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Error Omissions
Error Omissions

Error & Omission: Covering Risks, Increased Exposures with Medical Billing E&O Insurance


The U.S. Federal government has placed increased attention on controlling the rising costs of healthcare, with medical providers of all types coming under additional scrutiny regarding billing practices. Medicare, for example, is checking medical billing more frequently and finding errors that have resulted in fines for fraudulent payouts. These errors may be intentional or completely accidental.

Improper payments may be overpayments or underpayments. Overpayments can occur when health care providers submit claims that don’t meet Medicare’s coding or medical necessity policies. Underpayments can occur when health care providers submit claims for a simple procedure but the medical record reveals that a more complicated procedure was actually performed.

As you know, in a system as complex as our medical billing system errors are bound to be made. Sometimes they’re honest errors that occur when someone accidentally inputs the wrong code. The individual inputting the codes checks a variety of sources within the patient’s medical record to assign correct codes and service levels for the procedures performed and supplies used to treat the patient as well as properly identify the physician’s diagnoses. The codes vary slightly depending on the complication level of the procedure, and determine the claim amounts. There are times when higher amounts are billed in error for lesser procedures. Just one honest mistake in the code can reclassify the level of complication and therefore the charged amount.

Having proper Medical Billing Errors & Omissions coverage is essential to protect a firm from the common risks involved with the payment process at every level. This can include clerical errors on filings, failure to file claims, clerical errors on patient records, unauthorized disclosure of confidential information, malicious use of info and/or funds by employees, and more.

The E&O experts at Axis Insurance Services can help you with your insurance protection needs, tailored to your specific needs.

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Blogged on: November 8, 2011 by Mike Smith
Error Omissions
Error Omissions
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