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How can you get rid of Denials in Billing?

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Denials in medical billing are a constant headache that directly affects the revenue, cash flow and efficiency of a practice. The National Health Insurer Report Card (NHIEC) describes a few major reasons for denied medical claims as mentioned below.

  1. Missing Information: A denial can easily be triggered if any field is left blank on a claim form.
  2. Duplicate Claim/Service: This occurs when claims are submitted multiple times for the same service, beneficiary or date.
  3. Service is not Covered by Payer: It is important to check details of eligibility to determine coverage requirements. If the services are not covered, the claim will be denied.
  4. Limit for Filing the Claim is Expired: Medical claims need to be submitted within a certain number of days or service. The claim will automatically be denied if filed outside the time period.

It is therefore important to have a claim denial management system that functions to reduce the number of denials. The overall objective of this system is to improve the efficiency of your billing operations.

Steps to Reduce Denial Rates

Listed below is a rundown of all the important steps you can take to decrease denials with insurance companies.

Analyzing the Medical Coding Process

Errors in medical coding lead to most of the denials. The best way to prevent such errors is ensuring a smooth and streamlined communication between medical billing staff, coders and clinicians.

Also, make sure that you are not using misused modifiers and outdated CPT codes. Hire a medical billing team that is vigilant to rectify the errors before finalizing claim submission.

File Claim on Time

The claim usually gets denied if the deadline is missed. To make sure that the claims are processed on time, you must create processes and cheat sheets. Go for an automated process. Automated billing and verification of claim not only reduces errors but also maximizes the accuracy of claims, thereby allowing your practice to receive faster payments.

Tracking Denials

It is important to keep track of denied claims for further processing. One of the best ways is to hire a dental insurance billing company that makes use of proactive processes for getting the claims paid on time.

Staying up to date with the Payer’s Requirements

Medical billing rules keep changing constantly. This requires physicians to spend extra time and expenses to educate the training staff. There are some codes that are discontinued every year while there are others that are newly introduced. So, it is required to stay on top with these trends to keep your revenue stream flowing.

Claim denial is one of the toughest challenges for any dental practice. They affect your practice’s revenue, which is one major reason for why the dental offices outsource medical billing and collection services. 

Capline Dental Services works with you to submit clean claims. Our professionals work in coordination with you to go beyond fighting denials. 

Get in touch with us today to see how we can assist you in reducing claim denials and increasing profit for your practice.