How To Reduce Claim Denials For Your Medical Practice?

Claim Denials strategies

To grow your bottom line at your independent medical practice, you need to reduce claim denials. Denied claims, as well as missing or late charges, are two of the most common reasons for lost revenue at an independent medical practice. To avoid this, you need to work with a quality RCM services vendor. Together, you and your trusted RCM partner can identify areas that need help and take steps to improve them. Below are 5 steps to reduce claim denials at your independent medical practice.

How Medical Practices Can Reduce Claim Denials

Find the Root Cause

Finding the cause of why your claims are getting denied is essential. Together, you and your RCM services vendor can identify the root causes for your denied claims. This partnership along with a quality medical billing solution makes it easy to identify areas that need improvement. AI technology automatically notifies providers of red flags in their billing process. Whether the issue is errors in your coding or failure to check eligibility, finding the cause will help you reduce claim denials at your independent medical practice.

Prioritize According to Impact

After identifying the areas that need improvement throughout your billing process, prioritize according to impact. This means moving one step at a time to perfect your revenue cycle and reduce claim denials. If your practice lacks the quality tools it needs to make a change, start your search. Identify a vendor of services that offers what you need and get help to increase clean claims.


Eligibility Verification

Eligibility verification is essential when trying to reduce claim denials at your independent medical practice. Eligibility verification and prior authorization tools in your software can help you and your patients better prepare. If a patient comes in to receive services and they are not covered, your practice will miss out on a payment. With tools that help you identify and verify coverage before a visit, you can reduce claim denials. Once you know a patient is covered, you can gain peace of mind that your payment is on the way.

Quality Practice Management Software

Quality practice management software is essential to being able to achieve higher clean claims at your independent medical practice. Without the right technology, your practice won’t be able to get far. Quality medical billing software can give you everything you need to code more effectively, submit charges on time, and identify what parts of your revenue cycle need more attention. The impact of quality technology can not only build your revenue but also streamline your workflow efficiency.

Enhancing Front-End Revenue Cycle Management

Since most claims are denied because of missing information, providers should pay particular attention to collecting complete and accurate data during the start of the cycle: during front-end revenue cycle management processes like patient registration and scheduling.

Front-end revenue cycle management and billing staff should be more proactive about verifying patient demographic and insurance information during pre-registration to prevent claim denials.

By putting claim denial data into the hands of providers and billing teams, organizations will be better positioned to set claim denial benchmarks and improvement strategies.


Addressing Claim Denials on Time

When a payer denies a claim, providers risk losing crucial healthcare revenue if the claim in question is not corrected and resubmitted for payment. Engaging billing teams with claim denials management daily could also help providers keep track of claims. As evident from the most common claim denial reasons, payers expect claims to be submitted and resubmitted according to a specific time frame.

Establishing a standard claim denials management workflow will allow billing teams to track where claims are in the management process and what needs to be completed to receive claims reimbursement. Going forward, a daily claim denials management process will improve initial claims submission processes because billing teams better understand denial reasons.

Outsource RCM Services To CapMinds

The independent healthcare practices that wish to reduce claim denials can go with outsourcing RCM services to CapMinds. The expert billing team can help your practice to achieve high clean claims.

If you are looking to outsource your revenue cycle management, we are more than happy to help you. Schedule a free demo with our RCM experts to know more about our services.

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