What You Need To Know About Duplicate Claims in Medical Billing

duplicate claim in medical billing

A duplicate claim in medical billing is one of the most common billing errors. It can cause several issues for your medical practice, even resulting in disciplinary action by a Medicare administrative contractor. However, once you understand how to avoid duplicate claims, you can prevent denials in medical billing and improve your clinic’s efficiency.

Below, the PracticeForces experts share a brief guide on how duplicate claims happen in medical billing and how to avoid them.

What are Duplicate Medical Billing Claims?

Duplicate claims occur when a medical practice submits multiple claims for the same healthcare service they provide to a patient on a specific date of service. More than one identical medical claim diminishes your clinic’s administrative efficiency, wasting time and sucking up valuable resources. It also leads to denied claims, which incurs disciplinary actions and makes an establishment look far less professional.

So, understanding how to avoid duplicate claims when it comes to medical billing is essential to ensure your practice runs smoothly and efficiently.

What Causes Duplicate Claims and Claim Denials?

Duplicate and denied claims occur for various reasons, including human error and separate medical practices that conduct repeat procedures. If you want to avoid duplicating claims and the denials that are sure to follow, consider these common causes:

  • The practice submits a revised claim that does not contain the correct information.
  • The clinic bills a patient more than once for a single service.
  • The clinic performs the same service multiple times in one day.
  • Another medical practice gives a patient the same service as your clinic on the same day and then submits an identical CPT code.

Whatever the reason, your clinic will need to resolve these issues quickly. As soon as you notice a duplicate claim, you should notify the patient’s insurance company to avoid professional and legal repercussions. For example, if a clinic double bills a patient and doesn’t reverse the charges quickly enough, it could be subject to an FBI investigation for health care fraud

Although duplicate claims and denials are relatively common in the medical field, they can cause significant problems that jeopardize your practice and earning potential. Thankfully, a professional medical billing and coding company like PracticeForces can dramatically reduce these issues and diminish your clinic’s workload.

Contact PracticeForces for Exceptional Medical Billing and Coding Services in Florida

PracticeForces is one of Florida’s most trusted professional medical billing and coding services. We help medical practices enhance their coding and billing procedures for a smoother operation. We can also help you learn more about how to handle claim denials professionally so that your clinic can minimize the impact.

We’ve helped hundreds of medical practices improve their coding and billing procedures. We can do the same for you!

Do you want to avoid having to handle a duplicate claim in medical billing while improving your clinic’s functionality? Call PracticeForces at (727) 499-0351 today to see how we can help your clinic streamline its billing and coding!

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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