Family practice clinics serve a critical function in the health of the community, providing broad-based care to patients of all ages. But in billing, even the most seasoned practices encounter expensive mistakes. These billing errors do not merely affect revenue they can cause claim denial, compliance, and even patient dissatisfaction.
At MGSI, we’ve seen firsthand how avoiding common pitfalls can streamline operations and improve your bottom line. Let’s break down the five most common billing mistakes in family practice and how to avoid them.
1. Incorrect Patient Information
One of the simplest yet most frequent errors is entering incorrect patient demographics—such as name, date of birth, or insurance details. Even a minor typo can lead to denied claims.
How to avoid it:
Double-check patient information at registration and confirm insurance information with each visit. Use automated verifier tools whenever available.
2. Incorrect or Missing Codes
Family practices see a broad range of diagnoses and treatments. It’s simple to utilize older, incorrect, or missmatched CPT, ICD-10, or HCPCS codes.
How to avoid it
Maintain current coding materials and provide continuing staff education. Better still, think of contracting with a billing service such as MGSI that guarantees precise coding with professional supervision.
3. Underbilling or Overbilling
Not billing for all the services performed—or billing for services not completed—can both be problematic. Underbilling results in lost dollars; overbilling invites audits and fines.
How to avoid it:
Monitor your claims for accuracy periodically and maintain accurate documentation for every service. Use charge capture technology to reduce human error.
4. Not Following Up on Denied Claims
Denied claims that aren’t resubmitted or appealed create cash flow loss directly. Most practices lack a good process for following up on these rejections.
How to avoid it:
Implement a system for tracking claim status and resubmitting denials in a timely manner. MGSI’s billing professionals follow up aggressively to collect every dollar you’re due.
5. Inadequate Staff Training and Updates
Medical billing regulations and payer policies are changing daily. Without ongoing training, your staff can unknowingly repeat mistakes or overlook new compliance mandates.
How to avoid it:
Offer regular training sessions and sign up for industry updates. Or make it easy by outsourcing to a professional billing partner such as MGSI, where being up-to-date is our business.
Final Thoughts
Family practice billing errors might appear insignificant, but their revenue and compliance impact is enormous. By resolving these five essential areas, your practice can improve efficiency, minimize denials, and get faster reimbursements.
Seeking dependable, precise, and compliant medical billing solutions?
MGSI has more than two decades of experience assisting family practices throughout the U.S. in handling billing with accuracy and without worry.