Medical Billing Problems

There are times when a person files a claim for a medical procedure or service and they run into

a problem with the billing. There are times when a medical professional or facility does not

receive payment for a procedure or service rendered, because of a problem with billing. There

are billing problems on both sides of the transactions. These problems are not limited to the

consumer, health care professional, or the insurance companies. Each group or person may

have a problem only on their part of the billing. Problems that involve medical billing are not

just financial. The range of problems is diverse and far-reaching. There are problems that

include medical claims denials due to some type of error. Blue Cross Blue Shield deals with

medical errors, which are referred to as "never events". (Health Management Technology,

2008). There is always the ever present problem of incomplete and/or incorrect claims that are

filed. There are several things that can be done to decrease the number of medical billing errors

that occur here in the United States and abroad. Chart auditing is just one of the ways to help

keep track of medical billing. Checking that the right documentation is submitted is another

way of preventing billing problems. As the old saying goes where there is a will there is a way,

and we will cover not only the problems, but the solutions as well.

Up to 30% of medical claims filed have some error that causes it to be denied. Some of these

errors are never re-billed or re-filed, so health care providers lose millions of dollars. The

problem with re-billing may be because it is very time consuming to review each denial. Many

times there are hundreds sometimes thousands of claims that are denied because of varies

reasons and at varies stages of the filed claim. When medical personnel has to be taken away

from other assigned task to review the denials it becomes very costly and a waste of valuable

manpower. There is also the problem of the documentation not being filed within certain

timeframes. (Health Care Collector, 2009).

"Never events" are medical errors that should have never occurred, such as wrong procedures

being preformed, or a patient being given the wrong blood type. When there are medical errors

such as serious infection occur at a medical facility, certain medical insurance providers will not

pay the claims. When these type of errors occur it is known as a "never event". These kind of

errors are rarely ever billed to the consumer, but because of the intricacies involved in billing

some