5 Common Mistakes Physicians Commit with the Dermatology Billing

You must have an accurate and efficient medical billing experience for your dermatology practice to receive maximum service reimbursement. While every medical specialty requires precise billing procedures to receive treatment payments, dermatology practices must go above and beyond to ensure accuracy. Paying special attention to compliance guidelines and the specialty’s unique use of modifiers is part of proper medical billing for dermatology practices. In fact, Dermatology practices face distinct medical billing and coding challenges due to the specialty. As dermatology requires both medical and surgical aspects, Physicians commit with the dermatology medical billing can be complicated and necessitates a thorough understanding of dermatology CPT codes, modifier usage, and other factors.

Let’s have a deep understanding of common mistakes physicians commit with dermatology billing:

1. Insufficient Claim Information

A single empty or unchecked box on a claim can result in a denial. Even the most essential fields, such as gender, date of birth, and time of the accident or medical emergency, are frequently left blank.

Ensure that the second set of eyes performs a cursory review of each paper or electronic claim in your office files to ensure that all required fields are filled out. Check that your software system prompts users to review missing fields and enter all required information before allowing them to submit e-claims.

2. Insurance Verification Failure

The most common reason for claim denials is insurance issues. An overreliance typically causes failure to verify on routine. If a patient visits the office frequently, the staff may assume that their insurance provider or coverage plan hasn’t changed and may fail to check eligibility.

However, you must incorporate a verification step into the dermatology billing workflow for every patient visit, as insurance information can change anytime. This entails investigating all four potential causes of insurance-related denial:

  • On the service date, coverage had been terminated or was ineligible.
  • Not authorized services.
  • Non-covered services as per the plan.
  • Maximum benefits already reached.

By including a step in your dermatology billing workflow that verifies the patient’s insurance at each visit, you can ensure that there are no policy-related issues that could lead to denied claims.

3. Failure to Meet Filing Deadlines

Some payers provide two-year “timely filing” windows for individual medical claims, while others only offer 30 days. You’re out of luck if you don’t file your claim on time. Denials for timely filing are among the most difficult to appeal.

Maintain a list of your most common payers’ deadlines in your dermatology practice’s billing office and incorporate it into the organization of your biller’s “to-do” lists. Unfiled claims should be audited regularly to ensure that none fall through the cracks. A recurring reminder or calendar event can also help resolve this issue.

4. Lack of Specifics

Insurance companies frequently deny claims as they are not coded to the highest level of specificity or are “truncated” (unnecessarily or inaccurately shortened). Each diagnosis, as a trained coder knows, must be coded to the absolute highest level for that code – that is, the maximum number of digits for the code.

If your staff is unfamiliar with coding, they may make this type of mistake regularly without realizing it. Education is essential: show your dermatology billers how to spot truncated codes so they can fix them before filing.

5. Typing and Miscoding Errors

Simply put, sometimes you make mistakes. Whether an unbundled code, a duplicate charge, a mistyped patient name, or an incorrect date, even an honest mistake can derail an insurance claim. It’s easy to make a general error when you’re heavily involved in dermatology billing and coding—especially if you have other responsibilities. Here are a few of the most common ones to stay away from if at all possible:

  • Incorrect insurance, patient, or provider information (i.e., name, address, date of birth, policy numbers, etc.).
  • Entering ICD-10-CM codes with an unusually large or small number of digits.
  • In a given claim, no codes are entered.
  • Incorrect CPT codes were submitted.

Outsource your Dermatology Billing!

With recent billing changes and stringent compliance standards to uphold, dermatology practices can save a lot of time and energy (as well as peace of mind!) by entrusting their dermatology billing to an outsourced third party. A responsible and achievable financial health plan must be prioritized for dermatology practices to realize their true revenue potential. Dermatology medical billing outsourcing allows your practice or physicians to have the most efficient and accurate bill processing possible.

As the internal billers team must balance the rest of the practice’s operations, an outsourced dermatology medical billing firm can typically maintain better consistency of your practice’s finances. 24/7  Medical Billing Services is one such outsourced dermatology medical billing company that can provide your practice with the dermatology billing knowledge it requires to grow and thrive in today’s modern medical landscape.

Read more: Pros And Cons Of Outsourcing Dermatology Billing Services

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