5 common medical billing mistakes and how to avoid them


Ensuring your medical billing is accurate and your claims compliant is important.

Current industry standards suggest approximately 10% of claims are rejected. Keeping the number of rejected claims to a minimum is therefore important for your cash flow and for maintaining efficiency. We spoke to the medical billing team at Synapse Medical Services who has decades of combined billing experience. They came up with five common medical billing mistakes and what you can do to avoid making them.

  1. Claiming the same item number twice on the same date, without providing the time.This happens from time to time, most often with consultations. You may see a patient in the morning, and then due to change in the patient’s condition be required to see them again later that afternoon. Billing systems should provide a data field to enter notes. Use this to add in the times. It is a legal requirement that will ensure your claims are paid.
  1. Neglecting Informed Financial Consent for out of pocket costs prior to treatment.One of the biggest sources of arrears in medical billing is from patients themselves. We often hear “But I thought Medicare was covering this?” or “Doesn’t my private health fund pay you?” If you wish to charge any out of pocket cost to your patients, you need a good IFC process. It is sometimes a legal requirement, but always best practice. A quick phone call explaining fees before a procedure can save months chasing unpaid bills from angry patients.
  1. Claiming a subsequent attendance with certain surgical procedures with an MBS schedule fee of over $300.There are new restrictions on this practice and knowing when it is and isn’t permissible can save a lot of time and money. Medicare has blocked the claiming of subsequent attendances for certain surgical procedures which have a schedule fee of over $300.
  1. Claiming for an incorrect date of service.Payers check dates of service against the patient’s date of discharge from hospital and will reject anything after that date. The date of service must not be post discharge, so it’s a good idea to slow down. The simplest way to avoid this mistake to is to get into the habit of entering new billings straight after completion of the service. Smartphone app based billing solutions like Synapps MBS provide a convenient method of doing this while on the move.
  1. Claiming from an incorrect location.Doctors often work at more than one location. They may have a private outpatient clinic, admitting rights to a nearby private hospital, as well as a staff specialist position at the main public hospital in the area. Medical claims are always tied to a location and making sure you have the correct location selected is important to avoid rejections. Good medical billing platforms have safeguards in place at the point of entry to prevent selection of an incorrect location.

Synapse has developed the world’s first medical billing app. It features a powerful rules engine designed to reduce the number of claims rejected by insurers. Capable of handling all types of billing from outpatient bulk billing to known gap private health fund claims, it can be used by any and all medical specialties.


Learn more about Synapps MBS, the world’s first, app-based, online medical billing system.

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