How to Reduce Claim Denials from Providers?

Claim denials are common in medical billing for practices, but the impact it creates on your revenue can be way high. Most practices without having sufficient time to monitor and crosscheck their coding during claims submission end up in claim denials, thereby resulting in revenue loss. To overcome some of the common errors in medical billing and to reduce denials from the provider end, here are some easy tips for practices to follow.

#1: Use Automated Solutions

Most claim denials happen due to human errors which can be troublesome. The more human errors we remove; the more claim denials we can remove. Availing EHR solutions with specialized software which can self-code accurately without showing any flaws and improving reimbursement levels. When these claims are properly processed in the first attempt, revenue growth can be highly seen.

#2: Check Patient Information

Inaccurate information, errors in insurance eligibility verification can be easily fixed which can help avoid claim denials at the first step itself. Implement a patient portal to your medical billing system that updates their information from time to time because even a single error can make your payer reject your claim. Spend enough time to verify and check patient information to decrease the occurrences of denied claims. Educate your staff and keep your billing team updated on policies to improve data quality. Be sure about pre-authorization reports to avoid claim denials.

#3: Correct Your Mistakes from Previous Denials

Never repeat the mistakes in your medical billing and coding which you made in your previous claim denials. Enact employee improvement programs kind of things to train your staff on how to avoid such commonly and previously made errors during claims submission. This can save huge time and result in quick reimbursement of your claims.

#4: Meeting Deadline

Meeting deadlines are part of the system and it is crucial that as a medical billing company, you follow the deadlines as per the policies of your insurance company. Failing to follow so may show an impact during claims filing as well. Make sure that you provide proper CPT and HCPCS codes, so you can avoid claims denials extremely well.

#5: Medical Billing and Coding Experts

If you have plans to optimize your claim management, it is an excellent idea, to begin with, with experts and a highly skilled and trained medical billing and coding team. By doing so, all your medical billing and coding responsibilities are handled by the experts’ team; therefore, the chances of causing errors are extremely decreased. If you want your revenue to be improved at low risk, then claim denials should be reduced, which can be handled by the medical billing expert. These companies make sure your practice’s revenue keeps growing constantly.


Along with these best practices, be familiar with clearing house and understand the claim format properly, so you don’t have to think of making errors in your claim forms. Keep following up with your insurance provider on denials so that you can keep track of the status and try to get it reimbursed by eliminating the errors involved. If you are a busily running practice and do not find sufficient time to follow all these steps as best practices, outsourcing your medical billing process to an expert company like 24/7 Medical Billing Services that has more than 15 years of experience in the healthcare industry, serving multiple clients in the due course of various specialties.

If you want to talk to any of our certified medical coders/billers, give a call at +1-888-502-0537.

Read More: Medical claim denials & rejections in Medical Billing

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