Providing top-quality care is essential, but managing the financial side of a medical practice is equally important to avoid billing errors that could affect the bottom line. Medical billing is a complex process, involving multiple payers, numerous medical codes, and varying state regulations. This makes it challenging for many healthcare providers. Outsourcing medical billing services helps prevent errors, streamline claim submission, and improve the revenue cycle, which enhances overall practice efficiency. Expert billing services can handle the entire process, leading to better financial stability and improved patient satisfaction.
The truth is that a professional fertility billing company knows how to ensure an accurate fertility clinic billing process works and avoid all the rooms for errors. A single mistake in your fertility center billing process cans jeopardize your practice’s cash flow and cause revenue leakage at the end of a financial year. Accurate and clean IVF billing practices always ensures patient-trust and satisfaction, contributing to the healthy financial success for your clinic. To ensure an accurate fertility clinic revenue cycle management process, you must avoid the mistakes mentioned below:
Common mistakes that a fertility billing company always avoids:
1) Missing insurance eligibility verification in advance:
It is always important to provide your patient’s insurance company with complete and accurate patient information to avoid major number of claim denials. Some of the frequent insurance verification mistakes are misspelling in names, wrong date of birth, wrong policy numbers, etc. Always remember one thing that any small mistake in your IVF billing solutions can cause claim denials, payment delays and revenue leakage for your practice.
To avoid such types of mistakes, you must verify the patient information before submitting claims. You can rely on Outsourcing fertility billing to a third-party RCM company to avoid all the chances of mistakes and ensure all the captured information are accurate.
2) Not obtaining prior authorization approval:
There are specific drugs, diagnoses and procedures in your IVF billing services that require you to obtain prior authorization approvals from your patients’ insurance companies before administering them. If you do not obtain the PA approval, you will encounter claim denials from a patient’s insurance company.
3) Errors in fertility clinic billing codes:
You will face coding mistakes if you assign the wrong diagnosis or procedural codes. Some of the common errors that the majority of fertility clinics commit are upcoding, undercoding and unbundling. You must be extra-cautious at the time of coding.
Another critical coding error that you can experience is when you are unable to match diagnosis and treatment codes. Since codes get updated, using old or deleted codes can also cause problems, leading to underbilling or overbilling.
To avoid billing problems and legal issues, make sure the codes you use match the symptoms, diagnosis, or treatment that’s been documented. This helps keep everything accurate and smooth.
4) Duplicate billing:
Billing a same fertility service more than one time causes duplicate billing for your practice. Sometimes, billing departments re-file claims too soon before the insurance company has a chance to process the original one. Claims for identical services provided to a patient on the same day can also be denied as duplicates. Even if it’s unintentional, insurers may see duplicate billing as a form of fraud.
A reliable fertility clinic billing company always reviews claims carefully to avoid issues like duplicate billing.
5) Incomplete or missing documentation:
Without enough documentation, your claim could be denied. Missing or incomplete patient charts, lack of proof for medical necessity, or linking a diagnosis code that doesn’t support the procedure can lead to claim denials. Not providing detailed procedure notes or proper medical history can also cause issues. Incomplete records that miss important details, like the patient’s history, reason for the visit, or services provided, can result in problems with billing.
6) Missing claim filing deadlines:
Missing claim submissions is a common reason for denials and low reimbursements. Each insurance company has its own guidelines, which you can find in the patient’s insurance contract or policy. The filing window typically ranges from 90 to 180 days after the service date. You must adhere to claim submission deadline to avoid claim denials.
To avoid claim denials and increase revenue, many clinics outsource fertility billing to expert third-party companies. This allows clinics to focus on patient care while the fertility clinic billing company handles the Fertility clinic revenue cycle management, leading to better financial results.
