How to Reduce Rejections with Denial Management in Healthcare?

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How to Reduce Rejections with Denial Management
in Healthcare?
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• Before we discuss on ways to reduce claim denials
  let us understand the top reasons causing claim
  denials in Medical Billing
• Missing or Incorrect patient details
• Missing or incorrect provider and payor details
• Duplicate Claims
• Services already covered
• Service not covered under the patients insurance
  coverage
• Missed Timely Filing Limit (TFL)

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Accurate Patient Demographic

• Patient Name, Age, DOB, Gender, Address and
  Contact Number, Email along with relationship
  with the policy holder.
• Insurance Name and contact details, plan details,
  policy start and expiry date, policy coverage
  details.
• Allergies or major medical history
• Copay, Co-insurance and Deductibles as applicable
  on the insurance covered
• Payment method for patient responsibility

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Quality Coding and Charge Entry

• Medical Coding are mostly vulnerable to errors
  leading to major reasons for claim rejection and
  denials.
• And the process of Charge Entry in Revenue Cycle
  Management is not just doing the data entry of
  charges, but also to add value by identifying any
  issues with the claims, procedures or fee
  schedule and making necessary correction to
  enhance the claim quality.
• Having quality checks and regular audits and
  bring down the error percentage in these scopes
  and enhance first pass rate.

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Claim Audit and Analysis

• Every claim has a dead line called as the Timely
  Filing Limit (TFL) for submission with Insurance
  Company.
• Effective Denial management aims at processing
  the rejected and denied claims within the
  stipulated TFL to avoid further hassle due to
  late submission.

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Effective Account Receivable Follow up

• Timely and regular follow up with Insurance
  companies by the accounts receivable team helps
  in expediting the claims reimbursement process.
• Effectively following up requires additional time
  and effort to be invested by a dedicated team.

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Outsourcing Denial Management to Medical Billing
Company
The best solution to reduce claim rejection and
to handle claim denials effective is by
partnering with an experienced Medical Billing
Company who can handle the Accounts Receivable
and Denial Management Services for you while you
can focus on patient care.
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About MGSI

• MGSI is a 25 year old national Medical Billing
  and Revenue Cycle Management Company located in
  Tampa, FL.
• With cumulative years of expertise serving more
  than 600 physicians across the US, MGSI has the
  latest tools in place with experience working on
  multiple Medical Billing Software.
• A multi- specialty Medical Billing Company
  guaranteeing maximum benefits and Cost Effective
  Revenue Cycle Management Solution.
• To know more about MGSI call 877-896-6474 or
  login to Healthcare Denial Management Medical
  billing Services MGSI (mgsionline.com