.webp)
Healthcare providers in the United States deal with denied claims on a regular basis. Though eliminating rejected claims completely cannot be possible, decreasing the frequency is always possible.
When providers use the right approach, they get clean claims up to 99 percent of the time. Providers with a high percentage of clean claims are paid faster and have a lower chance of denials or rejections. Let's learn about the five-step process that will help you set up a denial management system that works for your practice.
Why Does Denial happen in Genral Surgery Billing?
Denials can happen due to various reasons that include:
- Coding Errors: Inaccurate or missing ICD-10 and CPT codes
- Documentation: Insufficient or incorrect patient records
- Insurance Issues: Expired or incorrect insurance information
- Missed Deadlines: Late Submission leads to automatic claim rejections
- Authorization Problem: No prior authorization leads to automatic claim rejections
5-Step Towards an Effective Denial Management System
Partnering with General Surgery Billing Services can make your revenue cycle seamless and hassle-free. It helps your practice with:
Claims Management
If a claim gets rejected due to any reason, the billing company rectifies the situation immediately and resubmits the claim within the provided time frame. This makes sure that providers get reimbursed for every single treatment they provide to the patient. Denied claims fall through cracks without claims monitoring feature. This might result in providers facing huge loss in their revenue.
If providers do not have efficient claims monitoring, it can be difficult to keep follow-ups with rejected claims in real-time. A claim monitoring software is important for any denial management process because it can help providers follow a claim’s progress.
Figure Out the Root Cause
Determine the common patterns responsible for denials in your practice. This is an essential step in the denial management process. It is done by using high-quality denial management software from a reputable provider.
This helps your team by automating processes that can easily identify common reasons for denial and provide solutions for prevention. Start noticing patterns of denials by reasons to determine the root cause of the problem. Most of the time it is a small charge entry error, or a wrong payer selected during claim generation that could be fixed in no time.
Advanced Claim Scrubbing
Monitor your claims to find common denial triggers. This is an important step in denial management strategy. Providers try to prevent possible denials before they are even submitted.
Determining possible denials results in clean claims and on-time payments. Errors in coding are the source of denied claims. Providers can quickly fix the coding issues and try again by settling these claims in the middle of the process until they are rejected.
Automatic Insurance Verification
The second most common reason of denial is lack of coverage. Verifying coverage for services before the services are rendered is an important step towards reducing claim denials. Automatic insurance verification is now possible with almost every medical billing software.
Your front desk staff can quickly check coverage in the beginning itself, which saves the time of the provider as well as time taken in rectifying the claims. It is important to check the coverage before services are rendered to the patient. Providers might have to face huge revenue loss if insurance verification is not done accurately.
Partner With a Medical Billing Company for Denial Management
Companies providing General Surgery Billing Services can simplify your entire billing process to a huge extent. Professional billers can navigate through the complex path of medical billing and coding. Providers will not have to waste their efforts on in-house resources by outsourcing their denial management.
A qualified medical billing company NY helps your practice boost clean claims so that you can concentrate on the patients. This also prevents staff exhaustion. An expert medical billing specialist can scrub your claims while delivering quality software which allows effective and reliable insurance verification. This also helps in detection of common denial trends within your organization.
Bottomline
Medical billing is a complex regime that requires immense precision and expertise. Not every healthcare provider has the time to indulge in these complexities. This is why partnering with Genral surgery billing services is important for healthcare providers.
Unify Healthcare Services provide professional and efficient services to simplify your revenue process. It is the best way to maximize revenue with general surgery CPT codes. We have a team of experts who are well-versed in all aspects of medical billing. Our professional billers make sure that all claims are accurate and in compliance with the latest billing guidelines.
Unify Healthcare Services ensure that you get reimbursed for every single treatment rendered to the patient so that providers can treat patients with peace of mind. This is a win win situation for providers as well as patients.
 1.jpg)