Medical billing is one of the major factors to decide the financial success rate of the practice, and claim denials affect the cash flow of the practice. Every new claim denials lead to revenue leaks. That’s why denials look like a painful financial drain on practices. For better claims denial management, you have to identify the denials and reasons of the denials. Avoiding and reducing the claims denials will improve the cash flow. Let’s discuss the claims denial management and strategies to avoid and manage the claim denials.
The Most Common Reason For Claim Denials
- Incorrect Patient Information
- Claim Duplication
- Improper Eligibility Verification
- Incorrect Coding
- Incorrect Modifiers Used
- Lack of documentation or medical necessity
To Avoid and Manage the Medical Claim Denials
Collect Detailed Patient Information
. Listed below are few mandatory patient demographic details to be collected.
- Patient name
- Patient’s date of birth
- Address
- Phone number
- Email Id etc
Also, collect the insurance plan information to collect the reimbursement.
- Subscriber name
- Name of the plan
- Group Name
- Insurance coverage effective dates
- Secondary or supplemental coverage details
Proper Documentation
For accurate billing, documentation plays a major role. It helps to prevent some complications during the coding audits. Poor documentation leads to underpayments and denials. To get accurate payments, the proper document needs to submit along with claims.
Outsource Your Medical Billing
Outsourcing is the best choice for denial management. Medical billing experts submit error-free claims. If any claims denial, the denial management team analyzes the denial reasons. To identify the denial reasons billing experts follow up with payers. Depending on the denial reasons, billing professionals resubmit the corrected claims with required documents without any delay. Outsourcing also provides more benefits for your business such as
- Improves cash flow
- Reduce denial rates
- Minimize medical billing and coding errors
- Processes medical claims faster
- Improves billing collection rates
- Saves operational cost
- Improves your business rating etc.
About e-care
e-care India is the leading medical billing service provider in India. We specialize in denial management. We also provide medical billing and coding service, Account receivable management, cardiology billing, radiology billing, FQHC billing, Anesthesia billing. Revenue cycle management, etc. We use the latest technologies to improve your business revenue, reduce denials rate. To know more about our medical billing and coding services, log on to our website: www.ecareindia.com