Did you know denial management in healthcare is essential for optimizing revenue cycles? It identifies issues, streamlines processes, and boosts cash flow.

Learn the top 10 reasons for medical claim denials and how to prevent them. Improve your billing and reduce claim rejections.

Many Primary Care Physicians lose money because of lack of understanding of payer specific claims submission guidelines. Educating physicians on their documentation responsibilities is an iterative process, that requires an understanding of the reasons for claim denials, ability to nail-down the issues that are causing the denials, determining the corrective actions, and hosting timely sessions between the denials team and the physicians to discuss them.

Bad quality scanning of superbills and lack of adoption of electronic claims submission creates a charge backlog situation and consequently, result in increased denials on account to timely filing dates not being adhered to. Read this case study about how our structured approach, technical expertise, and revenue cycle rigor combine to create value for our client.

Most revenue cycle systems have a wealth of unutilized functionality. Revenue cycle professionals need to evaluate workflow and reporting functionality on the revenue cycle system to not only ease their workload but also improve revenue cycle outcomes. Read more in this case study.

Notice of Levy issues may be wrongly construed to be claim denials if a thorough investigation is not done to understand the reason behind such cases. Further, it is imperative that physicians pay their taxes on time. By educating physicians/practice teams on the importance of filing taxes, an artificial surge in denials on account of notice of levy cases can be avoided.

The adage, “Prevention is better than cure”, does apply to Claim Denials as well. An effective denial prevention program requires an iterative process that includes identification of root cause, finding solutions to prevent the issue from recurring in the future, the institutionalization of these procedures through updates to standard operating procedures, and training the staff on these practices. In this whitepaper from Medical Billing Wholesalers, we bring you a few steps that you can take to prevent denials.

Standardized billing and coding practices for Spinal Cord Stimulator (SCS) Procedure Code 63650 reduce medical necessity denials and help collect 281 claims valued over $ 300K in 2 years. The Customer saw over 36% improvement in Collections, as much as 75% reduction in old AR over 61 days, and reduction of denied SCS claims from 68 to 8 over a 7 month period.

Get the statistics for claim denials and strategies for preventing them in this Denial Management infographic from Medical Billing Wholesalers.

Denied claims are the type of claims that were received and processed by the insurance payer and a negative determination was made. It is no wonder that in Physical Therapy there are a greater number of denied claims compared to any other specialty. Read more about reasons for claim denials in Physical Therapy and ways to rectify them.