Claims denial-management programs can significantly reduce the number of denied claims for practices, according to an American Medical News report.
Claims denial-management systems are systems set up in practices to determine why insurers deny claims. By using a claims denial-management system, a practice can determine the cause of denials and address those issues, whether they stem from problems with the practice's billing team or an issue on the payor side.
According to a March 16 GAO report, a significant percentage of denied claims go unpaid due to billing errors. While practices can get denied claims paid on appeal, re-submitting a claim costs money and means more time before reimbursement.
While some claims-denial management programs involve a computerized system, purchasing software is just one of several options. According to the report, experts recommend making a list of denied claims on paper or in an Excel spreadsheet. The list should include the reason for the denial along with the payor name, type of plan and other details. Billing team members can use this list to predict denials and avoid receiving the same type of denial twice. Billing teams should meet regularly to discuss the most common reasons for denials and develop solutions.
Read the American Medical News report on claim denials.
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Claims denial-management systems are systems set up in practices to determine why insurers deny claims. By using a claims denial-management system, a practice can determine the cause of denials and address those issues, whether they stem from problems with the practice's billing team or an issue on the payor side.
According to a March 16 GAO report, a significant percentage of denied claims go unpaid due to billing errors. While practices can get denied claims paid on appeal, re-submitting a claim costs money and means more time before reimbursement.
While some claims-denial management programs involve a computerized system, purchasing software is just one of several options. According to the report, experts recommend making a list of denied claims on paper or in an Excel spreadsheet. The list should include the reason for the denial along with the payor name, type of plan and other details. Billing team members can use this list to predict denials and avoid receiving the same type of denial twice. Billing teams should meet regularly to discuss the most common reasons for denials and develop solutions.
Read the American Medical News report on claim denials.
Related Articles on Billing, Coding and Collections:
Texas Bill on Out-of-Network Billing Rates Receives Support From TASCS
Report Examines How Fee Schedule Changes Affect Workers' Comp Payments
Medical Coder Salary by State: 50 Statistics to Know