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.
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 the 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|
What causes claim denials?
There are various reasons due to which payers reject medical claims:
How to reduce the occurrence of denied claims?
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.
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:
MBC helps practices maximize and accelerate their cash flow through:
|Charge entry analysis||+||Tracking payer denials||+||Tracking claim status|