When it comes to successful healthcare claims management, it’s important to build a system that manages rejected claims effectively. When it comes to working allegations, most medical practice administrators are concerned, especially when the claims are denied.
To resolve these claims, it’s important to understand the potential income loss and initiate an efficient medical claims management process. The interesting news is that even minor improvements would have a massive impact on your practice’s revenue cycle cash flow. Here are several pointers on how to process denied claims appropriately and improve the efficiency of revenue generation.
Streamlined Procedure for Tracking Claims
It’s important to maintain a streamlined procedure to track denied claims in real-time. It helps in monitoring the progress of claims throughout the process, and if one encounters a denial, you can quickly address and resubmit it. Denied claims will trigger a major delay in your practice’s cash flow when they slip between the cracks or take a very long time to resolve. You might even skip the time frame that you have to resubmit.
Discover Why Claims Are Being Denied
Applying denial management software can be incredibly helpful, as it prevents employees from having to analyze claims, so you can find places for a change. It could also be that you need to fix coding problems, or it could be that you need to track patients/procedures more accurately to ensure that they are protected by unique plans. Addressing these aspects will contribute to enhancing the rate of cleaner claims.
Enhance the Capacity of Claim Scrubbing
Claim scrubbing is the method of identifying – and removing – errors in the billing code before claims are made to the insurers. This effectively reduces the number of claims that are rejected or denied thus facilitating on-time payments. Most denials are triggered by incorrect codes, and modifying them can save resources, money, and time.
Make use of Automated Verification
One of the most important explanations for claim denials is that the patient’s plan doesn’t include the service provided. This can happen for a number of reasons: the patient may have modified insurance plans and missed to notify the clinic, or their coverage may have expired. This can be an expensive oversight in any scenario. You can’t efficiently optimize service time or obtain healthcare revenue until you first verify coverage.
Outsourcing Denial Management Process
Outsourcing the denial management process to a firm that specializes in Revenue Cycle Management systems is an excellent idea. When you outsource medical billing, you’re turning over control of the sales period to professionals who have received rigorous training. If you are experiencing trouble with your revenue cycle the best option is to outsource medical billing.
Wrap up thoughts
A sustainable, technology-driven workflow backed by data inputs and workforce experience is at the core of a successful denial management initiative. Businesses must engage and advise participants from each revenue cycle process to remain on top of the current situation and ultimately reduce the potential denial rate. The submission of a clean claim is the baseline for effective management and collection optimization.