your organization, an outsourcing partner can provide experience in quickly reducing error rates. They can employ tested methods and save you the trouble of implementing tactics that might be outside your expertise.
Centering patients in your medical coding and medical billing strategy might be new to you, but know you have access to support. To learn how we can support your patient financial experience efforts, start here.
References
[1] J. Asser, “Patients frustrated with process to address billing errors,” HealthLeaders, 19 January 2023. Available: https://www.healthleadersmedia.com/revenue-cycle/patients-frustrated-process-address-billing-errors.
[2] J. Finnegan, “4 ways to reduce medical billing errors and claims denials,” Fierce Healthcare, 3 August 2017. Available: https://www.fiercehealthcare.com/practices/4-ways-to-reduce-billing-errors-and-claims-denials.
