Nowadays, the recent challenges of medical billing have increased the problems for practitioners to handle billing and coding tasks. Practitioners are tending to outsource top electronic billing services to tackle these hurdles significantly.

However, the major technological breakthroughs and rigid coding rules have made medical billing more difficult to manage. Receive avoidable denials, manual processes, denial statistics, are the major problems that healthcare practitioners face nowadays. Moreover, it becomes so crucial for them to meet the current industry standards and manage the process of clean claim submission efficiently.

Therefore, healthcare professionals should adopt advanced healthcare billing solutions to stay updated with the recent trends and tackle each problem effectively.

Why do claims get rejected or denied?

Recently, claim denial has become a daunting challenge for healthcare professionals. Many medical facilities process medical claims manually. Therefore, as compared to the automated procedures the chances of billing and coding errors increase. Particularly, the common reasons for claim rejections are;

• Wrong coding.
• Incorrect patient’s information.
• Duplicated claims.
• Unverified insurance policies.
• Incorrect payment credentials.
• Late submission of medical claims.

Types of Claim Denials:

Here are the two common types of denials that cause a decrease in the cash flow remarkably;

• Soft denials:

It is interim or temporary denial. It doesn’t require an appeal. Examples:

• Denied due to inaccurate missing information.
• Charge or coding issues.
• Pending receipt of medical records.

• Hard denials:

A denial that results in written-off & lost revenue. It requires an appeal. Examples:

• Untimely filing.
• No pre-authorization.
• Bundling
• Not a covered service.

Claim line or non-payment of claim, and a true denial can cause;

• Lost revenue:

Practitioners can particularly lose their revenue due to incomplete or inaccurate billing, undetected payment errors, and missing information on the rendered services.

• Overpayment/underpayment:

Inaccurate payments, pricing issues, and other payment issues.

Therefore, denied claims are unpayable claims that were processed and received by the insurance payer. The denied claim lack prior authorization as well as contain errors and mistakes. While a rejected claim is particularly due to mismatched procedures, the transition of CPT or ICD codes, and coding errors.

Moreover, these errors put a negative impact on the financial stability of a business. It causes the reimbursements to get delayed and affects the cash flow significantly. Therefore, the solution to all these challenges and problems is to utilize top electronic billing services.

When you hire a reliable medical billing company, you get access to billing professionals. They have expertise and knowledge. They resolve your all issues and provide efficient medical billing services that can help you to improve the proficiency as well productivity of your business efficiently.

Strategies to Reduce Claim Denials:

Electronic claim submission:

Expert billing specialists utilize ICD-10 coding technology and help professionals to improve the rate of clean claim submission successfully. They provide top electronic billing services and eliminate the hassles of billing procedures.

Moreover, they quickly automate claims processing so they enable you to minimize revenue leakage, increase clean claim submission, and drive down unproductive manual procedures effectively.

Real-time claim monitoring:

A clean claim submission incorporates built-in code scrubbing_ before sending it to the clearinghouse. After the electronic submission of claims to the clearinghouse, medical billers provide real-time status checks on the insurance claims and manage the revenue collection significantly.

Ensure accurate information:

Errors due to inaccurate information and pre-authorization can lead to denials. Billing specialists understand the market policies and latest billing regulations. They utilize reliable top electronic billing services that help healthcare practitioners to ensure accurate information. In this way, they help you avoid those denials that occur due to prior authorization.

Automate billing tasks:

Billing and coding errors are troublesome. You face fewer denials when billing experts eliminate the chances of medical billing errors. They utilize EHR solutions to help you automate the entire billing cycle efficiently. In this way, they help professionals to reduce coding and billing errors significantly. Therefore, they help you witness the growth of your practice remarkably.

Advanced technology:

Hiring professional medical billing agencies can give you access to experienced staff and advanced technology. Medical billing experts stay updated with the advanced technology and provide effective profitable strategies to enhance the revenue stream.

Moreover, they provide top electronic billing services and innovative approaches that help you streamline denial management effectively. The tech advanced solutions help you minimize the error rates, prevent claim rejections, and enhance the cash flow effectively.

Workflow automation:

Experienced billing professionals enable you to take the assistance of certified billing experts. They help you automate your workflow and decrease workload efficiently. In this way, they help you make your billing and coding tasks more transparent. Moreover, they help practitioners to appeal denials, identify the latest trends, and share the best possible practice experience.

Take a Lead:

Medcare MSO is an experienced medical billing agency in the United States. Expert medical billers help you to streamline claim denial management efficiently. Get in touch with us, today to promote the long-term financial success of your business significantly!