Updated: Jan 17
There are many mistakes that people make on their medical billing claims, but there are three common mistakes that are hurting the chances of getting paid.
1. Missing authorization number on an claim or billing a claim without authorization on file with the payer.
2. Not sending the claim to the correct payer.
3. Not sending the correct claim to the payer.
If you want to know more about how to fix these mistakes, please read below or feel free to call me directly at (330) 349-8455 or email me at email@example.com. I will be happy to help you get more of your money!
Missing authorization number on an invoice or billing an invoice without authorization on file with the payer.
Depending on the payer, a home health agency (HHA) may be required to obtain a
‘prior authorization’ (PA) to provide home health services. Without obtaining a (PA) before services are rendered will result in a denied invoice. Also, if the prior authorization information is missing from the invoice the claim may be denied by the payer.
Not sending the claim to the correct payer.
Believe it or not, sending a claim to the incorrect payer happens more often than you realize. Before sending your claim make sure to read your provider contract or provider billing info from the payer before sending your claims. If none is noted, call provider services with the payer to obtain the correct mailing address or electronic payer id to ensure claims are sent to the correct payer.
Not sending the correct claim to the payer.
Depending on the type of home health agency (HHA), skilled or unskilled the claims must be sent to the payer either paper or electronically on an Institutional (UB04) or CMS 1500 form. If claims are sent on the incorrect form or electronic claim the claim will be denied for payment.
Home health billing is a specialty that takes a lot of work. Be sure to use claim templates and double-check your mistakes before you send them. Making mistakes on the home health medical billing claim will get your claimd rejected by insurance companies, payment will be denied and your revenue will be negatively affected.
We've created a guide to help Home health care billing professionals better understand the Medicare rules for billing for Home health care. Check it out in our store today!