10 Steps Will Help You Prevent Medical Claim Denials And Maximize Cash Flow
Key facts to remember:
Top 5 reasons for claim denials
According to the American Medical Association National Health Insurer Report Card, these are the top 5 reasons for claims denials:
- Missing information
- Duplicate claims
- Service already settled
- Service ineligible according to a healthcare plan
- Missed deadline
Following 10 steps will help you prevent denials and maximize cash flow.
Step 1: Verify Patient Demographics and Eligibility
This should be done at the front desk during the first contact with the patient. Hold front-end staff accountable for front-end denials but allow them to work with claims denial avoidance or medical billing teams to understand patient demographic errors and services not covered by the patient’s plan. Some tips when verifying insurance are:
Step 2: Check for Deficiencies in Provider Documentation
Step 3: Make Sure Charge Entry Is Correct on the Claim Form
Step 4: Scrub A Claim
Step 5: Evaluate Your Payment Posting Process
Step 6: Work on A/R
Step 7: Analyze the Causes of Billing Denials and Delays
Step 8: Analyze data and Leverage Technology
Step 9: Communicate and Educate
Step 10: Audit aggressively
DocCharge: Be productive again! Practice analytics, mobile charge capture, HIPAA compliant messaging, and tools for billers.
DocCharge is a mobile physician productivity platform enabling physicians and clinicians to save time by efficiently capture patient billings, communicate with back office and maximize revenue by avoiding lost charges using real-time analytics on a mobile device. Designed by a physician for fellow physicians, residents/fellows, and mid-level providers, DocCharge maximizes one’s productivity. Practice Administrators and outsourced billing companies find the application very intuitive, thus improving practice efficiency and revenue.
DocCharge is transforming healthcare data into useful and actionable insights, thereby allowing partner subscribers to focus their resources on the core business of providing high quality patient care. For more information, visit www.DocCharge.com, email: contact@DocCharge.com.