Denial Management – Check on the Web or Call?

Denials are a big problem faced by both healthcare facilities and individual physicians. Even though they take concerted efforts  on medical claims processing, claims do get denied by the payer for several reasons. Claims can be re-sent to the insurance company but only on learning the status of the denied medical claims. Till recently, physicians and healthcare practices had only the option of making calls to learn for what reason their claims got denied. However, this situation changed with recent technological enhancements in the internet and medical insurance billing domain. Now, checking the status of the denied claims is just a few clicks away! Let’s do a detailed analysis on both traditional and modern ways,

Traditional Method: As discussed earlier, physician practices and healthcare facilities made calls to insurance companies to learn the status of their rejected claims. Calls can be made only during US business hours and some of them might consume a lot of time to reach the right person in charge. However, one can still enjoy the benefits of this traditional method by disregarding the above mentioned facts. Individual physician practices and healthcare facilities get an elaborated explanation on their denied medical billing claims through the calls. It highly helps them in performing their medical claims processing perfectly next time.

Modern Method: In recent times, most insurance companies maintain their own websites in which they update denied claims and their status. Therefore, a physician or healthcare facility registered with the particular insurance payer’s website can login to their account and view the status easily. It takes only a few minutes to check, however if the reason stated is not clear, then the physician has to take up the traditional  of calling to ascertain the exact reasons. Once the clarification is made through call, further steps in medical claims processing can be taken.

Thus, the traditional way of making calls and the modern way of checking on the web to learn the status of denied claims go hand in hand. Using both methods can help physicians and healthcare facilities get a better understanding on where they went wrong in the medical insurance billing process. For exceptional denial management, outsourcing a part of medical claims processing to an offshore company like e-Care India that does a ‘full-court press’ will be a great idea.