How to Reduce Denied Claims

What does your practice’s denial rate look like? If it is higher than 4 percent, you need to take action. By implementing these simple steps, you can help to avoid billing mistakes and denied claims.

Verify Insurance
Not verifying insurance can cost both money and time, which is why it’s important to verify insurance with new and returning patients. Contact the insurance provider to check effective dates and coverage period, assess deductibles and copayments and check up on preexisting condition exclusions.

Reduce Errors in Patient Information
Even the smallest mistake, like a misspelled name, can cause an insurance company to reject a medical billing claim. Train your front office staff to help reduce these denials by familiarizing them more the patient chart, double checking things as simple as a patient’s name, and quadruple check the policy number. Denials caused as a result of these mistakes can be refilled, but expect 30 to 45 days before you receive a payment.

Implement a Practice Management System
Automate as much of the process as possible to reduce human errors, and you can do so with a practice management system. Train your staff to keep up with demands, as well as develop skills and habits within the system. A practice management system is especially useful for smaller, budget-conscious practices, that perform more work with fewer employees. 

Outsource Your Medical Billing
Keeping up with the ever-changing rules and requirements in the medical billing industry is difficult under the best of circumstances. It requires constant education and vigilance. New and deleted CPT codes come out annually, fees change, and carrier rules seem to vary daily.  Most practices just don’t have the time needed to dedicate to this task. Instead, let the experts help you process your claims, so you can focus on what you do best – treating patients.

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