Health care experts have been saying it for years, but new research confirms it: the vast majority of medical bills contain errors. In fact, researchers at a health care advocacy group say that the mistake-rate might be as high as 80 percent.
The potential problems extend far beyond the revenue lost, of course. In some cases, billing errors can result in Medicare invoking its “zero tolerance” policy and prohibiting a health care provider, group practice or home health agency from billing the federal program for years.
In a worst-case scenario, it is also possible for billing errors to trigger administrative or criminal investigations into suspected health care fraud or other illegal activities.
The president and CEO of Practice Management Institute says that potential complications derived from billing errors can include risks of harm to patients. After all, a bill containing errors can include incorrect diagnostic codes that could lead to improper care.
The director of healthcare business development at records-retention and management service GRM Document Management says that while billing errors are problematic, they are not as detrimental as the filing of claims with unverified information.
He said it’s more likely that mistakes are overlooked at small practices, resulting in “a less robust financial picture.”
The billing department supervisor at WCH Service Bureau said billing errors are due to a “combination of busy doctors and undertrained staff.”
No matter what the reason for the errors, when the mistakes affect a practice’s ability to bill Medicare and Medicaid or trigger investigations, the disruptions to business and mission can be costly.
You can discuss these matters with an experienced health care law attorney at Austin’s Rivas Goldstein LLP.