Are you tired of claim denials? Are your denial rates increasing day by day? Well, that is common in today’s world. As per the industry standards, the average rate of denial is somewhere between 5-10% and if you have a denial rate of more than 10%, then you need to worry and do something regarding that.
So, it is better to take preventive actions to avoid the claim denials that have a negative effect on the revenue.
Here are a few steps to minimize the claim denial -
Firstly, hire a skilled and competent front-end staff. If required, train them regarding the patient’s demographic errors as well as the services that are not covered in the patient’s claim plan. Make sure that your staff is well-versed with all the information related to the demographics and
eligibility. You can set a no-tolerance policy for the late claim submission. Also, you can set standards with your staff related to the target and to take action in case any such situation arises.
Take the timely feedback from the staff dealing with the claim settlement, to understand their struggles. This feedback will help you in making the changes in case there arises any serious issue.
- Refine and audit your report
Refining the reports will help in uncovering and focusing on the key indicators. Also, the timely audits will help in maintaining the accuracy with the billing teams and the front-end staff. Also, it helps in reducing the payors denials.
It is better to update the technology from time to time or engage a third-party vendor for the claim denial purpose. The software will also help you in automating the system by flagging the denial causing errors.
Analyzing the data will help in identifying the root cause of the problem. It will, in turn, help you in understanding why denials are taking place and then you can communicate a solution to the staff.
If required, train your staff to eliminate the occurrences of such claim denials. Also, educate them regarding the issues, audits, etc., so that they can work accordingly.
Discuss, revise, and try to eliminate the reasons that are causing the claim denials and appeals. For eg, you can study and analyze the biggest denial properly to understand the root causes of it. Taking the timely actions can help in avoiding or minimizing various denials.
In this current situation, the hospitals and medical billing services are overloaded with the work. So, we at 24/7 Medical Billing Services are there to help you. We can provide you the best claim settlement and medical billing services.
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