Medical Billing Tips: 5 Ways of Managing Denied Claims

As per the approximations by the experts in the medical industry, around $3 trillion worth of medical claims are submitted each year to various insurance companies, out of which, more than a whopping $260 billion worth of claims are denied. Furthermore, over 60% of these claims are not re-entertained by the companies from whom the claims have been denied in the first place. If we do a detailed math of the entire situation, it would show an alarming amount of finances being wasted away by each medical practice in the entire US.

Medical billing on the whole has its fair share of technicalities but claims management is a fairly daunting task with a ton of technicalities to account for, which is why the healthcare practitioners tend to be taken aback by such tedious implications. However, as the current situation stands, the importance of having effective medical billing services and denial management mechanism in place becomes indispensable. The key to being in command of the denial management mechanism is by creating a framework through which the practitioners can have a bird’s eye view of all medical claims. With that said, the following are the five tips that can be brought to practice in the interest of managing denied claims in the most favorable fashion:

• Promptness in Rectification - Submission of an incorrect claim can usually result in one of two consequences i.e. the claim would either return or be denied. Thereby, it is important to rectify the problem in the least possible time. Ideally the rectification time should be within a week, or sooner, depending on the degree of error.
• Monitoring the Rate of Denials - One of the essential elements of a smart medical billing system is maintaining and monitoring the track record of the medical claims. By doing that, the healthcare practitioners can easily monitor the frequency and rate of denied claims and can thereby take the mitigation measures wherever needed.
• Getting to the Root of the Problem - Through monitoring all claims, you can easily get to the heart of the problem. Usually the problems stem from the same kind of error that is found across the board. Pinpointing that one problem can save you from numerous potential mishaps that could result in the claims being denied.
• Keeping a Record of All Claims - This point might seem redundant to many people, but it is worth mentioning here nonetheless. The significance of maintaining a record of all claims seems lost on some practitioners, due to which, numerous claims get lost within the system. An intelligent medical billing system can help in minimizing the said issue and being prompt in terms of submitting the claims and eliminating the errors.
• Getting a Helping Hand - It cannot be stressed upon enough that medical billing is an incredibly demanding and complicated affair, due to which, the errors are likely to occur in some form or another for the majority of medical practices most of the time. To that effect, it is almost compulsory for the practitioners to outsource medical billing mechanisms so as to focus on their primary services i.e. providing healthcare as well as rest assured that their medicals claims are being monitored and managed in an orderly fashion.