In the medical billing world, we have gone way past the days of the clerk sitting in the doctors office punching out her bills by hand and popping them in envelops. Today, things are a lot more sophisticated. Bills are generated via computer and in some cases, the biller never even sees a piece of paper or a form. Yes, we've come a long way. Unfortunately, with this sophistication also comes a lot of headaches. Why? When you're dealing with machines, especially computers, they have a tendency not to work right on occasion. This is especially true on the retail sales end of medical billing, the problems common to which we will be covering in this installment.

You would think that with many supermarkets now having automated checkouts that scan your item and register the price for you without the cashier having to punch in numbers manually, that this process would be just as simple for the billing agency who also runs a retail operation. Well, for the most part it is. However, there are things inherent to medical billing and retail sales that you don't have when going to a supermarket.

One of the biggest problems and the most annoying to the patient, is when they're getting a prescription filled and the biller has to run it through to see if the insurance covers it and the computer is down. The question should be, is it down? In many cases what the problem is, is that the server on the other end is down and there is nothing wrong with the computer on the end of the cashier. In this case there is nothing you can do but wait until the server comes back up. Many times a patient is asked to come back another time. This is the annoying part.

But what if the server isn't down? This is easy enough to check out by simply putting in a call to the main location. In this case, the problem is most likely in the wiring to the server. In this case, a technician is going to have to be called in to find out where the break in the cable is. Of course, it can always be a bad network card.

What if the connection is good though and when trying to scan in the item, it doesn't show up in inventory and no price can be gotten? In this case, it can be one of two things. Either it is a new item and the item hasn't been entered yet into the database, or the label on the item itself is wrong. This actually goes back to the barcoding issue of printing out bad data. In either case, the item will need to be looked up manually. Make sure you have manual price sheets.

Other times, you can't find the patient to see if they're covered for the item. In this case it is either that the patient was never entered into the system or the patient gave you the wrong information at the counter. Either have the data center put in the patient info, or double check that they gave the insured name and not the patient name, if they are different.