Medical billing helps reduce claim denials thus minimising losses that arise due to late payments and manual errors. Since medical billing is a complex procedure; adhering to stringent rules and procedures and also keeping up to date with the current regulations is mandatory. It also means educating your staff and keeping check of the ongoing […]
Number of claims denied in the healthcare industry is a mystery. Claims are getting denied due to various reasons, and moreover the graph is showing an upward movement. It has been observed that most denials are in excess of 20%. As per a recent survey in Georgia, the table below depicts percentage of denials by […]
Medical claims denials have become a norm rather than an exception given that insurance payers’ computer software is geared to find the slightest anomaly and use it as a base for rejection. Simple statistics show that only 70% of claims are paid on first submission. Of the remaining, medical practitioners never bother to resubmit in […]
Denials are responsible for major erosion of practice revenues, and, despite the best efforts, denials continue to assume monstrous proportions. The situation has grown so alarming that: Medical practices fail to collect 25% of the money they are owed $125 billion is left in the bag as unpaid claims Only 70% of claims are paid […]
The transition from ICD-9 codes to ICD-10 codes presents a huge challenge for medical billers and also affects health care delivery system and physicians’ revenues. The staggering number of additional codes makes the learning process complex. Moreover, the scope for error increases which is exacerbated by a harder denial management process. Insurers have a distinct […]
Filing claims has become more complicated as health insurers tighten eligibility requirements, and the chances of claims being denied have increased substantially Hence when a claim is filed, there is a fair possibility it will be denied and most providers are struggling to balance their busy time schedules to implement additional care while filing claims […]
Payer denials and delays is a cause of worry for every doctor in the US. A denied or a delayed claim leads to loss of revenue for the physician. To top it all the physicians are now looking at an uncertain future working in the Medicare program due to introduction of reimbursement cuts. In the […]
The procedure of appealing an insurance claim is intricate, although it can be successful if completed properly because there are many grounds for claims to be denied by an insurance company or a payer. The payer collects a lot of claims on a daily basis and the claim can be easily denied if there has […]
Given the alarming statistics about medical billing industry average – 14% of all claims submitted to the payers are denied and have to be resubmitted, appealed or written off by providers, 50% of denied claims are never re-filed, and 50-70% of denied claims have higher chance of being recovered – physicians’ reasoning seems to be […]
Appealing denied claims is one of the important steps in enhancing the revenue of physicians and this fact is supported by a report by the U.S Government Accountability office (GAO). The report released on March 16, 2011 states that – “coverage denials occurred for a variety of reasons, frequently for billing errors, such as duplicate […]
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