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They say that every organization, project, idea, or anything is only as strong as its weakest link. This is no more true than in the world of medical billing. The problem is, medical billing has so many weaknesses in their structure, it is a miracle that anything at all is made. In this article we take a look at just a few of these potential disaster areas.

The biggest weakness in medical billing is the system itself. Oh, you can use all the arguments as you do the best that they can use a system that was doomed from the start, but it does not alter the fact that the medical billing process is a nightmare to begin with .

Let's start with the biller. Due to the regulations, a ton of knowledge is required to ensure an accurate accounts receivable. The truth is, there is not really a lot of training for medical personnel payroll. Most are on the job training. As a result, a lot of mistakes are made. Well, in most companies, if an error is made, it can quickly be corrected and no harm. But in medical billing, a mistake is a demand that the false or incomplete information. This leads to the claim denied. The application must then be corrected, and again to be paid. There are no hard and fast statistics on the number of claims, the bill is incorrect, it is estimated that somewhere in the range of approximately 10%. This means that theoretically there are for each day on which the workload is increasing by 10% because of claims that need to be again. This explains why such a backlog on receivables to be paid. It is a never ending cycle, just after the gate, which is never a better one.

Then there is the inefficiency of the people on the recipients of this information. As the largest claim processors in the United States by the authorities, these people are not really because the incentive for quick order processing. So the demand of the processing itself, by design, is very slow. This only compounds the problem. But the worst thing is the rights which it again received the lowest priority. This makes it even more important that claims the right the first time through.

Finally, as if the above two major problems were not enough, you have the problem of poorly developed methods for the settlement itself. These range from something bad, the software, of which there are many who step by step procedures, at least, inefficient. Plus, there is no standardization in the industry. Once upon a time, there was only one way, a claim bill. Now you have the standard form HCFA-1500, NSF, 3 / 01 for electronic invoicing and UB-92 and other formats as well as for the electronic transmission of information. No two medical billing companies do things the same way.

With so many weaknesses and many others not even mentioned, it is a wonder that the industry survived.

Michael Russell

Your independent guide to Medical Billing