How to Reduce Claim Denials?

Most physician practices have an average denial rate of 5-10%, costing $100/claim, with an average of $25 or more for each reworked claim.

With the fact that 90% of denials are avoidable, taking the following steps to reduce the denials:

  • Educate & Communicate.
  • Insurance Verification Before Service
  • Understanding Insurances
  • Document Accuracy
  • Improvement on Mistakes

Educate & Communicate:

Keeping the staff moving toward their goals is essential, and ongoing communication and education are imperative.  Effective communication is critical to any business’s success, and this is no less true in the rapidly evolving healthcare sector.  All the office staff, from the front desk to medical and to the back office, should necessarily understand their roles and the importance of that achieving the organizational goals, from patient check-in to correct documentation of information into EHR and collection of patient payments and then ensuring all data is being passed to the billing team, will ensure best financial results and patient satisfaction.

 

It’s also imperative that the office staff is well-versed with the key components such as what services your practice performs, what insurances cover and what not, co-payments and deductibles, and finally, correct coding of each service completed.  All services should be billed and coded, but most importantly, the ones where the office has invested money, i.e., vaccinations, injectables, etc.

 

It’s worth repeating that communication is critical, as is ongoing training and certifications that are continually updated so that every staff member is aware of the changes in healthcare.

Are you still struggling with reducing the claim denials?

If yes, reach the experts of 24/7 Medical Billing Services at (866)-918-EZMD or www.ezmdsolutions.com

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