Avoid Claim Denials To Get Paid Faster

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Avoid Claim Denials To Get Paid
Faster
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Avoid Claim Denials To Get Paid Faster

• Getting denied on a medical insurance claim is
  most common issue in healthcare facilities. This
  issue waste the physicians, admin, and patients
  valuable time, but filing an invalid claim can
  become something of a money-pit as well. Regular
  causes of denied insurance claims include missing
  information, billing errors, and questions
  regarding patient coverage.
• In order to avoid billing denials, its important
  to be aware where the biggest margin of error
  lies. Here we will discuss few reasons for
  denials.
• Missing Information
• Leaving even one required field blank can lead to
  the claim being denied. These type of denials
  account for 42 of denial write-offs. Examples
  include
• Demographic and technical errorslike a missing
  modifier
• Incorrect plan code
• Missing social security number
• Duplicate claim
• There are chances to file duplicate claims if you
  are not following correct process. Duplicate
  claims are like claims submitted for a single
  encounter on the same day by the same provider
  for the same patient for the same service item.
  Medicare B sees the majority of these claim
  denials.

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Avoid Claim Denials To Get Paid Faster

• Service are adjudicated
• This kind of denial occurs when benefits for a
  certain service are included in the payment of
  another service or procedure that has already
  been adjudicated.
• Procedure not covered by a payer
• Does your billing team check eligibility of
  patient before date of service? If procedures
  arent covered under a patients current benefit
  plan, they will be denied. These are generally
  easy to avoid, as going over a patients plan or
  calling their insurer before submitting a claim
  can head such denials off.
• Exceeding the time limit
• In a health insurance policy, you are required to
  apply for reimbursement within a certain period
  of time. As for emergency admission, the time
  given is 24 hours after the patient has been
  admitted, and in other cases, it can change
  according to the type of policy you have opted
  for and the treatment being availed by you. If
  you dont apply within the time specified, your
  claim can be rejected.
• It can be easily concluded that in order to avoid
  claim rejection/denials, you should have good RCM
  process or outsourced billing team in place. If
  youre looking for more information on medical
  billing services or revenue cycle management,
  please feel free to fill out the simple form and
  a representative will reach out shortly.

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