As per intellectuals, if you are facing increased claim rejections than it is advised to review the reports regularly and try to find out the pathway for claim rejections.
That eventually means medical practitioners like clinics, physicians, health-care associations; hospitals and medical departments need to be more aggressive on growing claim denials.
Unfortunately claim rejection report review and analysis requires highest level of industrial expertise and experience of years dealing with wide variety of claims, billing and coding procedures, awareness about state to state rules and regulation, HIPAA compliance guidelines and need to spare quality time is must.
Medical service providers somehow find it more difficult to take out time for review and analysis of their claim rejection reports or to device proper medical billing and coding procedures or to manage their revenue cycle. At this point of time employing medical billing services of a company or consultant can prove profitable.
Why Professionals Needed to Review Claim Rejection Reports?
• Better and quick electronic claim rejection reports review
• They have ability and experience to find rejection pathway
• Ability to reduce common claim rejection errors
• Claim clearinghouse and trading partners for billing coding have in-depth experience
• Can identify why claim failed to move forward
There could be many probable reasons of errors and claim rejections:
• Id error by receptionists
• Error by provider staffs
• Error while coding
• Invalid diagnosis code
• Demographic errors
• Name misspelled
• Missing subscriber date of birth
• Neglect of policy rules and regulation
• Improper claim form filling
• And more
An efficient and knowledgeable medical billing and coding can device revenue cycle management procedures to improve process and reduce errors and helps to get timely and right reimbursements for the services they have provided.
Ray Charles, author and professional at Medical Billing India (MBI), leading medical billing, medical coding and claim processing service and consultancy company based in India with years of experience and expertise in dealing with billing and coding services across USA, Canada, UK, Australia. Inquire for more information on info@medicalbilling-india.com
