Denied claims can cost your practice money by slowing down cashflow and creating extra work for your medical accounts receivable team. While not all denials can be prevented, many are often caused by easily avoidable mistakes. To ensure your practice’s insurance denials are kept to a minimum, educate your staff so that they can avoid the following issues plaguing claims submissions.
Cut down on incorrect or missing demographics and insurance information.
Denials often occur due to incomplete or incorrectly-entered insurance and demographic information. This is why it is important to verify insurance coverage and benefits eligibility, including taking down the right subscriber number, before each day’s appointments. Your staff will also need to make sure that you have the patient’s complete name, date of birth, and correct billing address, as well as whether the patient has multiple insurance providers and who to file as primary and secondary.
Make diagnosis codes as specific as possible.
Many insurance claims get denied because the diagnosis is not specific enough or the insurance carrier needs more detailed information. To avoid this from happening, many A/R companies suggest setting up electronic prompts in the charge capture system in order to alert users when there is a more detailed code available.
Don’t just write claims off. Appeal!
Though it may be easy to write-off denied claims, especially those for smaller amounts, small sums add up. Make sure your staff is devoting time to investigating why certain claims were denied, as well as to finding ways to appeal. If you are simply writing claims off without trying, your practice could be losing out on a lot of hard earned money.
Realistically, some registrations errors are likely to occur, no matter how well-oiled your medical accounts receivable machine is. When those mistakes are found, however, make sure billing employees communicate them to front-desk and patient registration staff, so that future errors can be prevented. Finally, because not all claims are denied due to billing or administrative errors, make sure your patients sign waiver forms before their appointments, detailing their financial responsibility in the event that any services aren’t completely covered by the patient’s insurance. This will protect your practice and ensure payment for services rendered.
