For the last few years, the medical billing industry has encountered a noticeable increase in medical claim denials. This situation has become worse, especially after the COVID-19 pandemic. Due to this increase, almost 35% of Medical Practices and Hospitals have entered a bad zone. Consequently, independent practices have come under massive pressure. In this blog, we will answer the 4 most common denial questions in medical billing. It should help medical practices avoid medical billing denials.
Top Denial Questions in Medical Billing
1. What’s the Situation of Claim Denials in Medical Billing Today?
In recent time, especially during the peak of COVID-19, claim denials in medical billing have gone very high. To cope with this rise in denials, there needs to be a perfect claim denial management plan in action that should involve all important factors
2. What Are The Most Common Claim Denial Reasons?
A recent report shows that there are several claim denial reasons that one should be very careful about. The most common reasons include duplicate service or claim, service that the payer doesn’t cover, cash management issues, payer behavior, coding errors, eligibility/registration issues, and coding errors. To avoid such issues, it is essential to pay special attention to all such details and ensure an effective holistic approach.
3. How to Execute Claim Denials Root-Cause Analysis?
You can execute root-cause analysis for all revenue cycle process segments. Eligibility is the topmost claim denial reason. To perform eligibility analysis, you should a thorough eligibility denial analysis by regularly checking the patient’s eligibility. You should perform it once at the time of online scheduling and a couple of days before visiting the doctor.
4. Why is it Important to Automate Claim Denial Management?
It takes approximately eighteen minutes to go through the medical record of the patient manually. However, automating this will speed up the process. Automation simplifies the billing process by comprehending the claim denial framework, real-time reports, tracking denial appeals progress, restructuring workflows, etc.
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