Tips for Managing Insurance Denials

Rejected claims are an immense waste of valuable time and money business office supervisor.

Based on a current industry survey, the typical cost averages over $25 per claim!

If you calculate that price by the number of claims that are denied each year, it easily can add up to thousands of dollars lost.

Even though it may be sometimes complicated, examining rejected claims can save you time and expense if you’re able to recognize a tendency that is resulting in the denial.

 

Tips for Managing Insurance Denials

 

To manage rejected insurance claims, you must do periodic evaluations. The good news is that most sytems used by practices can assist you in this process.. Your primary goal and first step is to assess the cause and remark codes per payor and denial. Then, you can perform a thorough relationship comparison and prognosis to determine if there might be a common problem amonst the denials.

For example, if you constantly receive denials for one diagnosis, start looking and figure out what is the common reason provided. Once you identify the problem, then half the battle is over. Most can be fixed relatively easily (like a wrong modifier) and you have now saved thousands of dollars in lost time and money dealing with future denials.

Sometimes, you will notice that the problem may be related to a particular employee or group of employees that need further training. In this case, one hour of additional training could save thousands hours and dollars down the road.

Similarly, you might find that a particular insurance is part of the problem. A simple call or meeting with them is worth far more trouble than continuing to deal with their denials and increased bureaucracy.

In short, the time you invest in analyzing your denials will pay you back ten-fold or more!

Don’t procrastinate any longer. If you don’t have the time to do it yourself, feel free to call us at HFA and we will try to help you. We’ve helped many practices with custom projects such as this and help your practice run more efficiently.

Call HFA now for more helpful tips for managing insurance denials!

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