Refusals And Delays In Your Medical Billing Claims

Refusals And Delays In Your Medical Billing Claims

Are you wary of the fight against denial of your medical billing needs? Do not be. Sometimes medical billing claims are rejected for legitimate reasons and other times a statement that should have been approved may be denied payment. Once a great while your staff may miscode a product because they are simply not up to date with the CPT and the rules of ICD-9-CM and just plain old human error factor from time to time.

Appealing a claim you feel should have been reimbursed is the way to maximize revenue in your practice. Many practices lose large amounts of revenue each year because they do not appeal rejected applications for lack of personnel or simply do not. Sometimes these claims are classified by their staff with the good intention of treating them later, but every day comes later, just seems to be pushed more and more, then the window of his call for a claim denial is gone.

Most rejections can be grouped into several categories:

* Record error - simple mistakes like a false insurance number or a mistyped date of birth may be all it takes to get an application for a kick back.

* Coding errors - these will sneak through from time to time, even with all the checks and balances.

* Processing errors as incompatible changes.

Delays in medical billing is another problem that will cost your practice thousands of money. Delays can occur due to not obtaining prior approval of a procedure or an item of DME. It can also occur when you forget to include documentation such as time line or medical necessity. Payment delays due to errors are frustrating. They cost time and money as a person of your staff would have put everything they do on one side and research needs, pulling files and resubmit.

If this happens frequently in your practice, it might be time to consider outsourcing your medical billing. Your medical billing partner will pursue any denial of payment for you. If you receive an application rejected for any reason, your provider of medical billing investigate the cause. In many cases they can go on the claim, the search errors and / or recode if necessary and resubmit the carrier and exchange. When we consider the applications submitted by professional medical billing companies have a failure rate below 1%, you can expect to see your refusal rates and delays due to errors in coding will be considerably reduced. This equates to more revenue for you practice and also more time managing your business and patient service instead of chasing paperwork.