5 Ways to Avoid Claim Denials

Claim denials cause a lot of unnecessary administrative burden on your staff. In order to avoid claim denials and all the work that it takes to appeal and get the money you deserve, follow the following steps.

1) Find someone competent to do your verifications

You have two options. You can either outsource your verification of benefits to a company like One Body or find a front desk staff who has expertise in verifying patient benefits. It is really important that you do your due diligence and find a person who knows what they are doing. Inaccurate verifications can lead to claim denials and a loss of expected revenue.

2) Pay attention to authorization requirements

Make sure you know whether preauthorization is required and how to submit authorization. This is an important step that must be taken seriously. If you do not get authorization in time, you may not get paid.

3) Call payers

While there are various electronic benefits tools and payer online portals that can tell you patient health benefits, they usually do not have the most up to date information which could lead you to misinterpret benefits. For example, sometimes visits used is not updated or even present. Without knowing that, it is risky to see the patient as you may not get paid.

4) Make sure you have the correct up to date patient information 

Make sure you get the most up to date information on patients. It is important to make it easy for patients to submit their demographic and insurance information.

5) Make sure to check all health plans if there are multiple insurance plans. 

If there is a primary and secondary insurance, it is important to check both plans to understand the requirements.

If you need help with verifying your patients’ benefits, please contact One Body at hello@onebodywellness.com. One Body has 30+ years experience verifying benefits for clinics.