According to the American Association of Retired Persons (AARP) about 200 million claims get rejected every year for myriad reasons. Hence, when a claim is rejected there are several ways that it can be cleared. One of the most important things to do when a claim is denied is to keep on re- applying. The reason for this is the insurance company is trying to spread the risk and keep the money with them as long as possible. Hence, if one keeps on re-applying the chances of the claim getting cleared are higher.
The Department of Labor estimates that about one claim in every seven claims made under the employer health plan that they oversee are initially denied.
Industry Snippet
The US insurance industry is at a revenue of about $731 billion. Characterized by a slow annual growth rate of a shade fewer than 3%. This might throw light on the fact why insurance companies are trying to deny or delay payments. A slow market means business is not growing but claims keep on coming. Hence the only way out for them is to either deny paying the claims or keep on delaying them. It is to be seen if the increase in health expenditure and the aging population helps in reviving the industry or it impairs the growth further.
In the event that the claim gets denied the provider needs to ensure following documents are kept ready for re applying:
After preparing the documents these are the steps one can take to appeal denied claims:
In case if it becomes a bit too much to look in to the denials; get in touch with MedicalBillersandCoders.com; their team of expert professionals will help you in getting your claims cleared and streamline the process so that denials get reduced.
