Did you know? 72% of medical practices lose 10-15% of their revenue to preventable billing errors. This guide reveals the 5 most common—and costly—mistakes, with step-by step fixes to reclaim your revenue.”
Mistake #1: Incorrect CPT/ICD-10 Coding
Why It’s Costly:
• 30%+ claim denials stem from mismatched codes (e.g., 99213 vs. 99214).
• Example: A clinic lost $28K/year by undercoding complex visits.
How to Fix It:
• Use AI coding tools to auto-suggest codes based on EHR notes.
• Train staff on annual CPT updates (e.g., 2024 telehealth changes).
Real-World Example:
“After switching to AI coding, webillhealth cut denials by 45% and recovered $52K in 6
months.”
Mistake #2: Skipping Insurance Eligibility Checks
Why It’s Costly:
• 25% of patient payments are delayed due to coverage gaps.
How to Fix It:
• Automate real-time eligibility checks with tools like Waystar or Availity.
• Flag high-risk plans (e.g., Medicaid requiring prior auths for imaging).
Checklist Included:
✅ Verify coverage 24 hours before appointments.
✅ Confirm deductible status and copayments.
Mistake #3: Missing Payer-Specific Modifiers
Why It’s Costly
Claims denied for missing modifiers (-25, -59, -95) cost clinics $18K+/year.
How to Fix It:
• Use a modifier cheat sheet (included on page 8).
• Example: Append -25 when billing an E/M service with a procedure (e.g., 99213 +
12002).
Red Flag:
“Medicare denies 90% of claims with modifier -59 if not properly justified.”
Mistake #4: Poor Documentation Practices
Why It’s Costly:
• Audits uncover 40%+ errors in EHR notes, leading to penalties.
How to Fix It:
• Use audit-proof templates for high-risk codes (e.g., 99205 requires “high
complexity” MDM notes).
• Train providers to document:
o Medical necessity (e.g., “Patient’s BMI of 40 justifies lipid panel”).
o Time-based codes (e.g., “90837: 60-minute session for acute PTSD”).
Template Included:
Download our “SOAP Note Checklist” for CMS compliance
Mistake #5: Ignoring Denial Trends
Why It’s Costly:
• 50% of denied claims are never resubmitted, costing $100K+/year.
How to Fix It:
• Build a denial dashboard to track top reasons (e.g., CO-16, CO-22).
• Hold monthly “denial resolution” meetings with billing teams.WeBill _ A Seamless Integration of your healthcare practice
Case Study:
Bonus Materials
1. 7-Day Denial Prevention Checklist
o Daily tasks to reduce coding errors and track payer deadlines.
2. Telehealth Billing Cheat Sheet
o Modifiers (-95), POS codes (02), and consent requirements.
3. Sample Appeal Letter Template
o For fighting CO-253 (“Invalid NPI”) denials.
If you would like to recover your lost revenue without incurring additional cost which you do
not have time to appeal for or chase. Let us help you.
We recovered more than $100,000 for a practice recently from denied claims.
You could be next.
Schedule Consultation Below and State reason Recover in Additional Info Box. After selecting
your time [Schedule Here].
