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presentation

Are You Too Losing 3-5% Of Your Revenue Due To Outdated Processes?

July 23, 2013



With decrease in medical claim reimbursements and substantial increase in payer regulations, it has become mandatory for every physician to manage their revenue cycle. Every physician needs to be paid fully and promptly in exchange of the services they offer in order to survive in todays harsh economic situation.

  • Average revenue lost due to below average/outdated processes – 3-5% of total collection
  • Percentage of total claims filed which are denied – 30%

Better performing practices exhibit lower denial rates!

Denial management is the crucial part of revenue collection system and industry experts state that most of the successful practices display denial rates below 5%, while any rate over 10% should be reviewed closely.

Many years ago, individual claim processors used to review, process, and pay the claims. However, with increase in the sophistication of computer systems, this is done by a set of predefined payment algorithm which mimics the work performed by traditional claims processor.This has led to more claims denial in the present. Hence it has become mandatory for physicians to not rely on outdated processes and as quickly as possible adopt new techniques to their practice management processes to help reduce their denial rates.

Why more claims are being denied in the present?

  • When the sophisticated claims management system presents incomplete data, payers prefer to simply deny the payment
  • Payers expect only a small percentage of medical practices to follow up on their claim denials and resubmit corrected claims/appeals
  • For Insurance companies-↑Claims Denial = ↑Money Saved

Eliminating outdated processes can help reduce denials in 3 simple steps-

  • Helps in measuring the total numbers of claims denied more accurately
  • Identifying the major reasons for denial
  • Creating a tracking/reporting process to measure overall performance

Increase your overall revenue with MBC's complete billing solution!

MBC uses all the necessary resources and updated processes to reduce claim denials and increase your collection ratio!

MBC is the largest consortium of billers and coders providing medical billing across all 50 US States in varied specialties. Our billing experts also offer  specialized billing services customized to practice managements needs which the physician can choose as per their requirements, like denial management services and so on.

MBC = Reduced denials by more than 70% + increase in overall collections by 15- 20%!
  • Track and report your claim denials that requires adequate knowledge of billing practice management system
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  • Identify the root cause of most frequent denial reasons like registration, charge entry, referrals & pre-authorizations, patient information, duplicates, ICD-9, ICD-10 and CPT mapping, documentation, modifiers, and credentialing
  • Provide customized denial report to help track performance over time
  • Focus on most frequent reason for denials in the most efficient way possible
  • Identify the main reason of denial such as  payer, location, specialty or provider
 

Category : Revenue Cycle Management