According to Advisory Board research, 90% of all medical claim denials are preventable. Yet, only 66% of claims are recoverable. Therefore, to save time and money, upfront prevention is key. Here are five ways to minimize medical claim denials so you can focus on assisting your patients with minimized stress.
- 1. Establish good communication between departments
The healthcare industry is constantly changing. Constant education and communication between departments to communicate these changes are vital for success. Whether it’s the billing team or the front administrative office, make sure everyone is updated on the basics regarding new updates and additions, such as changes in co-pays, deductibles, insurance plans, and more. Set up training sessions, audits, and updates as needed to get everyone up to speed and on the same page.
- 2. Check a patient’s insurance before every visit
It’s vital to check a patient’s insurance before every visit. Insurance changes are normal and can be affected by factors such as age, job change or loss, switching to or from Medicaid, or other factors regarding insurance. Even with the same insurance, a patient might have a different group or member ID number, coverage, deductible, or co-pay. Checking in on a patient’s insurance before their visit can minimize wait times while a patient is physically at the doctor’s office. Additionally, it leads to better overall communication with clients, giving them an upfront understanding of costs and insurance expectations.
- 3. Stay on top of deadlines
Medical billing claims have strict deadlines. A delay can cause a financial loss, with a lowered chance of recovering the claim. This is why staff must be aware of timelines, deadlines, and familiarize themself with each insurance company’s details.
- 4. Submit claims promptly
Submitting claims promptly is an important aspect of preventing medical claims denial. Insurance companies have specific time frames for submitting claims, which vary depending on the type of insurance plan and the state in which the service was provided. Delayed submissions can result in claim denials due to missed filing deadlines. Additionally, prompt claims submission can help providers receive reimbursement for in a timely manner.
- 5. Outsource the process to a medical billing company
Medical billing can get complicated. If your office doesn’t have the time or availability to deal with medical billing processes themselves, consider outsourcing to a company such as BrightDrive Healthcare Solutions. We can help with faster insurance payments, automation, coding, and more.
Additionally, with professionals handling billing, errors are minimized, saving your business time and money. At BrightDrive we specialize in a multitude of services to truly offer predictable and consistent results. Our organization of an adept team of denial management providers is highly trained in working with, negotiating, and navigating the complexities of the insurance system. Let our experts manage your follow-up and make all the difference between realizing your revenue or writing it off.
As technology advances and the healthcare industry changes, your medical billing processes must be up to par. Ultimately, outsourcing the entire process to a medical billing company can be cost-effective and reliable. For more information about our medical billing services, visit us at BrightDrive HCS or email email@example.com.