How Psychiatrists Can Avoid The Common Medical Billing Mistakes

by Roger Billy48 Writer

medical billing in Ontario

Billing mistakes are not strange and can occur in any specialization. One could forget to add a premium, input incorrect patient data or use the wrong diagnosis code. But although these may be little mistakes, they can lead to rejections which would delay payments. Therefore, it is essential to be cautious with medical billing processes. Automating medical billing in Ontario can help a great deal.

Psychiatric medical billing processes can be pretty complicated. Their assessments are more subjective, making their billing process more challenging. For instance, the duration of a consultation depends on the patient approach. It could also depend on the complexity of their situation and willingness to provide the needed information. Therefore, it is essential to avoid making billing mistakes.

Dealing With Common Medical Billing Mistakes

Familiarizing oneself with common billing mistakes helps avoid making those mistakes. This ensures that payments are not delayed. Here is how to deal with common medical billing mistakes.

Too Many Visits With Patients
Using The Wrong Code
Double Billing By Multiple Physicians

Too Many Visits With Patients

In terms of the Ontario physician billing, the system of fee codes in psychiatry and its timeframes to other specializations are similar. For instance, consultations are only billable yearly. They are billed once every twelve months. They also need to be referred to a psychiatrist by another physician or medical practitioner. A psychiatrist can work in a hospital and provides consultation on a patient in the ER. However, that consultation code can’t be billed again for that patient in the next 12 months. If that patient comes back to the ER for another consultation within six months, the psychiatrist will bill for a repeat consultation. This would not hold if it is for an entirely different issue or a regular time-based billing code is used.

Using The Wrong Code

OHIP medical billing standards won’t allow a psychiatrist to bill a patient on multiple codes in one day. This still holds even if the patient is checked numerous times. For instance, a patient can be billed for a consultation (A180) and later have another consultation that same day. If the second consultation is billed as a partial assessment (A184), the higher code, A180, in the claim will be rejected. This is because A180 has a higher dollar value than A184. It is essential to avoid this mistake, as OHIP rules don’t allow going over the allowable limit for the visits. Therefore, if one is scheduled to see a patient frequently, it is best to bill the patient correctly.

Double Billing By Multiple Physicians

In psychiatry, a patient can be under the care of several doctors. This is one of the issues when billing as a psychiatrist. For instance, if a psychiatrist works in an inpatient practice, their patient will be under the care of multiple doctors. This is against the OHIP rules, as they don’t allow various physicians to use the same code for one specific patient. In such a case, the claim will be rejected.

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