Medical Billing Services – Top 7 Reasons of Claim Denials

Medical Billing Services is an electronic source of billing practices that helps physicians or individual health care unit to streamline their revenue and cash flow. It’s one of the most secure ways to get faster reimbursement from the insurance companies for the provided services to patients. Claims are handled by the experts of billing and coding and the claim processing specialists. These experts can efficiently deal with the insurance companies. Sometimes claims are rejected or denied due to some reasons that definitely give a negative impact on the complete revenue cycle management and cash flow. The Best way to keep you income streamline is to prevent the number of claim denials. Here are the top most reasons of claim denials: 1. Replicated claim and services: If the duplicate claims or services are entered in the patient’s record then it leads to claim denials. A configurable EMR Medical Billing Software by Ebiometronics checks each and every service entered and alerts the user immediately if the service already present in record. 2. Claim or Service lacks information needed for adjudication: Some of the payers have very specific rules for their claims like they require information in some format that must be included on claims. Medical Billing Software allows the user to include such specialized code or data on claims. 3. Imbursement is incorporated in the payment for some other service or procedure: If the payment of service is included in the payment for some another service then the claim is legible to be denied as here is the replication of data occurs. 4. Time limit expires: When the time limit of filling up a claim has expired then the process of claim submission can’t be reached. As soon as you submit your claims, the faster you will be paid and it definitely eliminates the possibility of untimely filling denials. 5. Payer’s Medicinal Policies are not clearly defined: You must be well aware with the medical policies of your payers. As the policies decide what you get in the end will so be clear with medical policies of respective payer. 6. If patient’s health id number doesn’t matches with his/her name: Your medical billing services must be proper and secure. While claim filling one should carefully check the health Identification Number of a patient and his/her name. If this information doesn’t match then the claim is not accepted by the payer. 7. In absence of precertification, payment is adjusted: Appropriate authorization and precertification details must be included in the claim filling. If this section remains empty then the claim is rejected or denied due to lack of authorization. By utilizing the advanced Medical Billing Software and Medical Billing Services by Ebiometronics such denials will become a thing of past.}

Leave a Reply

Your email address will not be published. Required fields are marked *