Like top ten lists?  Well I’m not half the man Dave Letterman is so I’m offering up the top 5 dirty secrets of medical billing.  Drumroll please Anton…

5. 90% of practices are really really bad at it – but can’t admit to themselves they must change, so they stay stuck.

4. 80% of doctors undercode.  The reason they do it is because they are afraid they will be audited and found to be committing fraud.  Here’s the secret: undercoding is against the law too.

3. Most doctors do not document appropriate to the E/M coding requirements.  Performing a level 4 service, coding it as a level 3 and documenting it as a level 2 is still overcoding.

2. In US medical practices, it takes an average of 21 days from date of service to the time when your charges reach the insurance companies.  The reason for this is front office inefficency.  (The best practices do it in 2 days.)

1.  Up to 5%  of services performed in a medical practice are never billed for, because the chart and the claim information never get to the biller and there is no back-check in place.

I wish this were a joke but it’s not.  Most practices lose $100,000 per provider per year this way.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

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