Medicare Medical Billing Error Decrease

Medicare has released the stats for 2005 regarding The Comprehensive Error Rate Testing (CERT) program implemented last year and it is showing that in the initial stages it has done some good for medical billing. The Centers for Medicare & Medicaid Services heightened claim error awareness by initializing an error-testing program in 2005.

In 2004, the error rate for medical billing was 10.1%. At the end of 2005, this year’s CMS error rate was 5.1%. This is nearly half the amount of errors this year than last year.

The Centers for Medicare & Medicaid Services attribute this improvement to the new CERT program. They believe that providers are inherently more aware that their claims may be examined. This causes them to have more accurate and complete medical billing from the beginning. With the new policy, providers are allowed to submit significantly more documentation with their medical billing. Previously, information submitted was not enough to substantiate medical necessity.

Some of the most common medical billing errors on submitted claims are generally due to a practice being too busy to properly document their medical billing claims or medical codings are done incorrectly using incorrect or outdated medical billing codes.

When medical practices utilize medical billing firms for their claims processing responsibilities, errors tend to be much lower. These companies solely deal with medical billing. Your claims will be reviewed prior to submission and checked for errors. This will in turn allow your practice to see a faster turn around on your medical billing claims along with higher reimbursement rates.

View all Articles by: Melissa Clark, CCS-P