Más contenido relacionado Más de Medical Billers and Coders (19) How much Do Medical Practices Pay to Manage the Average Denial?1. End to End Medical Billing Solutions
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How much Do Medical Practices Pay to
Manage the Average Denial?
Denied claims can be quite exasperating for billers as well as providers. Not only
valuable time gets consumed in claim re-submission but it also costs money to manage
an average denial. This means, a significant amount for rendered services is already lost
even if the billing department manages to collect payment through re-submission.
If your denial rate is more than 5%, it means you are not paying attention to your
revenue cycle. It can result in major erosion of revenues, forcing you to close down or
merge your practice with a hospital.
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Industry Facts:
According to the Medical Group Management Association, approximately $25 to
$30 gets spent on managing an average denial
Nearly 30% from the total filed claims gets denied due to minor errors in coding
and technical aspects
As per the research done by American Medical Association (AMA), there was a
sharp increase in claim denial rates in 2012; however, in 2013, claim denial rates
reduced by 47%
Medicare happens to have the high denial rate at 4.92% while lowest denial rate
is of Cigna at 54%
As per an estimate by the CMS, there are chances of claim denial rates increasing
by 100% to 200% in the early stages of ICD-10 coding
3. End to End Medical Billing Solutions
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What causes claim denials?
There are various reasons due to which payers reject medical claims:
Lack of accuracy in registration, wherein a wrong payer is mentioned, patient's
insurance is not verified or it becomes difficult to decipher the identity of a
patient
Charge entry is done with unacceptable diagnosis codes or procedure codes
Inadequate information about a patient
No substantial proof to prove medical necessity of a procedure
Lack of pre-authorizations and referrals
Errors in clinical documentation
Lack of credentialing
Submission of claims with duplicate codes for same procedures
Bundling non-allowable items or applying modifiers where they aren't applicable
4. End to End Medical Billing Solutions
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How to reduce occurrence of denied claims?
Identifying the type of denial because denials can be clinical as well as technical
Training staff on how to submit error-free claims, edit claims and prepare
appeals
Formation of a strong billing team with certified, experienced coders and billers
Monitoring the progress made by in-house or billing company's team on a
regular basis
Most medical practices are overloaded with work due to which they have very little time
to fulfill the above-mentioned requirements. Since denial management is a daunting
task, they prefer outsourcing billing and coding services to a billing company that has
proven capabilities of providing effective denial management.
5. End to End Medical Billing Solutions
Call now 888-357-3226 (Toll Free)
http://www.medicalbillersandcoders.com
www.medicalbillersandcoders.com
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Tackling claim denial with MBC:
MBC has the largest consortium of certified coders and billers, helping practices
maximize revenue and minimize claim denials. The team at MBC is well-trained in error-
free claim submission, follow-ups with insurance companies and effective denial
management. MBC also specializes in:
Analysis of financial impact of denials
Finding causes for accumulation of denied claims
Providing feedback through financial impact analysis of denials and root-cause
analysis
MBC helps practices maximize and accelerate their cash flow through:
Charge entry analysis + Tracking payer denials + Tracking claim status
6. End to End Medical Billing Solutions
Call now 888-357-3226 (Toll Free)
http://www.medicalbillersandcoders.com
www.medicalbillersandcoders.com
Copyright ©-2013 MBC. All Rights Reserved.
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