The Unexpected Complexities of Medical Billing: Name Misspellings on Insurance Cards

Posted by admin | August 3, 2017 , (0) comments

Medical Billing Service








When it comes to medical billing and coding for small health care practice, like a family doctor’s office or a small specialty clinic, you would think that it would not be too hard to keep your medical coding and billing in-house. After all, if you don’t have an overwhelmingly large patient population, it seems like an office staff member or two could get the job done. However, you might be failing to account for the unexpected problems that you can’t predict — but that will inevitably slow down your revenue cycle. These kinds of problems easily fall into the category of “nobody’s fault,” but your practice still has to deal with them. One problem that is becoming increasingly common is name misspellings on insurance cards.

Dealing with Name Misspellings on Insurance Cards

These days, there is no shortage of sources for confusion when it comes to how people spell their names. For instance, lots of names have similar spellings, so it is easy for insurance carriers to make a typo. For instance, a customer’s name may be listed (correctly) in your system as “Johnston,” but their insurance company may have misspelled their name as “Johnson.”

Things get even more complicated when patients have hyphenated last names, but they may use only one of the names with their insurance company. There are also patients who have last names that are two separate words, which can cause trouble when health care offices or insurance carriers get confused and think the second name is a middle name, or even part of the patient’s first name.

The Dilemma of Filling Out Claims Forms with Misspelled Names

When the customer’s name is misspelled on the insurance card, many well-meaning office staff members at small physician’s offices immediately think to submit the claims form with the correct spelling. However, if you do that, your claim will automatically be rejected by the patient’s carrier — whether the patient has private insurance, Medicare, or Medicaid. Therefore, most medical billing professionals actually recommend submitting the claim using the incorrect spelling, and then contacting the customer to let them know that they need to contact their insurance carrier to make a change.

Of course, you may also run into trouble if the patient has already realized the error and contacted their insurance carrier to have the name misspelling changed in the carrier’s system…but without changing their insurance information at your practice. In that case, when you use the misspelled name, your claim will be rejected because the insurance carrier now has the correctly spelled name on file.

When it comes to misspelled names on insurance cards, the inordinate amount of time it takes for the staff at a small physician’s office to clarify the error and figure out what to do will inevitably interfere with the practice’s billing efficiency. If your staff makes the wrong choice and the claim is rejected, it will automatically increase your AR days. But even if your staff ultimately makes the right choice, the confusion will have drained valuable time and resources, and possibly caused them to fall behind on other patient billing. Once that happens, it can be hard to get back on track, indefinitely slowing down your revenue cycle.

To avoid the hassle and headaches associated with unexpected, yet unavoidable problems like name misspellings on insurance cards, you might want to think about outsourcing your medical billing to professionals. The experts at AnnexMed are well-equipped to handle these complex problems, allowing health care professionals to focus on what they do best. Contact us today for more information!


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