Claim Denials Are On The Rise. What Can You Do To Avoid Increasing Denials? - Verification of Benefits powered by One Body

Claim Denials Are On The Rise. What Can You Do To Avoid Increasing Denials?

Claim denials continue to rise. Below are the reasons for claim denials and how to avoid them

1) Lack of Denial Resources

There is a lack of resources on how to properly do eligibility checks and how to file claims. Misinformation and lack of experience leads to denials. In order to combat this, make sure you have your front desk staff train with your biller or you may choose to outsource verification of benefits to One Body and to outsource claims to a billing company

2) Staff Attribution and Training

Right now one of the biggest issues is retaining staff. Many clinics are having a hard time hiring and retaining front desk staff. This presents a risk for doctors where the only staff who know how to handle insurance verification and submission of claims are not staying in a position for the long term. One Body can help with that. We are always there for you and remove staffing risks. 

3) Growing Denial Backlog

Peak seasons and staffing issues lead to big denial backlogs that clinics have to go through and appeal. It’s a lot of work and some clinics just give up and don’t pursue the claims. If you can handle appeals in house, that’s great. If not, you should hire a biller to help you collect on the money owed to you.

4) Legacy Technology

Many of the old EMRs are not keeping up with new and improved ways to handle verifications and claims. Make sure you always check out the new billing software and EMRs to see if it make sense to upgrade/switch. It may make a difference in how much you can get reimbursed.

Source: https://www.ache.org/-/media/ache/about-ache/corporate-partners/the_change_healthcare_2020-revenue_cycle_denials_index.pdf

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